bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of gut microbiota changes on the intestinal mucus barrier in burned mice: a study using 16S rRNA and metagenomic sequencing
Authors: Zha Xule , Su Sen , Wu Dan , Zhang Panyang , Wei Yan , Fan Shijun , Huang Qianying , Peng Xi
Published: December 2023

Background

The gut microbiota is a complex ecosystem that plays a critical role in human health and disease. However, the relationship between gut microbiota and intestinal damage caused by burns is not well understood. The intestinal mucus layer is crucial for maintaining intestinal homeostasis and providing a physiological barrier against bacterial invasion. This study aims to investigate the impact of gut microbiota on the synthesis and degradation of intestinal mucus after burns and explore potential therapeutic targets for burn injury.

Methods

A modified histopathological grading system was employed to investigate the effects of burn injury on colon tissue and the intestinal mucus barrier in mice. Subsequently, 16S ribosomal RNA sequencing was used to analyze alterations in the gut microbiota at days 1–10 post-burn. Based on this, metagenomic sequencing was conducted on samples collected at days 1, 5 and 10 to investigate changes in mucus-related microbiota and explore potential underlying mechanisms.

Results

Our findings showed that the mucus barrier was disrupted and that bacterial translocation occurred on day 3 following burn injury in mice. Moreover, the gut microbiota in mice was significantly disrupted from days 1 to 3 following burn injury, but gradually recovered to normal as the disease progressed. Specifically, there was a marked increase in the abundance of symbiotic and pathogenic bacteria associated with mucin degradation on day 1 after burns, but the abundance returned to normal on day 5. Conversely, the abundance of probiotic bacteria associated with mucin synthesis changed in the opposite direction. Further analysis revealed that after a burn injury, bacteria capable of degrading mucus may utilize glycoside hydrolases, flagella and internalins to break down the mucus layer, while bacteria that synthesize mucus may help restore the mucus layer by promoting the production of short-chain fatty acids.

Conclusions

Burn injury leads to disruption of colonic mucus barrier and dysbiosis of gut microbiota. Some commensal and pathogenic bacteria may participate in mucin degradation via glycoside hydrolases, flagella, internalins, etc. Probiotics may provide short-chain fatty acids (particularly butyrate) as an energy source for stressed intestinal epithelial cells, promote mucin synthesis and accelerate repair of mucus layer.
Expression of hornerin in skin lesions of atopic dermatitis and skin diseases
Authors: Makino Teruhiko , Mizawa Megumi , Takemoto Keita , Shimizu Tadamichi
Published: December 2023

We have previously identified the filaggrin (FLG)-like protein, hornerin (HRNR). Recently, there have been several reports regarding the relationship between HRNR and atopic dermatitis (AD). In the present study, we examined HRNR expression in the skin lesions of seven unrelated patients with AD to clarify the role of HRNR in the pathogenesis of AD. HRNR was detected in chronic AD lesions (n = 4), whereas no HRNR signals were observed in acute AD lesions (n = 3). HRNR was detected in the cytokeratin 6-expressing epidermis, and Ki67-positive keratinocytes were more abundant in the HRNR-positive epidermis. These findings suggest that HRNR may be associated with epidermal hyperproliferation in AD lesions. Next, we examined HRNR expression in skin diseases associated with hyperkeratosis. HRNR signals were irregularly observed in different cells from those expressing FLG in epidermolytic ichthyosis and actinic keratosis. Therefore, HRNR may play a unique role in the molecular process of cornification.
General dermatology and dermatology in primary healthcare
Authors: Diong Sophie , Clowry Julianne , Wynne Bairbre
Published: December 2023

Heparin-induced bullous haemorrhagic dermatosis is an uncommon cutaneous adverse reaction to heparin, thought to be under-reported owing to its relatively asymptomatic presentation and favourable prognosis. This vesiculobullous condition is largely self-limiting and tends to resolve spontaneously despite continued anticoagulant therapy. Correct identification can reassure clinicians and patients alike.
Differential contribution of sensorimotor cortex and subthalamic nucleus to unimanual and bimanual hand movements
Authors: Merrick Christina M , Doyle Owen N , Gallegos Natali E , Irwin Zachary T , Olson Joseph W , Gonzalez Christopher L , Knight Robert T , Ivry Richard B , Walker Harrison C
Published: December 2023

Why does unilateral deep brain stimulation improve motor function bilaterally? To address this clinical observation, we collected parallel neural recordings from sensorimotor cortex (SMC) and the subthalamic nucleus (STN) during repetitive ipsilateral, contralateral, and bilateral hand movements in patients with Parkinson’s disease. We used a cross-validated electrode-wise encoding model to map electromyography data to the neural signals. Electrodes in the STN encoded movement at a comparable level for both hands, whereas SMC electrodes displayed a strong contralateral bias. To examine representational overlap across the two hands, we trained the model with data from one condition (contralateral hand) and used the trained weights to predict neural activity for movements produced with the other hand (ipsilateral hand). Overall, between-hand generalization was poor, and this limitation was evident in both regions. A similar method was used to probe representational overlap across different task contexts (unimanual vs. bimanual). Task context was more important for the STN compared to the SMC indicating that neural activity in the STN showed greater divergence between the unimanual and bimanual conditions. These results indicate that SMC activity is strongly lateralized and relatively context-free, whereas the STN integrates contextual information with the ongoing behavior.
Kth min Threshold Encryption for Privacy-preserving Data Evaluation
Authors: Chen Zhenhua , Li Ting , Xie Junrui , Li Ni , Nie Jingjing
Published: December 2023

The $k$th min threshold is to judge whether the $k$th smallest element of an attribute set along with a confidential file is greater than a predefined threshold, which is a fundamental, primitive operation in data evaluation, such as risk evaluation in business investment. However, it will compromise the privacy of the confidential files when proceeding with such a data evaluation because there is often a large amount of sensitive information involved in them, which the organizations/individuals are reluctant to expose due to the risk of losing a competitive advantage. Motivated by the issue how to preserve the privacy of the confidential files during data evaluation, in this research, we first present a new encryption notion called $k$th min threshold encryption (KTE) for serving privacy-preserving data evaluation. In this notion, the confidential file will be encrypted under an attribute set for its privacy protection prior to being sent to a receiver, and a decryption key is generated from a threshold $d$ and a rank $k$ of element, both selected by the receiver. The decryption will be successful if and only if the $k$th smallest element of the attribute set is greater than $d$. We then describe a concrete construction of KTE in the public-key setting. In particular, our construction features optimally short private keys, which only consists of one group element. By virtue of this advantage, it is quite practical because of only two pairing operations for decryption computation.
Panoptic Segmentation with Convex Object Representation
Authors: Yao Zhicheng , Wang Sa , Zhu Jinbin , Bao Yungang
Published: December 2023

The accurate representation of objects holds pivotal significance in the realm of panoptic segmentation. Presently, prevalent object representation methodologies, including box-based, keypoint-based and query-based techniques, encounter a challenge known as the ‘representation confusion’ issue in specific scenarios, often resulting in the mislabeling of instances. In response, this paper introduces Convex Object Representation (COR), a straightforward yet highly effective approach to address this problem. COR leverages a CNN-based Euclidean Distance Transform to convert the target instance into a convex heatmap. Simultaneously, it offers a parallel embedding method for encoding the object. Subsequently, COR characterizes objects based on the distinctive embedding vectors of their convex vertices. This paper seamlessly integrates COR into a state-of-the-art query-based panoptic segmentation framework. Experimental findings validate that COR successfully mitigates the representation confusion predicament, enhancing segmentation accuracy. The COR-augmented methods exhibit notable improvements of +1.3 and +0.7 points in PQ on the Cityscapes validation and MS COCO panoptic 2017 validation datasets, respectively.
Detection of E-Commerce Fraud Review via Self-Paced Graph Contrast Learning
Authors: Zhao WeiDong , Liu XiaoTong
Published: December 2023

Recently, graph neural networks (GNNs) have been widely used for e-commerce review fraud detection by aggregating the neighborhood information of nodes in various relationships to highlight the suspiciousness of nodes. However, existing GNN-based detection methods are susceptible to sample class imbalance and fraud camouflage problems, resulting in poor quality of constructed graph structures and inability to learn reliable node embeddings. To address the above problems, we propose a novel e-commerce review fraud detection method based on self-paced graph contrast learning (SPCL-GNN). Firstly, the method constructs a subgraph by initially selecting nodes through a labeled balanced extractor. Secondly, the subgraph connections are filtered and complemented by combining self-paced graph contrast learning and an adaptive neighbor sampler to obtain an optimized graph structure. Again, an attention mechanism is introduced in intra- and inter-relationship aggregation to focus on the importance of aggregation under different relationships. Finally, the quality of the node embedding representation is further improved by maximizing the mutual information between the local and global representations. Experimental results on the Amazon and YelpChi datasets show that SPCL-GNN significantly outperforms the baseline.
Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis
Authors: Alexander Emma C , Faruqi Duaa , Farquhar Robert , Unadkat Ayesha , Ng Yin Kyla , Hoskyns Rebecca , Varughese Rachel , Howard Sasha R
Published: December 2023

Objective

Hypogonadotropic hypogonadism is characterized by inadequate secretion of pituitary gonadotropins, leading to absent, partial, or arrested puberty. In males, classical treatment with testosterone promotes virilization but not testicular growth or spermatogenesis. To quantify treatment practices and efficacy, we systematically reviewed all studies investigating gonadotropins for the achievement of pubertal outcomes in males with hypogonadotropic hypogonadism.

Design

Systematic review and meta-analysis.

Methods

A systematic review of Medline, Embase, Global Health, and PsycINFO databases in December 2022. Risk of Bias 2.0/Risk Of Bias In Non-randomized Studies of Interventions/National Heart, Lung, and Blood Institute tools for quality appraisal. Protocol registered on PROSPERO (CRD42022381713).

Results

After screening 3925 abstracts, 103 studies were identified including 5328 patients from 21 countries. The average age of participants was <25 years in 45.6% (n = 47) of studies. Studies utilized human chorionic gonadotropin (hCG) (n = 93, 90.3% of studies), human menopausal gonadotropin (n = 42, 40.8%), follicle-stimulating hormone (FSH) (n = 37, 35.9%), and gonadotropin-releasing hormone (28.2% n = 29). The median reported duration of treatment/follow-up was 18 months (interquartile range 10.5-24 months). Gonadotropins induced significant increases in testicular volume, penile size, and testosterone in over 98% of analyses. Spermatogenesis rates were higher with hCG + FSH (86%, 95% confidence interval [CI] 82%-91%) as compared with hCG alone (40%, 95% CI 25%-56%). However, study heterogeneity and treatment variability were high.

Conclusions

This systematic review provides convincing evidence of the efficacy of gonadotropins for pubertal induction. However, there remains substantial heterogeneity in treatment choice, dose, duration, and outcomes assessed. Formal guidelines and randomized studies are needed.
Digest: The importance of genetic background in bacterial evolution
Authors: Dionisi Sara , Huisman Jana S
Published: December 2023

How does genetic background influence a population’s evolutionary response to an environmental change? Which traits are selected for and how quickly does the population adapt? Filipow et al. (2024) address these questions by exploiting the natural genetic variation of Pseudomonas aeruginosa, a bacterium often found in the lungs of cystic fibrosis patients. They find that while genetic background influences the rate of phenotypic evolution, it does not alter the evolutionary outcome. Their findings contribute to a growing body of work that connects genetic background to future evolvability.
Recombination hotspots in Neurospora crassa controlled by idiomorphic sequences and meiotic silencing
Authors: Yeadon Patricia Jane , Bowring Frederick J , Catcheside David Edward Arnold
Published: December 2023

Genes regulating recombination in specific chromosomal intervals of Neurospora crassa were described in the 1960s, but the mechanism is still unknown. For each of the rec-1, rec-2, and rec-3 genes, a single copy of the putative dominant allele, for example, rec-2SL found in St Lawrence OR74 A wild type, reduces recombination in chromosomal regions specific to that gene. However, when we sequenced the recessive allele, rec­2LG (derived from the Lindegren 1A wild type), we found that a 10 kb region in rec-2SL strains was replaced by a 2.7 kb unrelated sequence, making the “alleles” idiomorphs. When we introduced sad­1, a mutant lacking the RNA-dependent RNA polymerase that silences unpaired coding regions during meiosis into crosses heterozygous rec-2SL/rec-2LG, it increased recombination, indicating that meiotic silencing of a gene promoting recombination is responsible for dominant suppression of recombination. Consistent with this, mutation of rec-2LG by Repeat-Induced Point mutation generated an allele with multiple stop codons in the predicted rec-2 gene, which does not promote recombination and is recessive to rec-2LG. Sad-1 also relieves suppression of recombination in relevant target regions, in crosses heterozygous for rec-1 alleles and in crosses heterozygous for rec-3 alleles. We conclude that for all 3 known rec genes, 1 allele appears dominant only because meiotic silencing prevents the product of the active, “recessive,” allele from stimulating recombination during meiosis. In addition, the proposed amino acid sequence of REC­2 suggests that regulation of recombination in Neurospora differs from any currently known mechanism.
Heterozygosity alters Msh5 binding to meiotic chromosomes in the baker's yeast
Authors: Dash Suman , Joshi Sameer , Pankajam Ajith V , Shinohara Akira , Nishant Koodali T
Published: December 2023

Meiotic crossovers are initiated from programmed DNA double-strand breaks. The Msh4–Msh5 heterodimer is an evolutionarily conserved mismatch repair–related protein complex that promotes meiotic crossovers by stabilizing strand invasion intermediates and joint molecule structures such as Holliday junctions. In vivo studies using homozygous strains of the baker's yeast Saccharomyces cerevisiae (SK1) show that the Msh4–Msh5 complex associates with double-strand break hotspots, chromosome axes, and centromeres. Many organisms have heterozygous genomes that can affect the stability of strand invasion intermediates through heteroduplex rejection of mismatch-containing sequences. To examine Msh4–Msh5 function in a heterozygous context, we performed chromatin immunoprecipitation and sequencing (ChIP-seq) analysis in a rapidly sporulating hybrid S. cerevisiae strain (S288c-sp/YJM789, containing sporulation-enhancing QTLs from SK1), using SNP information to distinguish reads from homologous chromosomes. Overall, Msh5 localization in this hybrid strain was similar to that determined in the homozygous strain (SK1). However, relative Msh5 levels were reduced in regions of high heterozygosity, suggesting that high mismatch densities reduce levels of recombination intermediates to which Msh4–Msh5 binds. Msh5 peaks were also wider in the hybrid background compared to the homozygous strain (SK1). We determined regions containing heteroduplex DNA by detecting chimeric sequence reads with SNPs from both parents. Msh5-bound double-strand break hotspots overlap with regions that have chimeric DNA, consistent with Msh5 binding to heteroduplex-containing recombination intermediates.
The Imperial Court and the Localities during the Reign of Holy Roman Emperor Friedrich III
Authors: Schlag Richard C
Published: December 2023

The centrality of the territorial principalities and imperial diet is a defining feature of the historiography of the late medieval Holy Roman Empire. This tendency risks restricting discussions of the Reich’s political life to the arena of high politics and obscuring important links and relationships between the imperial monarchy and its non-princely subjects. This article sets out to examine interactions between the late medieval imperial government and its subjects in the localities. The analysis focuses on the court and government of Emperor Friedrich III of Habsburg (r. 1440–1493), whose ‘peripheral kingship’ has been interpreted by historians as the moment of the crown’s definitive alienation from the Empire’s core lands. The article presents two case studies of protracted legal disputes in which communities of different size, importance and location came into the orbit of the emperor’s court seeking to protect their rights and interests. These case studies provide illustrative examples of how routine matters and local conflicts could be inextricably bound up in the structures of the emperor’s government. This evidence suggests that a complete account of the political and governmental history of the late medieval Holy Roman Empire needs to incorporate both new insights about the effectiveness of the imperial monarchy and the complex, multi-layered and interdependent nature of local politics.
VETERAN DIRECTED CARE: A MIXED METHODS STUDY TO INFORM SELF DIRECTED CARE PROGRAM EXPANSION FOR VETERANS AFFAIRS (VA)
Authors: Dang Stuti , Bouldin Erin , Hathaway Wendy , Tyagi Pranjal , Penney Lauren , Intrator Orna , Nasr Samer
Published: December 2023

The Department of Veterans Affairs (VA) is shifting from institutional to Home and Community Based Services, such as the Veteran-Directed Care (VDC) program, a self-directed program in which Veterans choose services and employ their providers to avoid or delay long-term institutionalization. The VA plans to expand VDC to all VA facilities by FY2026, but factors affecting VDC expansion are poorly understood. We focused on facilitators and barriers in the seven Veterans Integrated Service Network (VISN) 8 VDC programs between May 2022 and January 2023 to inform program expansion. We used a mixed-methods approach, with surveys followed by semi-structured interviews with VA VDC staff, their partners at Aging and Disability Network Agencies (ADNAs) and VISN 8 leadership, such as lead program coordinators, using the Consolidated Framework for Implementation Research to guide the project rapid analysis techniques. We found substantial variability in the structure, size, and operations of the VDC programs reflecting challenges noted by respondents. VA staff were consistently enthusiastic about VDC’s quality benefits for Veterans, however, they recommended additional staff, a dedicated VDC coordinator, and a national guidebook or standard operating procedures to streamline processes. Respondents also noted the need for more program education targeting referring providers. Unique local challenges, like the lack of available caregivers or no local ADNA, and limited local leadership support were other factors noted that could limit expansion. Importantly, Veterans were often overwhelmed by the employer responsibilities they needed to fulfill. Addressing these concerns remains a challenge to VISN 8 and national leadership.
INTERACTION BETWEEN NATIVITY AND NEIGHBORHOOD ON DEMENTIA RISK: FINDINGS FROM TEN YEARS OF NATIONAL US DATA
Authors: Wong Roger , Soong Daniel
Published: December 2023

Prior research indicates neighborhood disadvantage increases dementia risk. There is, however, inconclusive evidence on the relationship between nativity and cognitive impairment. To our knowledge, our study is the first to analyze how nativity and neighborhood interact to influence dementia risk. Ten years of prospective cohort data (2011-2020) were retrieved from the National Health and Aging Trends Study, a nationally representative sample of 5,362 U.S. older adults aged 65+. Cox regression analyzed time to dementia diagnosis using nativity status (foreign or native-born) and composite scores for neighborhood physical disorder (litter, graffiti, vacancies) and social cohesion (know, help, trust each other), after applying sampling weights and imputing missing data. Average baseline neighborhood physical disorder was significantly higher among foreign-born (0.28) compared to native-born (0.18) older adults [t=-2.4, p=.02]. Average baseline neighborhood social cohesion was significantly lower for foreign-born (3.57) compared to native-born (4.33) older adults [t=5.5, p<.001]. After adjusting for sociodemographic, health, and neighborhood variables, foreign-born older adults had a 51% significantly higher dementia risk (aHR=1.51, 95% CI=1.19-1.90, p<.01). There were no statistically significant interactions for nativity with neighborhood physical disorder or social cohesion. Our findings suggest foreign-born older adults have higher neighborhood physical disorder and lower social cohesion compared to native-born older adults. Despite the higher dementia risk we observed for foreign-born older adults, this relationship was not moderated by either neighborhood physical disorder or social cohesion. Further research is needed to understand what factors are contributing to elevated dementia risk among foreign-born older adults.
ASSOCIATION BETWEEN NEIGHBORHOOD ENVIRONMENT AND FEAR OF FALLING AND FALLS AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Dunlap Pamela , Zhu Xiaonan , Brach Jennifer , Moored Kyle , Harding Alyson , Rosso Andrea
Published: December 2023

Neighborhood built environment may influence both objective and perceived risk of falling. We examined the association between neighborhood built environmental characteristics and falls, fear of falling (FOF), and gait efficacy among older adults. We used baseline data from a randomized trial that measured falls over the past 12 months, FOF, and Modified Gait Efficacy Scale (mGES). Walkability audits were conducted for participant home addresses using Google StreetView and summarized by two factors: urbanicity and neighborhood quality. Logistic and linear regression were adjusted for age, gender, race, comorbidity index, and body mass index. Analyses were also stratified by past falls and gait speed (< or ≥1.0m/s). We included 249 participants (mean age: 77.4 years; 65% female) with 29.7% reporting a fall over the past year and 40.6% reporting FOF. Mean mGES (0-100) was 85.2±13.7 and 32% participants had gait speed <1.0m/s. In unstratified analysis, greater urbanicity was associated with lower gait efficacy (β=-1.88, p=.039). Among those who had not fallen, greater urbanicity was associated with FOF (β=0.47, p=.012) and greater urbanicity and higher neighborhood quality were associated with lower gait efficacy (β=-2.8, p=.006; β=-2.1, p=.047). Among those with better mobility, urbanicity was associated with lower gait efficacy and FOF (β=-2.4, p=.009; β=0.5, p=.01). There were no significant associations among those who had fallen or with poorer mobility. Neighborhood environmental characteristics may play a larger role in FOF among those who have better mobility and have not yet fallen, as they may have more opportunities to interact with varied environmental conditions.
DO NEARBY PHYSICAL ACTIVITY DESTINATIONS ENCOURAGE PEOPLE TO BE F.I.T.T.?
Authors: Donahue Patrick , Moored Kyle , Crane Breanna , Richards Emily , Desjardins Michael , Rosso Andrea , Carlson Michelle
Published: December 2023

Neighborhood amenities may reduce barriers to engaging in physical activity (PA). However, it is unclear whether proximity to these amenities will indeed promote increased PA. This study examined whether living near PA destinations was associated with greater self-reported PA. The sample included Cardiovascular Health Study participants (N=3,922; mean age=75.3 years) from visit 5 (1992-1993). Quantity of PA destinations (e.g., gyms) within a one-kilometer Euclidean buffer of each participant’s home address was provided by the National Establishment Time-Series database. PA over the previous two weeks was self-reported via the Minnesota Leisure Time Activity Questionnaire. The exposure was dichotomized into having at least one PA destination (vs. none) within one kilometer of participants’ homes. Outcomes were based on the FITT components of PA outlined by the American College of Sports Medicine: Frequency (activities per week), Intensity (MET-minutes per week), Time (minutes per day), and Type (number of different activities, i.e., variety). Outcomes were modeled separately as five-level ordinal variables considering PA guidelines. Using ordinal logistic regression models adjusting for age, sex, health status, smoking, and body mass index, we found that living within one kilometer of at least one PA destination was associated with significantly increased odds of engaging in higher levels of all four PA components (odds ratios: 1.17-1.20, all Ps < 0.01). After adjusting for social factors (race, education, income), associations were attenuated and no longer significant. When evaluating barriers to PA, social determinants of health should be considered, in addition to proximity of PA destinations.
PRIMARY OUTCOMES FROM CAREGIVER-REPORTED SURVEYS IN THE SHARE TRIAL
Authors: Wolff Jennifer , Giovannetti Erin , Boyd Cynthia , Roth David , Zhang Talan , Echavarria Diane , Hanna Valecia , Scerpella Daniel
Published: December 2023

This presentation will introduce SHARE, a randomized-controlled trial to proactively engage family caregivers and normalize advance care planning in primary care. The objective of the study is to engage family caregivers in longitudinal interactions with primary care clinicians and stimulate and support ACP discussions in primary care. We focus on persons with mild, moderate, and severe cognitive impairment regardless of clinical diagnosis because of the importance of addressing advance care planning early in the disease trajectory, the under-diagnosis of ADRD, and because of the greater implementation potential of a protocol with broader applicability. We will describe the study design and present on 6-month outcomes to test our hypothesis that as compared with the minimally enhanced control care group, caregivers in the intervention group will report better quality of communication about end-of-life care with primary care clinicians at 6 months (primary outcome).
EXPLORATION OF PREPAREDNESS FOR MEDICAL DECISION MAKING FOR FAMILY CAREGIVERS OF PEOPLE WITH DEMENTIA
Authors: Zhang Peiyuan , Cagle John
Published: December 2023

As dementia progresses, many family caregivers of people with dementia (PWD) often experience increasing demands of making medical decisions for their loved ones and feel unprepared, causing severe psychological distress. This presentation explores what factors influence preparedness level of family caregivers in medical decision-making for PWD. As part of a larger two-group randomized trial in which 273 PWD-family caregiver dyads received either a control protocol or a multi-component communication intervention including advance care planning (ACP) facilitation, this qualitative study used thematic analysis methods to analyze 10 transcripts resulting from audio-recorded and transcribed ACP conversations with an ACP facilitator, PWD, and family caregivers. Interview duration was over 30 minutes. The major themes identified were: (1) knowledge about PWD’s treatment preferences, (2) experience with death and dying, (3) previous decision-making involvement, and (4) spiritual beliefs. Many family caregivers found ACP conversations with PWD about their goals of care to be beneficial in improving their confidence in making medical decisions. A few participants also reported witnessing a loved one’s suffering at the end of life or having made care decisions for family before helped them to initiate conversations with PWD about medical wishes, thus enhanced readiness for decision making. Lastly, few caregivers reported belief in God would help them make the “right decisions”. Preliminary results highlight that caregivers’ understanding of PWD’s treatment preferences helps to prepare family caregivers for decision-making, underlining the need for early and culturally appropriate ACP conversations among residents, caregivers, and clinicians.
ETHICAL CONSIDERATIONS UNDERLYING ACP FOR ACCOMPANIED OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Saylor Martha Abshire , Boyd Cynthia , Dy Sydney , Hanna Valecia
Published: December 2023

While clinicians understand the importance of ACP, it is difficult to overcome logistical and ethical challenges in the limited time providers have in primary clinic appointments with older adults with ADRD and other complex co-morbidities. Ethical/moral dilemmas faced by patients, families, and clinicians are reflected in the four principles of biomedical ethics including autonomy, beneficence, nonmaleficence, and justice. While ethical challenges are recognized there is a lack of real-world evidence to guide clinicians or family caregivers in ACP for older adults with ADRD based on the reality of complex patient and family dynamics. Throughout the SHARE trial, facilitated ACP conversations with trained ACP facilitators, older adult patients with cognitive impairment, and their family caregiver were audio recorded and transcribed. The purpose of this presentation is to expand our understanding of best practices for facilitating ACP conversations among persons with ADRD and their family caregivers, guided by medical ethics and the Learning Health Care System Ethics Framework. We draw on the unique dataset of recorded ACP conversations involving older adults with severe cognitive impairment (N=92, average age=88 years), family caregivers, and trained ACP facilitators. We qualitatively coded transcripts for ethical considerations of ACP conversations and conducted the thematic analysis. We will present major themes related to ethical considerations in facilitating ACP conversations among persons with moderate to severe ADRD and their family caregivers. We will provide a discussion framed in balancing patient, family, and provider needs within a Learning Health Care System.
WHO’S UP NEXT? EXTENDED FAMILY CAREGIVERS OF PERSONS LIVING WITH DEMENTIA: CURRENT AND FUTURE CARE
Authors: Savla Tina , Roberto Karen
Published: December 2023

Various societal trends and expanded family boundaries have led to a broad array of family members involved in caring for persons living with dementia (PLwD). We examined how extended family caregivers (FCG) manage their care responsibilities and how the care arrangement impacts the provision of future care for PLwD. Mixed-method data from 48 extended FCG and 56 nuclear FCG (71% White, 68% female, 63% co-reside with PLwD) revealed that 70% of extended FCG rely on informal helpers to care for PLwD. Spouses and daughters were more often sole caregivers while most sons relied on informal helpers. If no longer able to help, sisters, granddaughters, and nieces more likely foresaw moving PLwD to a care facility, whereas brothers, grandsons, and nephews anticipated another informal helper would assume their care. Extended FCG often expressed dissatisfaction with one or more informal helpers for failing to meet care responsibilities, potentially leading to unmet needs and increased risk for early nursing home placement for the PLwD. The discussion will focus on the attributes of informal helpers of extended FCG that contribute to stable or inconsistent care arrangements for PLwD, which can ultimately affect the well-being of PLwD and FCG.
FROM MODEL ORGANISMS TO HUMANS, THE OPPORTUNITY FOR MORE RIGOR IN METHODOLOGIC AND STATISTICAL ANALYSIS, DESIGN, AND INTERPRETATION OF AGING AND SENESCENCE RESEARCH
Authors: Austad Steven
Published: December 2023

DOI: 10.1093/gerona/glab382
PHYSICAL ACTIVITY AND DEMENTIA PREVENTION: THE ROLE OF HEALTH COGNITIONS AMONG 50+ HEALTHY INDIVIDUALS IN ISRAEL
Authors: Edelstein Offer
Published: December 2023

Background

Although dementia cannot be cured, it can be prevented by adopting various health behaviors, including regular physical activity. The current study sought to i) estimate the participation of Israel-born healthy individuals aged 50 years or older in regular physical activity; ii) assess the associations linking Health Belief Model variables (Rosenstock, 1966, 1974) and engagement in regular physical activity.

Method

This cross-sectional study was conducted in 2021-2022, using online convenience sampling. The study included 328 Israel-born participants aged 50 years or older. Physical activity was assessed by asking whether participants regularly engaged in physical activity (type of activities/times per week/minutes). Cognitive perceptions were assessed using the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction questionnaire (Kim et al., 2014).

Results

The average weekly minutes of physical activity was 165.62 (S.D. 176.17), whereas only 43.6% performed 150 minutes of physical activity weekly. A multivariate linear regression indicated that among all of the model’s variables, perceived severity (β=-.204, p<.001), cues to action (β=.134, p<.001), feminine gender (β=-.155, p<.01), and low income (β=-.113,p<.05) emerged as significant predictors of weekly minutes of physical activity. The model explained 14.2% of the variance in the performance of weekly minutes of physical activity [F(7,320)=12.22, p<.001].

Conclusions

The current research underlines the role of health cognitions (perceived severity, barriers, and cues for action) regarding engagement in physical activity. The results of the current study might serve as a basis for intervention programs among various target populations.
ADULT DAY SERVICES DATA COLLECTION AND OUTCOMES: A NATIONAL STRATEGY REALIZED
Authors: Zagorski William
Published: December 2023

The National Adult Day Services Association (NADSA), in its commitment to advance the development and recognition of adult day services across the United States, has defined a comprehensive set of data points and uniform outcome measures to be utilized throughout the Adult Day Services (ADS) industry. NADSA represents more than 500 unique Adult Day Service Centers (ADSCs) across the country. This project has culminated in the opening of a single national secure data entry portal and repository for the collection of this data free to use for adult day service providers across the country. Prior to its full release in January 2023, the beta testing phase allowed for the utilization of this platform across nearly a dozen states, more than 20 ADSCs and more than 500 ADS participants in a variety of settings. As of January 2023, the system is now available to more than 500 ADSCs serving more than 12,000 participants. This session will describe the data points and outcome measures as well as the uniform tools to be utilized for collection and introduce the data portal to the greater academic community. This longitudinal data will be available to NADSA academic partners to provide greater avenues of research into the benefits of adult day services use to participants, caregivers, payors, and the community.
EMOTION REGULATION SUCCESS IN A LABORATORY TASK IN YOUNG ADULTS AND COGNITIVELY DIVERSE OLDER ADULTS
Authors: Growney Claire , English Tammy
Published: December 2023

Age is associated with declines in cognitive resources viewed as important for emotion regulation, and older adults with mild cognitive impairment (MCI) are expected to experience difficulty with emotion regulation. The present study examines how providing support through emotion regulation instructions might contribute to improved emotional well-being using different indices of emotion regulation success. Young adults (age 21–34, n = 66) and older adults with MCI (age 70–84, n = 60) and cognitively normal older adults (age 70–84, n = 90) completed a laboratory task in which they viewed high-arousal negative emotional film clips under instructions to regulate prohdonically (a) using any emotion regulation strategy, and (b) using an instructed strategy based on condition: distraction or reappraisal. We examined three indices of emotion regulation success: self-perceived emotion regulation success, self-reported experience of the target emotion, and behaviorally-coded expression of the target emotion. Overall, there were no group differences in experience or expression, but older adults with MCI perceived that they regulated with less success compared with younger adults and cognitively normal older adults. Younger adults reported experiencing less of the target negative emotion on instructed versus self-selected strategy trials, whereas older adults with MCI expressed less of the target negative emotion on instructed versus self-selected strategy trials. Findings suggest that younger adults and older adults with MCI might benefit more from support with regulating emotions compared with cognitively normal adults, who are theorized to have expertise in this domain.
DID CHILDHOOD ABUSE PREDICT CARE EXPECTATION FOR FORMAL CARE: THE ROLES OF FAMILY FUNCTIONING AND CARE PREPARATION
Authors: Bai Xue , Liu Chang , Zhou Jiajia , Hu Bo
Published: December 2023

Objectives: The influence of childhood abuse could be lasting and extensive. This study aims to examine the associations between childhood abusive experiences (i.e., physical abuse, emotional abuse, and bully victimization) and ageing adults’ care expectation for formal care in later life, as well as the potential mechanism of the associations. Methods: This study used data from the Panel Study of Ageing and Society (PAAS) in Hong Kong, with 5,007 participants aged 50 and over included in the study. Path analyses were performed to examine the direct effects of abusive experiences in childhood on future care expectation and formal care, and the indirect effects through serial mediators of family functioning and care preparation. Results: Ageing adults experiencing more childhood abuse were less likely to report care expectations in the future ( = -0.051, p < 0.01), and the direct effects ( = -0.042, p < 0.05) and indirect effects ( = -0.009, p < 0.05) from the serial mediation were significant. Among those people who reported clear care expectations, they were more likely to choose formal care if they had more abusive experiences in childhood (= 0.049, p < 0.05), from which the association was largely explained by decreased family functioning and more care preparation ( = 0.042, p < 0.001). Discussion: This study is the first to connect childhood abuse and late-life care expectation. From a life course perspective, it encourages more considerations regarding care preparation and formal care among people with a history of childhood abuse.
FINANCIAL EXPLOITATION AND MENTAL HEALTH OF HOLOCAUST SURVIVORS: THE MODERATING ROLE OF POSTTRAUMATIC SYMPTOMS
Authors: Weissberger Gali , Bensimon Moshe , Shrira Amit
Published: December 2023

Financial exploitation (FE) is associated with devastating emotional, health, and economic consequences. We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced amongst Holocaust survivors, especially those with high-level posttraumatic stress disorder (PTSD) symptoms. A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. Holocaust survivors (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939-1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5). Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates. Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups. Findings suggest that the experience of FE may be particularly impactful amongst survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.
USING RE-AIM TO GUIDE INTERVENTION DEVELOPMENT AND PILOT TESTING: CASE STUDY OF THE TLC INTERVENTION
Authors: Utz Rebecca , Thompson Amber , Sparks Cathi , Wong Bob , Iacob Eli , Terril Alexandra , Caserta Mike
Published: December 2023

Research-based interventions are often not fully translated or implemented into health or community settings, even after assessing and establishing feasibility and efficacy during pilot tests and randomized trials. The Time for Living and Caring (TLC) study, an intervention designed to improve respite care for dementia caregivers funded by NIA R01-AG061946, employed the principles of the RE-AIM framework to guide stage-1 research activities related to intervention (re)development and pilot testing, with the hope that implementation could be achieved more quickly and efficiently. RE-AIM is a framework used to guide dissemination and implementation activities by evaluating an intervention in terms of its: Reach to target populations; Effectiveness or efficacy; Adoption by target staff, settings, systems and communities; Implementation consistency, costs and adaptions made during delivery; and Maintenance/sustainment of intervention effects in individuals and settings over time. This presentation will describe the types of data used to evaluate each component of RE-AIM during the study’s stage-1 activities. Data include feedback from a community advisory board (n=12), a randomized waitlist-control sample evaluating feasibility and initial efficacy of intervention of the TLC intervention (n=163), and feedback from stakeholders and providers who would be partners in the implementation of the TLC intervention (n=59). Based on stakeholder feedback, our findings support recommending adopting and designing interventions with an eye toward the principles of RE-AIM as best practices to increase the likelihood that interventions developed in the research context can be translated and implemented to those who will benefit from them.
ACCESS TO NEIGHBORHOOD AMENITIES AND RISK OF INSTITUTIONALIZATION AMONG PERSONS WITH DEMENTIA
Authors: Choi Yeon Jin , Fennell Gillian , Ailshire Jennifer
Published: December 2023

Compared to only 2% of the total population between ages 65 and 84, 15% of persons with dementia (PWD) transition to nursing homes. This may be due to caregiving challenges associated with the behavioral symptoms PWD exhibit and their reduced capacities to perform daily tasks. Access to neighborhood amenities (e.g., parks, food access, libraries, service providers) may reduce the risk of institutionalization by helping PWD maintain their health and independence through the provision of opportunities for physical exercise, nutritious diets, social interaction, and cognitive stimulation while providing their caregivers with supportive services. Using data from the2006-2016 waves of the Health and Retirement Study (HRS), the HRS Contextual Data Resource, and the National Neighborhood Data Archive, this study aimed to identify neighborhood factors that are associated with transition into a nursing home among PWD who lived in the community (N=3,366). A series of logistic regression models were estimated adjusting for sociodemographic characteristics, health status, and neighborhood characteristics. Findings suggest that access to more park areas, healthy food outlets (i.e., grocery stores, supermarkets, supercenters), social amenities (e.g., museums, libraries), and social services for older adults and those with disabilities (e.g., senior centers, adult day care centers, disability support groups) were significantly associated with a lower risk of 2-year institutionalization. Retail stores and home health services were not significantly associated with the risk of institutionalization. These findings emphasize the importance of neighborhood amenities, such as parks and healthy food outlets, in enabling PWD to age in place.
CASE SCENARIOS OF CANADIAN MEDIC-ALERT SUBSCRIBERS WITH DEMENTIA WHO GO MISSING
Authors: Daum Christine , Vahedi Vanessa , Rutledge Emily , Adekoya Adebusola , Miguel-Cruz Antonio , Liu Lili
Published: December 2023

With the increasing prevalence of dementia worldwide, it is expected that incidences of getting lost and going missing among persons living with dementia due to wayfinding challenges will also increase. Despite this, there is currently a gap in accessible education materials specific to risk factors and incidents of getting lost and going missing, aimed at first responders and family care partners. Case scenarios can effectively convey the circumstances of recurring events while also accounting for lived experiences. The purpose of this project was to develop case scenarios informed by real-life missing incidents that involve persons living with dementia in Canada. Qualitative description and conventional content analysis were used to analyze summary notes of missing incidents (n=515) obtained from Medic-Alert Foundation Canada hotline database. Summary notes contained: demographics of the missing person, their living situation and circle of support, events leading up to incident, by whom and where they were found, their health condition, and how they were re-united with their care partners. Case scenarios were developed that reflected the common (e.g., going missing while on foot, being found on the street) as well as less common (e.g., going missing while driving, being found seriously injured). Five experts (person living with dementia, care partner, health care professional, support providers) reviewed these scenarios to ensure relevance. Case scenarios can raise awareness of the circumstances encountered during missing incidents. The scenarios can be used by first responders and care partners to learn how to respond to missing incidents and receive support.