bluuebunny/crossref_metadata_2025 huggingface dataset:
Vapor isotopic evidence for the worsening of winter air quality by anthropogenic combustion-derived water
Authors: Xing Meng , Liu Weiguo , Li Xia , Zhou Weijian , Wang Qiyuan , Tian Jie , Li Xiaofei , Tie Xuexi , Li Guohui , Cao Junji , Bao Huiming , An Zhisheng
Published: December 2020

Significance

Water vapor emitted from anthropogenic combustion for winter heating in northern China may exacerbate air pollution. This hypothesis is of considerable scientific and environmental interest. We conducted a multiyear sampling campaign of air vapor isotope compositions and associated atmospheric data from the city of Xi’an, located in an enclosed basin in northwestern China. We found that the fraction of combustion-derived water vapor increases with increasing relative humidity and with the concentration of particulate matter with an aerodynamic diameter less than 2.5 μm in polluted conditions based on field observation, isotopic analysis, and numerical simulation. Our results demonstrated that combustion-derived water is nontrivial when considering energy policy for improving air quality.
Stimulation of soil respiration by elevated CO2is enhanced under nitrogen limitation in a decade-long grassland study
Authors: Gao Qun , Wang Gangsheng , Xue Kai , Yang Yunfeng , Xie Jianping , Yu Hao , Bai Shijie , Liu Feifei , He Zhili , Ning Daliang , Hobbie Sarah E. , Reich Peter B. , Zhou Jizhong
Published: December 2020

Significance

The magnitude of CO2efflux from soils (resulting from autotrophic and heterotrophic respiration) is one of the largest uncertainties in projecting future carbon–climate feedbacks. Despite research over several decades, the magnitude, direction, and duration of such feedbacks and their underlying microbial mechanisms are poorly understood, especially in the context of potentially interacting global environmental changes. In a decade-long experiment examining the interactive effects of CO2and N enrichment, N limitation strengthened the stimulatory effects of elevated CO2on soil respiration, primarily via N mining during the decomposition of more recalcitrant organic compounds. This study also provides a strategy for integrating genomics information into ecosystem and Earth system models to improve carbon-cycle predictions.
Crop wild relatives of the United States require urgent conservation action
Authors: Khoury Colin K. , Carver Daniel , Greene Stephanie L. , Williams Karen A. , Achicanoy Harold A. , Schori Melanie , León Blanca , Wiersema John H. , Frances Anne
Published: December 2020

Significance

This study provides conservation assessments for 600 US native plants that are wild relatives of important agricultural crops. We found that more than one-half of the species may be endangered in their natural habitats, and that the great majority require further conservation action, both ex situ (in gene banks and botanical gardens) and in situ (in protected areas). Diversity hotspots across the nation represent focal regions for further collecting for ex situ conservation as well as for enhanced habitat protection. Wider collaborations, as well as greater awareness, access to, and information about these resources are needed to bolster their conservation and use.
Uncovering the genetic blueprint of theC. elegansnervous system
Authors: Kovács István A. , Barabási Dániel L. , Barabási Albert-László
Published: December 2020

Significance

A fundamental question of neuroscience is how the brain wires itself. Here, we propose a modeling framework that explains how cellular connectivity emerges from neuronal identity, allowing us to offer experimentally falsifiable predictions on the genetic encoding of the connectome. The rapid advances in brain science require quantitative frameworks to integrate genetic and connectome information. The proposed model responds to this need, helping us unveil the genetically driven mechanisms that govern the formation of individual links in the brain.
Machine-learning–driven biomarker discovery for the discrimination between allergic and irritant contact dermatitis
Authors: Fortino Vittorio , Wisgrill Lukas , Werner Paulina , Suomela Sari , Linder Nina , Jalonen Erja , Suomalainen Alina , Marwah Veer , Kero Mia , Pesonen Maria , Lundin Johan , Lauerma Antti , Aalto-Korte Kristiina , Greco Dario , Alenius Harri , Fyhrquist Nanna
Published: December 2020

Significance

Contact dermatitis is an inflammatory skin disorder that arises from direct skin contact with irritants or allergens. Representing over 90% of occupational skin disorders, it has a considerable socioeconomic impact, and patients suffering from contact dermatitis can develop a notable physical handicap. Current diagnostic regimes rely on allergy testing, exposure specification, and follow-up visits. However, distinguishing the clinical phenotype of irritant and allergic contact dermatitis, which is important for appropriate therapeutic strategies, remains challenging. This study identifies and validates biomarkers to distinguish allergic and irritant contact dermatitis in human skin, to be used for the development of novel diagnostic methods and to guide clinical diagnosis.
Exopolysaccharide defects cause hyper-thymineless death in
Escherichia coli
via massive loss of chromosomal DNA and cell lysis
Authors: Rao T. V. Pritha , Kuzminov Andrei
Published: December 2020

Significance

The
thyA
mutants of
Escherichia coli
cannot synthesize their own thymidine (dT) and rapidly die without dT supplementation. Confusingly, this thymineless death has an integral resistance phase, as if chromosomal damage has to accumulate before eventually becoming irreparable. Here we show that during the resistance phase, the
thyA
mutants survive by deriving dT from a significant pool of endogenous dTDP-sugar conjugates. Inability to synthesize dTDP-sugars shortens the resistance phase, while inability to recover dTTP from this pool eliminates the resistance phase altogether. Moreover, the resulting dT-hyperstarvation causes catastrophic chromosome loss and cell lysis. We conclude that the resistance phase, rather than being a part of thymineless death, delays acute starvation, while dT-hyperstarvation has the second, cell envelope dimension.
Vitamin B
12
-dependent biosynthesis ties amplified 2-methylhopanoid production during oceanic anoxic events to nitrification
Authors: Elling Felix J. , Hemingway Jordon D. , Evans Thomas W. , Kharbush Jenan J. , Spieck Eva , Summons Roger E. , Pearson Ann
Published: December 2020

Significance

Hopanoids are bacterial membrane lipids that are abundant in the geologic record. Hopanoids methylated at the C-2 position (2-methylhopanoids) are particularly abundant during Mesozoic episodes of ocean anoxia, yet the sources and factors that contribute to accumulation of these biomarkers remain poorly understood. Here, we report 2-methylhopanoid production in
Nitrobacter
, a ubiquitous group of nitrite-oxidizing bacteria that are favored under nutrient-rich growth environments, and we demonstrate that 2-methylhopanoid biosynthesis depends on cobalamin (vitamin B
12
). We propose that
Nitrobacter
spp. acquire their cobalamin from ammonia-oxidizing archaea in a mutualistic relationship that promotes nitrification. Therefore, accumulation of 2-methylhopanoids during the Mesozoic could have resulted from intensification of the oxidative steps of the marine nitrogen cycle in a nutrient-rich ocean.
Predicting long-term dynamics of soil salinity and sodicity on a global scale
Authors: Hassani Amirhossein , Azapagic Adisa , Shokri Nima
Published: December 2020

Significance

Land degradation due to soil salinization has detrimental impacts on vegetation, crops, and human livelihoods, leading to a need for a methodologically consistent analysis of the variability of different aspects of salt-affected soils. However, previous studies on the soil salinity issue have been primarily spatial and localized, leaving the large-scale spatiotemporal variations of soil salinity widely ignored. To address this gap, we present a globally validated analysis quantifying the long-term variations (40 y) of topsoil salinity at high spatial resolutions using machine-learning techniques. The results have significant implications for agroecological modelling, land assessment, crop growth simulation, and sustainable water management.
Shear stress activates mitochondrial oxidative phosphorylation by reducing plasma membrane cholesterol in vascular endothelial cells
Authors: Yamamoto Kimiko , Nogimori Yoshitsugu , Imamura Hiromi , Ando Joji
Published: December 2020

Significance

The mechanotransduction of shear stress in vascular endothelial cells is still not completely understood. We show a pathway of shear stress signal transduction mediated by plasma membrane cholesterol-dependent mitochondrial oxidative phosphorylation. The latest imaging technology using domain 4 mutant-derived cholesterol biosensors and a fluorescence resonance energy transfer-based adenosine triphosphate (ATP) biosensor revealed that shear stress rapidly decreases cholesterol levels in the plasma membrane via both efflux and internalization, and reduction in plasma membrane cholesterol was linked to the activation of mitochondrial ATP production. The addition of cholesterol blocked these shear stress effects. Increased mitochondrial ATP production led to ATP release from the endothelial cells, thereby activating purinoceptors in the plasma membrane and leading to purinergic Ca
2+
signaling in response to shear stress.
Mirror-image antiparallel β-sheets organize water molecules into superstructures of opposite chirality
Authors: Perets Ethan A. , Konstantinovsky Daniel , Fu Li , Chen Jiantao , Wang Hong-Fei , Hammes-Schiffer Sharon , Yan Elsa C. Y.
Published: December 2020

Significance

The structure and function of biomacromolecules depend on water structures in the hydration shell. We perform experiments and computations to examine the water molecules around an antiparallel β-sheet. Our experiments show that the sign of chiral optical responses of water reverses when the β-sheet is an (
l
-) or a (
d
-) enantiomer. Molecular modeling reveals a chiral topology of water assembled around the β-sheet. These results suggest that mirror-image proteins organize water molecules into supermolecular structures of opposite chirality. Hence, a complete description of biomacromolecular chirality must include the surrounding water molecules. This finding invites a new line of inquiry about the role of water in chiral selectivity of biomolecular interactions and the molecular origins of homochirality in the biological world.
Allosteric cooperation in a de novo-designed two-domain protein
Authors: Pirro Fabio , Schmidt Nathan , Lincoff James , Widel Zachary X. , Polizzi Nicholas F. , Liu Lijun , Therien Michael J. , Grabe Michael , Chino Marco , Lombardi Angela , DeGrado William F.
Published: December 2020

Significance

A major mechanism of evolution involves fusing genes that encode single-domain proteins to create multidomain structures that achieve new functions. Here, we develop methods to design multidomain proteins entirely from scratch and achieve the premier de novo design of an allosterically regulated phenol oxidase that responds to the binding of a synthetic porphyrin.
Grain-boundary topological phase transitions
Authors: Chen Kongtao , Srolovitz David J. , Han Jian
Published: December 2020

Significance

We reveal the existence of a topological phase transition (Kosterlitz–Thouless type) in grain boundaries (GBs)—important internal surfaces in crystalline materials. GB dynamics are controlled by the formation/migration of line defects (disconnections) with dislocation and step character. Below the GB KT transition, disconnections of opposite signs are bound as pairs, while above it they unbind and proliferate. We demonstrate that GB KT transitions provide a fundamental understanding of many GB properties, the temporal evolution of microstructure, and how it deforms/degrades under stress.
A new ultrafast energy funneling material harvests three times more diffusive solar energy for GaInP photovoltaics
Authors: Willich Marcel M. , Wegener Lucas , Vornweg Johannes , Hohgardt Manuel , Nowak Julia , Wolter Mario , Jacob Christoph R. , Walla Peter Jomo
Published: December 2020

Significance

Using molecular systems that harvest diffusive sunlight on large areas and funnel it onto much smaller areas of precious high-performance solar cells could pave the way to affordable high-efficiency photovoltaics. Here, we discovered important structural principles of molecules suitable to align diffusive light, the underlying ultrafast depolarization/repolarization dynamics, and a material with significantly higher light harvesting in the peak of the solar spectrum.
Investigation of temporal long-range correlation and anti-correlation of the fluctuations in a radiofrequency produced plasma in a diverging magnetic field configuration
Authors: Ghosh Abhijit , Saha S K , Chowdhury S , Janaki M S , Iyengar A N S
Published: December 2020

Long range temporal correlation of the fluctuations in both the floating potential (ϕ

f
) and the ion-saturation current (I

s
) have been investigated in a radio frequency produced magnetized plasma, in which the magnetic field diverges from a narrower quartz tube into a bigger stainless steel expansion chamber. Both argon and helium have been used as the filling gases. The Hurst exponents estimated from the rescaled range statistics indicate that the fluctuations in the ion-saturation current in argon plasma are anti-correlated inside a conical surface. The same fluctuations exhibit a transition to long range correlated behaviour over a narrow radial region of the conical surface. For helium plasma, the fluctuations in I

s
are mostly long range anti-correlated. The log-log plot of the power spectra of the fluctuations in I

s
and ϕ

f
have been observed to follow power laws and the same happens in the power spectrum of the particle flux also, indicating that the self-organized-criticality may exist in the present system.
Hardware architecture for real-time EEG-based functional brain connectivity parameter extraction
Authors: Gutierrez Nuno Rafael Angel , Chung Chi Hang Raphael , Maharatna Koushik
Published: December 2020

Objective. Design a novel architecture for real-time quantitative characterization of functional brain connectivity (FC) networks derived from wearable electroencephalogram (EEG). Approach. We performed an algorithm to architecture mapping for the calculation of phase lag index to form the functional connectivity networks and the extraction of a set of graph-theoretic parameters to quantitatively characterize these networks. This mapping was optimized using approximations in the mathematical definitions of the algorithms which reduce its computational complexity and produce a more hardware amenable implementation. Main results. The architecture was developed for a 19-channel EEG system. The system can calculate all the functional connectivity parameters in a total time of 131 µs, utilizes 71% of the total logic resources in the FPGA, and shows 51.84 mW dynamic power consumption at 22.16 MHz operation frequency when implemented in a Stratix IV EP4SGX230K FPGA. Our analysis also showed that the system occupies an area equivalent to approximately 937 K 2-input NAND gates, with an estimated power consumption of 39.3 mW at 0.9 V supply using a 90 nm CMOS application specific integrated circuit technology. Significance. The proposed architecture can calculate the FC and extract the graph-theoretic parameters in real-time with low power consumption. This characteristic makes the architecture ideal for applications such as a wearable closed-loop neurofeedback systems, where constant monitoring of the brain activity and fast processing of EEG is necessary to control the appropriate feedback.
A robust two-stage sleep spindle detection approach using single-channel EEG
Authors: Jiang Dihong , Ma Yu , Wang Yuanyuan
Published: December 2020

Objective. Sleep spindles in the electroencephalogram (EEG) are significant in sleep analysis related to cognitive functions and neurological diseases, and thus are of great clinical interests. An automatic sleep spindle detection algorithm could help decrease the workload of visual inspection by sleep clinicians. Approach. We propose a robust two-stage approach for sleep spindle detection using single-channel EEG. In the pre-detection stage, a stable number of sleep spindle candidates are discovered using the Teager energy operator with adaptive parameters, where the number of true sleep spindles are ensured as many as possible to maximize the detection sensitivity. In the refinement stage, representative features are designed and a bagging classifier is exploited to further recognize the true spindles from all candidates, in order to remove the false detection in the first stage. Main results. Using the union of all experts’ annotations as the ground truth, its performance outperforms state-of-the-art works in terms of F1-score (F1) on two public databases (F1: 0.814 for Montreal archive of sleep studies dataset and 0.690 for DREAMS dataset). The annotation consistency between the proposed method and certain selected expert as the trainer could exceed the consistency between two human experts. Significance. The proposed sleep spindle detection method is based on single-channel EEG thus introduces as less interference to the subjects as possible. It is robust to subject variations between databases and is capable of learning certain annotation rules, which is expected to help facilitate the manual labeling of certain experts. In addition, this method is fast enough for real-time applications.
Relative phantom maps and rational homotopy
Authors: Kishimoto Daisuke , Matsushita Takahiro
Published: December 2020

We generalize some results of Gray and McGibbon-Roitberg on relations between phantom maps and rational homotopy to relative phantom maps. Since the

l
i
m

⟵

1

\underset {\longleftarrow }{\mathrm {lim}}^{1}

and the profinite completion techniques do not apply to relative phantom maps, we develop new techniques.
Optimal constants in non-commutative Hölder inequality for quasi-norms
Authors: Sukochev F. , Zanin D.
Published: December 2020

We resolve an open problem due to B. Simon [Trace ideals and their applications, Cambridge University Press, Cambridge–New York, 1979; Trace ideals and their applications, American Mathematical Society, Providence, RI, 2005] concerning optimal constants in Hölder inequality for certain quasi-normed principal ideals of importance in Mathematical Physics and Noncommutative Geometry.
Ancient solutions to the Curve Shortening Flow spanning the halfplane
Authors: Ma John
Published: December 2020

In this note we construct an infinite family of compact ancient solutions to the Curve Shortening Flow which span the halfplane.
Myosin II isoforms promote internalization of spatially distinct clathrin-independent endocytosis cargoes through modulation of cortical tension downstream of ROCK2
Authors: Wayt Jessica , Cartagena-Rivera Alexander , Dutta Dipannita , Donaldson Julie G. , Waterman Clare M.
Published: December 2020

We utilize quantitative endocytic assays of endogenous clathrin-independent endocytosis (CIE) cargoes to determine that the Rho-associated kinase ROCK2, but not ROCK1, is required for CIE of major histocompatibility complex class I (MHCI) and CD59 through promotion of myosin II activity. We further show that myosin IIA promotes internalization of MHCI and myosin IIB drives CD59 uptake in both HeLa and polarized Caco2 cells.
Homonationalism and Media
Authors: Dhoest Alexander
Published: December 2020

Homonationalism, as defined by Jasbir Puar, refers to the growing embrace of LGBT rights by (mostly Western) nations, as well as the parallel complicity of lesbian, gay, bisexual, and transgender (LGBT) individuals and associations with nationalist politics. First developed in the context of the U.S. “war on terror,” where the United States presented itself as exceptionally LGBT-friendly in contrast to “homophobic” Muslim others, the concept of homonationalism was quickly adopted by authors across the world and in different disciplines, writing on a number of LGBT-friendly in-groups in contrast to a number of homophobic out-groups. Besides the United States, other Western countries figure prominently as in-groups in this literature, particularly Western and Northern European ones, but also larger regions such as the European Union (EU) as well as subnations such as Catalonia and Québec. Muslims constitute the most prominent out-group in homonationalist discourses, although other groups and regions also appear, in particular, African countries and, in the European context, Central and Eastern Europe as well as Russia. In each case, a simplistic opposition is set up between a homogeneously modern and LGBT-friendly “us” and an equally homogeneous antimodern homophobic “them.” These discourses are prominent in (often right-wing) politics but are equally replicated across a range of media, which play a crucial role in the spread of homonationalist discourses but remain underexplored to date.
Which Fitch?
Authors: Jago Mark
Published: December 2020

Jago (2019) uses a Fitch-style argument in an attempt to demonstrate that every truth has a truthmaker (maximalism). But Trueman (forthcoming) shows that there is a parallel argument, this time to the conclusion that no truth has a truthmaker. Since we cannot accept both, we must ditch at least one Fitch. But which?

Keywords: Truth, truthmaking, truthmaker maximalism, Fitch paradox, Robert Trueman
I Am Not Invisible: The Impact of Age Discrimination in the Workplace
Authors: McConatha Jasmin Tahmaseb , Schnell Frauke , Stricker Lauren , Magnarelli Jacqueline
Published: December 2020

Ageism and age stereotypes are widespread. They shape the lived experiences of older workers. This presentation focuses on the results of responses to an online survey exploring the impact of ageist treatment in the workplace. The results of online surveys from 113 teachers over the age of 50 indicated that ageist treatment is widespread. An analysis of open ended questions addressing the stressful impact of being victimized by ageism indicated that feeling invisible, isolated, and helpless are the three most common responses to ageist treatment in the workplace. Being victimized by ageism presents a threat to older workers sense of self and feelings of competence. The cultivation hypothesis suggests that in technologically advanced societies such as the United States, people often rely on the media as a primary source of cultural information. Media images tend to depict older adults in ways that maintain and create ageist stereotypes. Our research suggests that the framing of media content significantly influences the self-worth of older workers. In this presentation, we discuss examples of ageism in the workplace, the family, and the media, and discuss ways of combating biased and discriminatory treatment. Based on our ongoing research, we make suggestions for ways of responding to and coping with ageist treatment.
Self-Rated Health in Older Adults (60+) Who Are Sexually Active: Association With Pleasure
Authors: Viviano Nicole
Published: December 2020

Older adults who engage in sexual activity (SA) tend to have greater enjoyment in life compared to their less sexually active counterparts. Further, older adults tend to report more satisfying or pleasurable SA when less health conditions are reported. Although self-rated health (SRH) is often incorporated in studies concerning SA, it is not always included when examining sexual intimacy, pleasure, and pain/discomfort. It is important to understand how SRH is associated with both SA and sexual pleasure as it could indicate when providers need to initiate conversations with their patients regarding safe sex practices and/or diagnose related health conditions (i.e. erectile dysfunction, vaginal dryness, etc.). The current study examined the association between SRH and experiencing pleasurable sexual interactions in older adults (60+). The Midlife in the United States (MIDUS) Refresher dataset (2011-2014) was used for this secondary data analysis. The dependent variable is pleasure in sexual interaction; the independent variable is self-rated health. Covariates include marital status, race, sex, sexual intimacy and sexual pain/discomfort. An ordinal logistic regression shows that for every one-unit increase in SRH, there is 1.341 times odds of experiencing pleasure in sexual interactions in older adults 60+ after adjusting for covariates. Individuals who had higher SRH had increased odds of having pleasurable sexual encounters. It is already clear that older adults are engaging in sexual activity, despite stereotypical myths. Further understanding the relationships between factors of SA like pleasure, pain/discomfort, and intimacy and health factors might allow for the extension of a healthy sexual life.
Social Problem-Solving and Suicide Risk Across the Lifespan: A Qualitative Investigation
Authors: Molaie Ali , Chong Adrienne , Fisher Jane
Published: December 2020

Social disconnectedness, or thwarted belongingness (TB) is a risk factor for suicide across the lifespan. Perceived time left (PTL) to live may impact perceptions of hopefulness for future social connectedness, and thus the generation of problem-solving strategies for decreasing TB and the risk for suicide. We conducted an exploratory analysis of the quantity and quality of older and younger adults’ recommendations for decreasing TB of characters in vignettes who were depicted as having high or low TB (i.e., described as lonely or not lonely) and high or low PTL (i.e., described as being 35-years-old or 85-years-old). We also examined the relation between participants’ social recommendations and suicide risk. Participants with higher suicide risk endorsed higher hopelessness on the High TB/Low PTL vignette and were more likely to recommend contact with family as a means of reducing TB (χ^2(1) = 4.25, p = 0.04) than were participants with lower suicide risk. Participants with higher suicide risk were also more likely to recommend social activity with friends than were participants with lower suicide risk on the High TB/High PTL vignette, (χ^2(1) = 6.66, p = 0.01) and on the High TB/Low PTL vignette (χ^2(1) = 6.14, p = 0.02). Additionally, age differences were observed such that older participants made fewer recommendations involving socializing with family and friends than did younger adults, and provided more nonsocial or made no recommendations across vignettes. The results suggest that social problem-solving may be an important differentiating variable among older and younger adults at risk for suicide.
Role Overload, Perceived Gratitude, and Health Among Spousal Caregivers: A Longitudinal Study
Authors: Nah Suyoung , Martire Lynn
Published: December 2020

Spouses are likely the most vulnerable caregivers due to their advanced age and more intense caregiving than other family members. Thus, it is crucial to identify risk and protective factors for spousal caregivers’ health. According to Pearlin’s stress process model, caregivers’ subjective stressors and resources may impact their health. We focused on spousal caregivers’ role overload, a critical indicator of subjective stressors, and their perception that the partner is grateful for their help, which may be beneficial for their health but has rarely received attention. This study tested the hypotheses that spousal caregivers’ higher role overload and lower perceived gratitude are associated with poorer physical and mental health over time. We also examined whether greater perceived gratitude buffers the negative relationships between role overload and health. We focused on 223 spousal caregivers of older adults without dementia from the 2015 and 2017 National Study of Caregiving. Autoregressive models revealed that spousal caregivers’ higher role overload at baseline was associated with poorer self-rated health at follow-up (b = -0.23, p < .05), but not with depressive symptoms or anxiety. Spousal caregivers’ greater perceived gratitude at baseline was associated with lower anxiety at follow-up (b = -0.32, p < .01). There were no moderating effects of perceived gratitude on the relationships between role overload and health. These findings suggest that spousal caregivers’ role overload is a risk factor for their physical health, while their perception that the partner is grateful for their help serves as a protective factor for their mental health.
Epidemiology of Suicide in Older Adults
Authors: Pearson Jane
Published: December 2020

This individual symposium abstract will focus on the epidemiology of suicide in older adults, with particular focus on risk factors, changing demographics, and population shifts with the baby-boomers aging. Epidemiologically, older men aged 75 and older have a suicide rate of 39.7 deaths per 100,000 in 2017, compared to the general population of 14.0 deaths per 100,000. Risk factors for suicide in older adults include functional disability, multiple chronic physical conditions, and social isolation. In addition, older adults often face stressors such as relationship issues, life crises (loss of spouse), and social factors (employment and financial challenges, housing stress, and legal issues). Limited mobility, physical and mental health conditions, and lack of social support can affect healthcare access and utilization. Many older adults do not routinely seek behavioral health treatment, with reported under-detection of mental health conditions such as depression, substance use disorders, and suicidal ideation.
Factors Associated With Social Isolation Among Older Adults: The Singapore Chinese Health Study
Authors: Barrenetxea Jon , Yi Yang , Koh Woon Puay , Qiushi Feng
Published: December 2020

Social isolation is a determinant of mortality and well-being among older people. Factors associated with isolation could be different in societies where older adults live mainly with family, as individuals might feel isolated despite living with others. We studied the factors associated with isolation among 16,948 older adults from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age of 73, range: 61-96 years). We defined social isolation as having “zero hour per week” of participation in social activities involving 3 or more people and scoring the lowest decile on the Duke Social Support Scale of perceived social support. We used multivariable logistic regressions to compute odds ratio (OR) and 95% confidence interval (CI) for factors associated with likelihood of social isolation. Although only 14.4% of isolated participants lived alone, living alone remained a significant factor associated with isolation (OR 1.93, 95% CI 1.58-2.35), together with cognitive impairment (OR 1.73, 95% CI 1.46-2.04) and depression (OR 2.44, 95% CI 2.12-2.80). Higher education level was inversely associated with isolation (p for trend<0.001). In stratified analysis, among those living alone, compared to women, men had higher odds of social isolation (OR 2.18, 95% CI 1.43-3.32) than among those not living alone (OR 0.99, 95% CI 0.84-1.17) (p for interaction<0.001). Our results showed that living alone, cognitive impairment and depression were indicators of isolation among older Singaporeans. In addition, among those living alone, men were more likely to experience social isolation than women.
Using Big Data for Clinical Decision Making
Authors: Woods Diana , Yefimova Maria
Published: December 2020

The current workforce is ill prepared for the rise in Americans 65 and older from 46.3 million in 2010 to 98.2 million by 2050, a national increase of 112.2 % accompanied by increasing chronic conditions. The increase in older Americans, the prevalence of those with dementia, accompanied by behavioral symptoms of dementia (BSD) is increasing. Innovative technology may alert health providers to early signs of decline in frail older adults with multiple chronic conditions. Remote monitoring in the home and community living spaces can address complex care needs for older adults. Monitoring may identify and predict deviations in a person’s daily routine that herald a change in a chronic condition. We present two examples that can potentially assist in clinical decision making. The first exemplar used 24/7 sensor data to identify changes, potentially clinically significant, such that early intervention may prevent hospitalizations; the second exemplar presents the use of pattern recognition software (THEME TM) for temporal pattern analysis, to identify and quantify behavior patterns with regard to intensity, frequency and complexity, such that interventions may be individually tailored and timed. Clinical researchers and technology developers need to collaborate early in the process to consider the sources and frequency of clinical measures for meaningful predictions. One major challenge lies in the interpretation of the vast amounts of within individual data. Our insights strive to improve future interdisciplinary development of monitoring systems to support aging in place and support clinical decisions for timely and effective care for frail older adults.
Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan
Authors: Yoshida Hiroto , Kihara Yuriko
Published: December 2020

This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.
The Electronic Frailty Index and Area Deprivation Index: Independent Constructs in Risk Stratification
Authors: Callahan Kathryn , Lenoir Kristin , Pajewski Nicholas
Published: December 2020

Frailty and social determinants of health (SDOH) have been associated with mortality for older adults. Given time limitations, passive electronic tools such as the eFI and publicly available data such as the Area Deprivation Index (ADI) hold appeal for targeting limited resources to support at-risk older adults. Literature is conflicting with regards to the relationship between frailty and SDOH. A retrospective, observational cohort of adults 65+ (n=44,548) identified as part of the Wake Forest Baptist Health (WFBH) accountable care organization was used to evaluate the association between ADI, eFI, and mortality between 1/1/2019 and 1/1/2020. A cox proportional hazard model was fit, adjusting for age, sex, race, and weighted Charlson Comorbidity Index. Sources of mortality data include claims data, the EHR at WFBH, and NC Vital Statistics. Block-level geographic identifiers (GEOID) were extracted and used to merge ADI national percentiles (Neighborhood Atlas), derived from U.S. Census 5-year American Community Survey estimates, which incorporates 17 SDOH measures (e.g., income, education, housing, employment.) Frailty was calculated by the WFBH eFI. 9216 (20.7%) were frail by eFI (eFI>0.21) and 235 (0.5%) died. The interaction between ADI tertile and eFI category was not significant (p=0.78). Being frail was associated with poorer survival when compared to the fit group; HR= 1.94 (95% CI =1.23, 3.08; p<0.01.) Survival did not differ between the maximum deprivation tertile and the minimum tertile, HR=1.21 (95% CI=0.88-1.68, p=0.25). Frailty and SDOH may represent independent constructs in risk stratification for older adults. Future work will explore associations within healthcare utilization.
Factors Associated With Food Intake, Nutritional Status, and Function Among Nursing Home Residents With Dementia
Authors: Taani Murad , Plotkin Adam
Published: December 2020

Declined food intake is prevalent among long-term care (LTC) residents with dementia and associated with deleterious health outcomes. This study explores food intake, nutritional status, and function and its associated factors in LTC residents with dementia. Data from 82 LTC residents with dementia were used in this secondary analysis. In the primary study, appetite was assessed using the Short Nutritional Assessment Questionnaire (SNAQ). Dementia level, comorbidity, agitation, pain, mood, food intake, nutritional status, and function variables were extracted from the electronic medical record, including the most recent Minimum Data Set (version 3.0) assessment. The majority of residents were either malnourished or at risk of being malnourished and demonstrated a worse appetite than previously described in the literature. Comorbid illness, depressed mood, and appetite were associated with 37.1% of the variance in food intake over 30 days. Dementia level and appetite were associated with 22.2% of the variance in nutritional status. Food intake and nutritional status were associated with 29.1% of the variance in function. This study also highlights a new demographic that may require extra assistance in combating declined food intake: LTC residents with dementia who reside in a facility that follows restrictive food practices such as a kosher diet. The potential reversibility of factors associated with food intake and nutritional status provides opportunities for intervention.
Is Handgrip Strength a Valid and Reliable Measure in Older Adults?
Authors: Spicher Jefferson , Silva-Smith Amy , Benton Melissa
Published: December 2020

Handgrip strength is related to mortality, disability, functional independence, and quality of life in older adults, and cut points for diagnosis of sarcopenia have been proposed. However, there is no standardized procedure or device, so measurement may not be accurate. To assess validity and reliability we compared hydraulic (HD) versus digital (DD) handgrip dynamometers. Sixty-seven older (76.2 ± 0.9 years) men (n=34) and women (n=33) completed two measurements on sequential days (T1, T2) using both devices in random order. Participants sat in a chair with the device held in their dominant hand, their arm supported on a table or other stable surface, their wrist in a neutral position, and their elbow bent at a 90° angle. To avoid muscle fatigue that has been attributed to multiple attempts, participants squeezed the device one time as hard as possible for 3 seconds. Strong (p<0.001) intraclass correlations were observed for both devices (HD=0.98; SS=0.96) indicating good reliability. However, there were significant differences between devices and between measurements. Strength measured with HD was greater than DD at T1 (27.4 ± 1.4 vs. 23.4 ± 1.1 kg, p<0.001) and T2 (25.3 ± 1.4 vs. 21.8 ± 1.2 kg, p<0.001). Day-to-day measurements were also significantly different. Between T1 and T2 strength decreased 8% with HD (p<0.001) and decreased 7% with DD (p=0.001). In this group of older adults, significant differences in handgrip strength were observed between devices and timepoints indicating poor validity. As a diagnostic tool, standardization is needed for handgrip measurement procedures to improve accuracy.
Older Adults’ Experience of Health and Life Events as Reported Online Over 150 Consecutive Weeks
Authors: Kaye Jeffrey , Mattek Nora , Beattie Zachary , Sharma Nicole , Riley Thomas , Dodge Hiroko
Published: December 2020

Key activities and life events that impact quality of life and health may be gleaned from cross-sectional annual surveys or for medical data, derived intermittently from electronic health records. These methods cannot reflect the day-to-day and week-to-week changes that typically occur in domestic life. To assess the frequency and types of major life activities and events occurring at finer-grained temporal scale, we queried online, every week, three domains of activity and function (life events such as having an overnight visitor, travel away from home; health-related events such as medication changes, falls, ER/hospital visits, health limitations; and internal states such as pain, mood, or loneliness). Over a mean assessment period of 2.9 ± 1.2 years, 16,738 online surveys were completed by 129 community-residing volunteers with mean age 84 years. Overall the most frequent events reported were physical health limitations (14%), travel away from home (12%) and overnight visitors (9%). Needing new in-home assistance for medication management, bathing, dressing or grooming was rare (1%). Accidents were also rare (1%). Low mood, pain ratings (0-10 scale) and loneliness were infrequently reported; 4% low mood, 8% pain rated > 5, 3% reporting loneliness. Low mood and increased pain intensity were highly correlated with health changes (medication changes, ER/hospital visits, health limitations, falls; all p<0.0001). Continuous home-based online assessment of life activities and health can provide a more detailed and timely characterization of older adult function. These data may be used to guide more timely and effective health maintenance programs and interventions.
Bidirectional Association Between Knee Osteoarthritis and Depressive Symptoms: A Nationwide Cohort Study
Authors: Lu Han , Shang Shaomei , Wang Limin , Chen Hongbo
Published: December 2020

Both knee osteoarthritis (KOA) and depressive symptoms are common health issues affecting the quality of life of old adults. Although it is presumed that KOA has a bidirectional relationship with the depressive symptoms, no cohort study has proven it. This is the first study to determine the strength of association for the bidirectional relationship between KOA and depressive symptoms. Data were gathered from the nationally survey of China Health and Retirement Longitudinal Study in 2011-2015. The presence of depressive symptoms was defined by the 10-item Center for Epidemiologic Studies Depression Scale score of 10 or higher. The adjusted Cox proportional hazards regression model was conducted to estimate hazards ratios (HRs). Controlled covariates include gender, age, education, marital status, residence, number of chronic diseases, and disability. The analysis of KOA predicting the depressive symptoms onset consisted of 4,377 participants free from depressive symptoms at baseline. During 4 years follow-up, diagnosed KOA participants were more likely to have depressive symptoms than their peers without KOA (HR = 1.50, 95% CI: 1.23-1.83). The parallel analysis of depressive symptoms predicting KOA onset included 6,848 participants without KOA at baseline, those with depressive symptoms had a higher relative risk of developing KOA (HR = 1.64, 95% CI: 1.41-1.92). Our results provide compelling evidence that the KOA-depressive symptoms association is bidirectional, highlighting the importance of evaluating the relationship between physical and mental health among older people. Particularly, taking this association into consideration in the risk assessment and primary prevention of KOA and depression symptoms.
A Practical and Validated Fall Risk Screening Instrument: A Systematic Review
Authors: Meekes Wytske , Korevaar J C , Leemrijse C J , van de Goor L A M
Published: December 2020

Early detection of a high fall risk is important to start fall preventive interventions in time and to reduce fall risk among older people. Several fall risk screening instruments are available, however it is unclear which instrument is validated and most suitable for the primary care setting. This systematic review aims to identify the most suitable fall risk screening instrument(s) for the primary care setting (i.e. requires limited time, no expensive equipment and no additional space) with good prognostic ability to assess high fall risk among independently living older people. An extensive search was conducted in the databases PubMed, EMBASE CINAHL, Cochrane and PsycINFO. Twenty-six out of 2277 articles published between January 2000 and February 2019 were included. Six fall risk screening instruments were identified; TUG test, Gait Speed test, BBS, POMA, FR test, Fall History. Most articles reported AUCs ranging from 0.5-0.7 for all instruments. Sensitivity and specificity varied substantially across studies (e.g. TUG, sens.: 10-83.3%, spec.:37-96.6%). The results showed that none of the included screening instruments had sufficient (AUC>0.7) predictive performance (Šimundić, 2009). As suitability for the primary care setting prevails for now, Fall History appears to be the most suitable screening instrument. Compared to the other instruments, Fall History requires the least amount of time, no expensive equipment, no training, and no space (adjustments). Patient’s fall history together with a health care professional’s clinical judgment, might be a promising screening strategy for the primary care setting to identify high fall risk among older people.
Relationship Between Patient and Informant Assessment of Personality and Cognitive Status
Authors: Tolea Magdalena , Galvin James
Published: December 2020

Personality has been linked to risk of dementia. Most studies ask individuals to rate their own personality traits or for a knowledgeable informant to perform the rating; few collect data from both. When informants are asked to give an estimate of the patient’s lifelong personality traits, they often describe personality before disease onset. When asked to self-rate, patients may instead assess their personality as they see themselves, providing a personality-state measure. The goal of this study was to assess agreement between two independent measures of personality and evaluate whether stage of cognitive impairment and characteristics of patients or caregivers impact concordance. In 79 consecutive patient-caregiver dyads presenting to our center (mean age:76.8±8.4; 44.1% female; 6% cognitively normal, 41% MCI; and 53% dementia) with in-depth psychosocial and neuropsychological evaluations, we found informants rated patients lower on openness (O) (ICC=0.434; 95%CI: 0.235-0.598) and agreeableness (A) (ICC=0.491; 95%CI: 0.302-0.643) and higher on extraversion (O) (ICC=0.396; 95%CI: 0.191-0.568) and neuroticism (N) (ICC=0.444; 95%CI: 0.247-0.607). Greater discordance was observed in established dementia (ICCE=0.497; 95%CI: 0.222-0.700; ICCA=0.337; 95%CI:0.031-0.586; ICCN=0.422; 95%CI: 0.191-0.683), compared with MCI (ICCO=0.568; 95%CI: 0.282-0.762). We explored the effect of patient and caregiver mood and caregiver burden on personality ratings. Although personality is typically described as a trait, we present evidence that in the eyes of patients, personality ratings may represent a state that changes across the spectrum of cognitive impairment. Understanding how patients and caregivers differentially perceive personality may assist in developing novel psychotherapeutic interventions and approaches dealing with behavioral manifestations of dementia.