bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uninterruptible Power Supply Improves Precision of Telomere Length Measurement via qPCR
Authors: Hastings Waylon , Shalev Idan 
Published: December 2020

Abstract
Epidemiological literature has produced robust associations between telomere length (TL) and health, wherein individuals with shorter TL are at increased risk for chronic disease and death. Even so, technical challenges associated with TL measurement have led some to question their utility as a biomarker of aging. Several pre-analytical factors influence TL assessment via qPCR including tissue source, sample storage, and DNA extraction method. Additional work has investigated how conditions within the PCR run (e.g. mastermix reagents) influences precision and reproducibility of TL measurements. However, the impact of power supply remains unclear. Momentary fluctuations in power supply can affect the functioning of high-performance electronics, including real-time thermocylers. These fluctuations can be mitigated by using an uninterruptible power source (UPS), an electronic apparatus capable of supplying constant, uninterrupted voltage to high-performance electronics. The current study investigated how using a UPS influenced TL assessment via qPCR. Standard deviation and coefficient of variation across replicates were compared for samples assessed with or without the use of a UPS. Samples run with a UPS had significantly lower standard deviation (p&lt;0.001) and coefficient of variation (p=0.002) than those run without a UPS. Notably, neither the efficiency of exponential amplification (p=0.674) nor the standard curve R2 (p=0.638) varied as a function of UPS status. Thus, UPS status decreases variability within sample replicates while maintaining the overall quality of the qPCR assay. *The work presented was supported by the Telomere Research Network, an NIH-sponsored working-group recently established to coordinate best practices for measuring telomere length in population-based research.
Cognition, Depression, and Genetics: Examining Sex Differences Using Polygenic and Genetic Inference Techniques
Authors: Ware Erin , Gard Arianna , Fu Mingzhou , Schmitz Lauren , Bakulski Kelly , Ware Erin Bakshis 
Published: December 2020

Abstract
Alzheimer’s disease and its related dementias (ADRD) are debilitating neurodegenerative diseases. As nearly two-thirds of persons diagnosed with Alzheimer’s disease are women, more research is needed to understand sex differences in the biological mechanisms that underlie ADRD. Depression is a risk factor for Alzheimer’s disease and higher rates of depression among women, compared to men, suggest that depression-related phenotypes and underlying biological factors may contribute to sex differences in ADRD. Using the Health and Retirement Study (N = 9908, European ancestry), a US panel-cohort study, the current analysis leverages Mendelian randomization techniques to assess sex-specific inferred causality of depressive symptoms on odds of dementia. All analyses assess most recent cognition and account for sex, education, study cohort, age and year of most recent cognition visit, and genetic ancestry principal components. A one standard deviation increase in depressive polygenic score was associated with 1.11 times higher odds of dementia (95% confidence interval: 1.02-1.21) relative to normal cognition. Each additional endorsed depressive symptom was associated with 1.13 times higher odds of dementia (95% confidence interval: 1.09-1.18) relative to normal cognition. Using the depression genetic instrument, a significant inferred causal relationship was observed between depressive symptoms and dementia (P=0.01, 1.73 odds ratio, 95% confidence interval: 1.12-2.67). When stratified by sex, this relationship was only significant in females (P=0.02, 1.76 odds ratio, 95% confidence interval: 1.08-2.87). These findings demonstrate that depressive symptoms are likely causally related to dementia, and this relationship is most pronounced in females.
Impact of Family Caregiver Training on Hospitalization During Medicare Home Health Care
Authors: Burgdorf Julia , Wolff Jennifer 
Published: December 2020

Abstract
Medicare home health providers are required to offer family caregiver training; however, there is little information regarding the impact of family caregiver training on patient outcomes in home health or other care delivery settings. A better understanding of this relationship is necessary to guide development of caregiver training interventions and inform policy discussions surrounding family caregiver training access. This research assesses whether and how unmet need for family caregiver training is associated with acute care utilization during Medicare home health. We examine 1,217 (weighted n=5,870,905) fee-for-service Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011-2016. We link NHATS data with home health patient assessments and Medicare claims, drawing measures of family caregivers’ need for training from home health clinician reports and determining provision of training from Medicare claims. Using weighted, multivariable logistic regressions, we model the marginal change in probability of acute care utilization during home health as a function of family caregivers’ unmet need for training. We found that older adults whose family caregivers had an unmet need for training had a probability of acute care utilization during home health that was 18 percentage points (p=0.001) greater than those whose family caregivers both needed and received training, holding all covariates at their means. Findings support the importance of connecting family caregivers to training resources and suggest one avenue by which investing in caregiver training may be cost-effective for integrated payers and providers.
Systems Addressing Frail Elder Care: An Implementation Study
Authors: Aronow Harriet , Bolton Linda Burnes , Diniz Marcio , Kim Linda , Coleman Bernice 
Published: December 2020

Abstract
SAFE CareTM was developed at one hospital and found to be an effective care model for frail older adults. SAFE CareTM includes nurse screening for frailty risks, multidisciplinary assessments, team huddles and care recommendations. Underlying implementation is an organizational change process. Study aim was to evaluate the implementation and outcomes of SAFE CareTM in three additional hospitals. Two units from each hospital were randomized to SAFE CareTM or usual care. Process evaluation employed semi-structured interviews. Inpatients were aged 65+ years with positive frailty risks (N = 1,151). Outcomes evaluated ICU admission, length of stay (LOS), and discharge destination. All outcome analyses were conducted with intention to treat models. Patients were on average 80 years old, 54% female, 58% Caucasian, 83% English speaking, with 3.4 positive frailty risks. Median LOS was 4.2 days, 6.5% ICU admissions, 32% discharge institutional care. Hospitals differed in patient demographics and outcomes. While no differences between treatment groups in patient demographics, intervention patients had more frailty risks and longer expected LOS. 62% of intervention unit patients received intervention. There were no univariate treatment effects on outcomes. In multivariate analysis, intervention unit patients had shorter LOS. While hospitals reported different experiences, all reported challenges in preparing the electronic health record to support SAFE CareTM. Staff reported increased interprofessional team communications. Differences among the hospitals in patients and organizational attributes argue strongly that implementation should be tailored to meet varying institutional needs while common measures and processes underlying implementation should be followed closely.
Can Functional Performance Predict Long-Term Mortality Post Hip Fracture in Older Adults (65–100 Years of Age)?
Authors: Bajracharya Rashmita , Orwig Denise , Magaziner Jay , Guralnik Jack M 
Published: December 2020

Abstract
Functional performance measures (grip strength, Short Physical Performance Battery (SPPB), and 3-meter gait speed) represent underlying disease progression and predict mortality. However, there is little information regarding whether these measures assessed at 2-months post-hip fracture predict long-term mortality (10-year follow-up). To address this gap, a longitudinal analysis of Baltimore Hip Studies-7 cohort, with mortality verified by National Death Index, was conducted. Mean difference in 2-month functional performance measures (n=242, men n=121, female n=121) among those who survived and did not survive over 10 years was determined using t-test. Prediction of mortality by these measures, overall and by sex, was estimated using cox proportional hazard models, for which Hazard ratios (HR) with 95% confidence intervals (CI) were estimated. We found that, gait speed [0.47(standard deviation,SD=0.39) versus 0.31(SD=0.27)] and SPPB score [4.89(SD=3.31) versus 2.83(SD=2.24)] were significantly higher at 2 months among those surviving compared to those who did not. Adjusting for covariates, functional performance predicted long-term mortality in men and women. Increase in gait speed by 0.1m/s predicted 15% decrease in mortality for men [HR=0.85(0.55-0.96)] and 17% for women [HR=0.83 (0.74-0.93)]. Increase in SPPB by 1 unit predicted decrease in mortality by 14% for men [HR=0.86(0.77-0.95)] and 17% for women [HR=0.83(0.74-0.93). Increase in grip strength by 1 kg predicted 5% decrease in mortality for men [HR=0.94(0.92-0.97)] and 9% for women [HR=0.90(0.86-0.95)]. Functional performance measured at 2-months post-hip fracture predicted long-term mortality. Those with poor functional performance at 2-months can be referred for further assessment to optimize their care to promote survival.
Emergency Department Nurses’ Experiences in Caring for Older Adults With Dementia
Authors: Park YuJin , Kong Eun-Hi , Kim Hyejin 
Published: December 2020

Abstract
The aim of this study was to describe emergency-department nurses’ experiences in caring for older adults with dementia. A qualitative descriptive method was employed. A convenience sampling method was used to recruit nurses from seven regional emergency medical centers. Data were collected through to in-depth interviews and field notes until data were saturated. A total of 23 emergency-department nurses participated in the first interview and 18 of them participated in the second interview. Data were analyzed using qualitative content analysis with the ATLAS. ti 8.2 software program. Through data analysis of interview data, 36 codes and 10 categories were identified. Finally, four themes emerged from data analysis: lack of preparation for dementia care, tired of caring for older adults with dementia, an inappropriate emergency-department environment for older adults with dementia, and needs for improvements in dementia care. Emergency-department nurses felt completely unprepared for dementia care and felt exhausted after caring for older adults with dementia. In addition, the emergency department is considered to be an environment that does not consider older adults with dementia and thus is unsuitable for older adults with dementia. Also, nurses require systematic support when caring for older adults with dementia and improvement in awareness in the emergency department. Study results provide important data to develop educational material for emergency care including criteria for emergency medical assessments and policies of emergency medical institutions. In addition, the results provide evidence for clinical practice guideline for nurses who care for older adults with dementia in the emergency departments.
A Systematic Review of Observational Dyadic Persons Living With Dementia: Caregiver Communication Instruments
Authors: Kim Sohyun 
Published: December 2020

Abstract
To facilitate social interaction and providing quality care in persons living with dementia (PLWD), an effective means of evaluating communication quality between PLWD and their caregiver is needed. However, there is no systematic review of current instruments to assess dyadic PLWD-caregiver interactions in various care settings. The purpose of this review was to critically evaluate existing dyadic observational communication instruments used to provide recommendations. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline was conducted. Literature that were published by May 2019 in English were searched from CINAHL, AgeLine, PsychINFO, Communication and Mass Media Complete, ProQuest Dissertations and Theses Global, and Scopus. Keywords were “communication strategy,” “communication,” “caregivers,” “dementia,” and any combination of these terms or MeSH terms. Data were extracted including development process, operational concept, target population and setting, items/scoring format, psychometric properties, and research/clinical use. A total of 3042 articles were identified and 15 instruments from 29 studies were evaluated by the scoring of 12 psychometrics: participants/items ratio, reliability (internal consistency, intra-rater, inter-rater), and validity (content, concurrent, predictive, known group difference, divergent/discriminant, convergent, structural). The total score was ranged from 0 to 22 (high quality: 16-22, moderate: 8-15, low: 0-7). There was no instrument with high quality assessing dyadic interaction. Only one instrument was evaluated as moderate quality (modified Behavioral Observation Scoring System, BOSS). While existing instruments are still in the early stages of development and testing, they demonstrate potential evidence that may require further testing before application in research and clinical practice.
Developing a Spatial-Skills-Focused Music Program for Older Adults With Changes in Cognition
Authors: Dorris Jennie , Rodakowski Juleen 
Published: December 2020

Abstract
Older adults with cognitive changes need stimulating programming to maximize their cognitive abilities. One area to maximize includes spatial skills, its decline can lead to disorientation and wandering. Music has potential to maximize spatial skills: reading music’s notation is associated with enhanced spatial skills in children and professional musicians. It’s critical to understand the potential impact of a spatially focused music program for older adults with changing cognition; if successful, future music programs could support people staying orientated in their environments and living independently longer. We developed and assessed a six-week marimba program focused on reading music with 15 older adults ages 65-89 with changes in cognition. We compared their scores on the Orientation Test from the Test of Visual Perceptual Skills pre- and post-intervention and assessed if participants self-selected to read music notation. Participants scored an average Modified Mini Mental State Examination (3MSE) score of 81.3 (SD = 11.0). On average, participants’ scores on the Orientation Test moved from 13.4 (SD =1.9) to 14.1 (SD= 2.7), providing a cohen’s d effect size of 0.3. Over the six weeks, 11 out of the 15 participants selected to read music for at least one class, indicating a statistically significant change using the Wilcoxon signed-rank test (Z = -3.16, p &lt; 0.01), suggesting that older adults with cognitive changes may be able to learn to read music. This is important, as a spatially focused music program may maximize spatial skills that older adults need to successfully navigate their world safely and independently.
Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age
Authors: Splonskowski Moriah , Cooke Holly , Jacova Claudia 
Published: December 2020

Abstract
Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.
Rural Hoarding in Older Adults: A Pilot Characterization Study
Authors: Dozier Mary 
Published: December 2020

Abstract
There has been limited research on geriatric hoarding disorder in rural areas. Older adults living in rural areas are more likely to feel stigmatized due to mental health difficulties and to have multiple barriers to healthcare. The purpose of this study is to present the clinical picture of eight older adults (mean age 68, range 57-92) with hoarding disorder who live in the rural southeastern U.S. Participants completed a semi-structured interview and the NIH Toolbox Emotion and Cognition Batteries in their homes. Participants were mostly female (n = 6) and identified as White (n = 5) or African American (n = 3). All participants reported being Christian. Most participants were divorced or had never married (n = 6). All participants reported having at least one current medical condition, with the most commonly reported diagnosis being high blood pressure (n = 4). Half of participants reported that they had experienced at least one intervention from their family; however, only one participant reported ever experiencing an intervention from another source (i.e., property manager). On average, participants reported having a low level of emotional support and life satisfaction and a high level of loneliness and somatic symptoms of fear. Participants’ performance on tests of cognitive functioning was worst for processing speed, with three out of the eight participants performing at the level of borderline impairment or worse. Understanding the clinical presentation of hoarding disorder in rural-dwelling older adults is the first step to the development and implementation of evidenced-based treatments in this population.
Transforming Aging Services: Area Agencies on Aging and the COVID-19 Response
Authors: Gallo Haley B , Wilber Kathleen H 
Published: December 2020

Abstract
For over four decades, Area Agencies on Aging (AAAs) have served as focal points to help older adults remain in their homes and communities. AAAs partner with other organizations to administer services authorized under the Older Americans Act (OAA). AAAs represent loosely coupled systems; they are responsive to guidelines established by the OAA while maintaining flexibility to leverage limited resources, establish partnerships, and create innovative programs to meet community needs. As stay-at-home orders and concern for safety have kept many older adults homebound during the coronavirus disease 2019 (COVID-19) pandemic, an important question is how the Aging Network, including the over 600 AAAs, has responded to these rapidly changing needs. Although time and more systematic assessments are required, available information suggests that the loosely coupled network of AAAs has been a key, adaptable resource. This article begins with a description of the Aging Network and its history before turning to how the community-specific, collaborative, and evolving nature of AAAs places them at a unique position to respond to the challenges that arise with COVID-19. It concludes with how AAAs can continue to adapt to meet the needs of older adults and the people who care for them.
Pharmacokinetics of bedaquiline, delamanid and clofazimine in patients with multidrug-resistant tuberculosis
Authors: Alghamdi Wael A , Al-Shaer Mohammad H , Kipiani Maia , Barbakadze Ketevan , Mikiashvili Lali , Kempker Russell R , Peloquin Charles A 
Published: December 2020

Abstract

Background
Pharmacokinetic data are needed for newly implemented anti-tuberculosis drugs to help optimize their use.

Objectives
To help fill existing knowledge gaps, we evaluated the pharmacokinetic parameters of novel and repurposed anti-tuberculosis drugs among patients with drug-resistant pulmonary tuberculosis.

Methods
A prospective cohort study among patients ≥16 years with confirmed pulmonary drug-resistant TB was conducted in Tbilisi, Georgia. Patients receiving bedaquiline, delamanid and/or clofazimine were included. Blood samples were collected 4–6 weeks after drug initiation, and serum concentrations were measured using validated liquid chromatography tandem mass spectrometry assays. A non-compartmental analysis was performed, and the association of exposure parameters with covariates was explored.

Results
Among 99 patients, the average age and weight were 40 years and 65 kg, respectively. The median Cmin was 0.68 mg/L for bedaquiline, 0.17 mg/L for delamanid, and 0.52 mg/L for clofazimine. The median AUC0–24 was 30.6 mg·h/L for bedaquiline, 16.1 mg·h/L for clofazimine, and the AUC0–12 was 2.9 mg·h/L for delamanid. Among the significant covariates associated with drug exposure parameters were weight and sex for bedaquiline, alcohol use for delamanid, and weight for clofazimine.

Conclusions
We found a strong association of weight with bedaquiline and clofazimine exposure parameters, suggesting the need for weight-based dosing for those agents.
Characterizing the performance of high-speed data converters for RFSoC-based radio astronomy receivers
Authors: Liu Chao , Jones Michael E , Taylor Angela C 
Published: December 2020

ABSTRACT
RF system-on-chip (RFSoC) devices provide the potential for implementing a complete radio astronomy receiver on a single board, but performance of the integrated analogue-to-digital converters (ADCs) is critical. We have evaluated the performance of the data converters in the Xilinx ZU28DR RFSoC, which are 12-bit, 8-fold interleaved converters with a maximum sample speed of 4.096 Giga-sample per second (GSPS). We measured the spurious-free dynamic range (SFDR), signal-to-noise and distortion (SINAD), effective number of bits (ENOB), intermodulation distortion (IMD), and cross-talk between adjacent channels over the bandwidth of 2.048 GHz. We both captured data for off-line analysis with floating-point arithmetic, and implemented a real-time integer arithmetic spectrometer on the RFSoC. The performance of the ADCs is sufficient for radio astronomy applications and close to the vendor specifications in most of the scenarios. We have carried out spectral integrations of up to 100 s and stability tests over tens of hours and find thermal noise-limited performance over these time-scales.