bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subjective Cognitive Impairment in Liver Transplant Recipients
Authors: Ko Dami , Dietrich Mary , Gifford Katherine , Ridner Sheila 
Published: December 2020

Abstract
Cognitive impairment is an emerging health concern in the liver transplant (LT) population. To successfully address this condition and improve patient-centered outcomes (e.g., quality of life), it is essential to involve LT recipients and caregivers in developing care plans for cognitive impairment and take into account their subjective ratings regarding recipients’ cognitive function. Although a high degree of agreement between recipient-rated and caregiver-rated cognitive function is desirable to reduce conflicts in developing plans, disagreement between the two may exist. This cross-sectional study is the first to examine the correlation between recipient-rated and caregiver-rated cognitive function in the LT population. Sixty pairs of adult LT recipients (mean age 60.4±6.9) and their caregivers (mean relationship with recipients 35 years) participated in this study. Two versions of Modified Everyday Cognition (ECog), one for LT recipients and the other for caregivers, were used to assess recipient-rated and caregiver-rated cognitive function in six domains, including memory and planning. Significant intra-class correlations were found in the ECog total and domain scores. The correlation coefficient of the ECog total score was 0.48, indicating a fair correlation, and the coefficients of the ECog domains ranged between 0.35 and 0.56, indicating poor to fair correlations based on the guideline of Cicchetti (1994). These findings suggest that a tailored approach to addressing the poor agreement between recipients and caregivers should be adopted to develop successful treatment plans for cognitive impairment. Future studies should examine the degree of agreement between objective (e.g., cognitive tests) and subjective ratings of cognitive function.
The Quantile Frailty Index: A Cutpoint-Free Approach to Biomarker-Based Health Assessment
Authors: Stubbings Garrett , Farrell Spencer , Mitnitski Arnold , Rockwood Kenneth , Rutenberg Andrew 
Published: December 2020

Abstract
We develop a frailty index (FI) from continuous valued biomarker measurements that does not use thresholds to binarize deficits. In this work we construct a quantile frailty index (FI-Q) directly from risk quantiles, without binarizing the deficits. FI-Q is the average risk quantile for an individual in the population with respect to the set of measured biomarkers. We show that FI-Q predicts adverse health outcomes better than either a quantile-based cutpoint approach or an FI-Lab method used in previous studies. We also address practical questions such as how to use longitudinal data. We use data from the English Longitudinal Study of Ageing (ELSA) for longitudinal analysis and data from the National Health and Nutrition Examination Survey (NHANES) and the Canadian Study of Health and Aging (CSHA) to compare predictive value of FI-QM with previous FI-Lab studies.
A SAS Macro for Cosinor Analysis of Automated Heart Rate Data in the ICU
Authors: Doyle Margaret , Murphy Terrence , Knauert Melissa 
Published: December 2020

Abstract
Cosinor analysis, developed by Franz Hallberg and colleagues in the 1960s, allows for the fitting of a cosine curve to data of known period and is frequently used in the analysis of circadian data. While software packages exist which will perform cosinor analyses, SAS has historically steered users to a reference (Ferrarra, 1993) that contains a flaw that results in miscalculation of the acrophase (peak) and nadir (minimum) values about half the time. The R package ‘cosinor’ includes the same error as the SAS reference. The macro we have written 1.) outputs a dataset with the correct values of acrophase, mesor, amplitude, nadir p-value for rhythmicity and R-squared for a curve fit to an individual’s data and 2.) plots the resulting curve and underlying data. While the macro does not allow for the simultaneous analysis of data from multiple individuals it will output the data from multiple curves so that these parameters can be used in downstream data analysis. We demonstrate the use of this macro on a dataset of automated heart rate data collected on patients in the intensive care unit. Given the growing use of automated data collection, it is vitally important that software that provides accurate statistical analysis of circadian phenomena be made widely available to clinical investigators.
Metabolic and Inflammatory Biomarkers, Multimorbidity Combinations and Disability Burden Among Older Americans
Authors: Botoseneanu Anda , Markwardt Sheila , Quinones Ana 
Published: December 2020

Abstract
Specific multimorbidity combinations, in particular those including arthritis, stroke, or cognitive impairment have been associated with high burden of ADL/IADL disability. However, the biologic underpinnings of these associations are still unclear. We used data from the Health & Retirement Study (N=5,359, age 65 years or older at baseline) and negative binomial regression models to evaluate if metabolic and inflammatory biomarkers [HbA1c, HDL-cholesterol, C-Reactive Protein (CRP)] mediate the association between specific multimorbidity combinations (at baseline in 2010-2012; grouped around one of eight index diseases: arthritis, cancer, cognitive impairment, diabetes, heart disease, hypertension, lung disease, and stroke) and ADL/IADL disability (at subsequent wave in 2012-2014). Results were adjusted for sociodemographic characteristics, body-mass index, number of coexisting chronic diseases, and baseline ADL/IADL score. HbA1c (IRR=1.01, p=0.004) and CRP (IRR=1.01, p=0.003), but not HDL, were positively associated with the number of coexisting diseases. After adjustment for coexisting diseases, higher HbA1c was associated with greater ADL/IADL limitations for multimorbidity combinations including arthritis (IRR=1.11, p=0.047) and stroke (IRR=1.11, p=0.047), but not for combinations centered around other diseases, while CRP was no longer significantly associated with ADL/IADL limitations for any of the multimorbidity combinations. Models accounting for HbA1c and CRP, respectively, showed that only combinations including cognitive impairment had greater ADL/IADL limitations (IRR=1.45, p=0.015) compared to combinations without cognitive impairment. Insulin resistance and inflammation are strongly associated with the burden of multimorbidity; this strong association, rather than the biomarkers per se, appears to explain the greater ADL/IADL burden observed with all disease-specific multimorbidity combinations, except cognitive impairment.
Do Centenarians With Higher Life Satisfaction Live Longer?
Authors: Ribeiro Oscar , Araújo Lia , Afonso Rosa Marina , Teixeira Laetitia 
Published: December 2020

Abstract
Subjective well-being (SWB) is defined as a person’s cognitive and affective evaluation of life and has been recognized as one of the main psychological factors associated with better health and longevity in different age groups. Several studies evidenced its influence on all-cause mortality, but such a relation has been scarcely explored in individuals aged 100 years and over. The aim of this study is to evaluate the role of SWB in the survival of a sample of centenarians. Two studies conducted in Portugal (PT100 Oporto and PT100 Beira Interior) followed individuals from the age of 100+ years, checking their survival every six months over the period of December 2013 until June 2019. The Satisfaction With Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985) was used at baseline as a measure of subjective well-being. Given that this is a self-reported scale, only a subsample of centenarians with cognitive capacity were included in this study (n=82; 67 (80.7%) women; mean age at baseline 101 years (sd=1.3 years)). Results obtained through a univariate Cox proportional hazards model suggest that longer survival was associated with higher levels of life satisfaction, highlighting the importance of this psychological dimension for longevity even at very advanced ages.
Macular Ganglion Cell–Inner Plexiform Layer as a Marker of Cognitive and Sensory Function in Midlife
Authors: Merten Natascha , Paulsen Adam , Pinto A Alex , Chen Yanjun , Dillard Lauren , Fischer Mary , Schubert Carla , Cruickshanks Karen 
Published: December 2020

Abstract
Neurodegenerative diseases are public health challenges in aging populations. Early identification of people at risk for neurodegeneration might improve future treatment. Noninvasive, inexpensive screening tools are lacking but of great potential. Optical coherence tomography (OCT) measures nerve cell layer thicknesses in the retina, which is an anatomical extension of the brain and might be reflective of generalized neurodegeneration. We aimed to determine associations of macular ganglion cell-inner plexiform layer (mGCIPL) thickness with cognitive and sensorineural function in midlife. This study included 1880 Beaver Dam Offspring Study participants from the 10-year follow-up examination. We assessed cognition (principal component analysis of multiple cognitive test scores), cognitive impairment, hearing sensitivity thresholds and impairment, central auditory processing (% correct on a dichotic digits test), and visual and olfactory impairment. We measured mGCIPL using the Cirrus 5000 HD-OCT Macular Cube Scan. Multivariable linear and logistic regression models were used to determine associations of mGCIPL thickness and thin mGCIPL, defined as 1 standard deviation below average, with cognitive and sensorineural functions. Thinner mGCIPL was associated with worse cognition (0.01 standard deviation increase per µm thickness;95% confidence interval (CI) 0.01,0.02;p&lt;.0001), worse central auditory function (0.07% increase per µm thickness;CI 0.01,0.13;p=.03) and visual impairment (Odds Ratio=0.95;CI 0.94,0.97;p&lt;.0001). MGCIPL thickness was associated with hearing sensitivity in women only. There were no associations with impairments in hearing, olfaction and cognition. Results for thin group comparisons were consistent. MGCIPL thickness is associated with cognitive and sensorineural function and has potential as a marker for neurodegeneration in middle-aged adults.
Experience-Based Co-Design to Develop an Injury Prevention Intervention in Skilled Nursing Facilities
Authors: McConnell Eleanor , Berry Sarah , Hecker Emily , Herndon Laurie , Colon-Emeric Cathleen 
Published: December 2020

Abstract
Experience-based co-design (EBCD) improves clinical effectiveness and safety by incorporating end-user perspectives in the design of clinical interventions. To refine a centralized, multi-component fall-related injury prevention service (IPS) to be tested in skilled nursing facilities (SNFs) in a pragmatic trial, we employed a modified EBCD process. We first conducted in-depth interviews with SNF residents, family members, and staff (n = 28; three facilities in two states) regarding their experiences in falls prevention. We then engaged these and other stakeholders from multiple institutions (n=4) in a day-long co-design workshop with our interdisciplinary research team. Building upon themes drawn from the analysis of interviews, we targeted three intervention components that were refined during the workshop: de-prescribing process, osteoporosis treatment, and educational videoconferences. Key outcomes from the ECBD process included development of strategies to ensure that: (1) residents, families, and SNF staff are involved in communication about residents identified as high risk for fall-related injury, and in related treatment decisions; (2) approaches to monitoring for unintended consequences from the injury prevention plan are clearly understood by direct care staff and are compatible with existing workflow; (3) treatment plan risks and benefits are presented in a manner easily understood by stakeholders; and (4) staff education conferences build trust with the IPS nurse and provide direct care staff with support and advice about challenging cases. EBCD is a feasible approach to strengthen intervention development in SNFs and can lead to testable new ideas for protocol refinement to address diverse stakeholder perspectives.
Differences in Characteristics Associated With Mobility in Older Dwellers of a Hillside Residential Community
Authors: Nitanai Ryoichi , Ogino Ryogo , Umemoto Daisuke , Matsumura Yu , Sakurai Rika , Hosogaya Kazutate , Endo Takaaki , Goto Jun 
Published: December 2020

Abstract
In a super-ageing society, sustaining outings as an elderly person is necessary for maintaining good health and preventing frailty and social isolation. Avoiding driving cars and walking due to ageing are among factors that deter the elderly from going out. However, the characteristics associated with mobility on foot and by car in actual outings of the elderly have not been examined. To explore these characteristics, we conducted interviews with 23 elderly participants living in a suburban hillside residential community in Japan, and investigated the destinations, routes, and means of all their outings for a certain week. Then, spatial analysis was conducted to identify differences in behavioral characteristics associated with mobility on foot and by car/taxi among three age groups: 70–79, 80–84, and 85+. Consequently, two inclinations were identified. First, the older the group, the smaller the area of the outing on foot due to difficulties in walking on slopes for a long duration with luggage. Second, the use of a car/taxi varies among the three groups. While the 70–79 age group used cars/taxis for district-to-district trips, the 80–84 age group rarely used them, and further, the 85+ age group mainly travelled by them one-way or made back-and-forth trips. To summarize, for older suburban dwellers in a hillside residential community, mobility on foot is lowered by physical and mental weakness and the landscape. Therefore, even though mobility increases by using cars/taxis, willingness for outing has changed with ageing, and thus, they make limited use of opportunities.
Confirmatory Factor Analysis of the Perceived Stress Scale-10 Across Age Groups
Authors: Intrieri Robert , Goodwin Paige 
Published: December 2020

Abstract
The Perceived Stress Scale-10 (PSS; Cohen et al, 1983) was developed to measure subjective elements of stress. Most measures focus on objective characteristics of stress (e. g., frequency of occurrence) and specific situations that produce stress (e. g., divorce) but ignore the cognitive appraisal associated with stressful stimuli. The PSS-10 assesses the interplay between stressor and appraisal-mediated coping ability. Factor analytic studies provide support for two factors: perceived helplessness and perceived self-efficacy (see Roberti et al. 2006). The current study presents data from 591 people across three groups: 221 young adults (mean age 19.31, SD = 1.21), 283 middle-age adults (mean age 48.27, SD = 5.14), and 109 older adults (mean age 72.95, SD = 7.22). An ordinal confirmatory factor analysis (CFA) using robust weighted least squares (WLSMV) evaluated invariance across age groups. Results showed CFI/TLI values of .964/.953, 965/.960, and .964/.969 for Configural (CI), Metric (MI), and Scalar (SI) models. The RMSEA for CI, MI, and SI models was .086, .081, and .071. Based upon recommendations of Cheung and Rensvold (2002), Sass (2011), and Chen (2007), a cutoff of ΔCFI ≥ 0.01 was established as evidence of invariance. The ΔCFI between CI and MI models was &lt; .01 so analysis continued with the SI test. Once again, ΔCFI between MI and SI models was &lt; 0.01 which did not justify rejection of the null hypothesis. Based on these analyses, PSS-10 scores are valid across multiple age groups. Further, results support the multidimensional nature of the PSS-10.
eMental Health Literacy and the Relationship to Barriers to Mental Health Care
Authors: Root Eve , Caskie Grace 
Published: December 2020

Abstract
According to the American Psychological Association (2017), one in four individuals who are 65 years and older experience a mental health problem; however, many older adults do not receive the services they need and deserve (Karlin, 2008). The current study utilizes a new concept similar to eHealth Literacy called eMental Health Literacy, defined as the degree to which individuals obtain, process, and understand basic mental health information and services needed to aid their recognition, management, or prevention of mental health issues. The relationship of eMental Health Literacy to perceived barriers to receiving mental health services was examined in a sample of middle-aged and older adults. We hypothesized that higher eMental Health Literacy would predict fewer reported barriers to mental health services. A sample of 243 participants (M=63.33, range=55-80 years) were recruited online through Amazon Mechanical Turk to complete measures assessing eMental Health Literacy (eMHEALS) and mental health barriers (BMHSSS-R). After adding two correlated errors, a structural equation model specifying eMHEALS as a predictor of extrinsic and intrinsic barriers to mental health services achieved good fit (χ2(60)=170.014, p&lt;.001, SRMR=.068, CFI=.944, GFI=.901, TLI=.927, RMSEA=.087). All indicators were significantly related to their latent construct (p&lt;.001). The results indicate higher eMental Health Literacy significantly predicted fewer reported intrinsic and fewer extrinsic barriers to mental health services. These relationships were statistically significant even when examined across differing socioeconomic status and age. These findings indicate eMental Health Literacy may have significant impact on the way individuals in later life navigate through the mental healthcare system.
The Effects of the COVID-19 Pandemic on the Lived Experience of Diverse Older Adults Living Alone With Cognitive Impairment
Authors: Portacolone Elena , Chodos Anna , Halpern Jodi , Covinsky Kenneth E , Keiser Sahru , Fung Jennifer , Rivera Elizabeth , Tran Thi , Bykhovsky Camilla , Johnson Julene K 
Published: December 2020

Abstract

Background and Objectives
Even before the COVID-19 pandemic, older adults with cognitive impairment living alone (an estimated 4.3 million individuals in the United States) were at high risk for negative health outcomes. There is an urgent need to learn how this population is managing during the pandemic.

Research Design and Methods
This is a qualitative study of 24 adults aged 55 and older living alone with cognitive impairment from diverse racial/ethnic backgrounds. Participants’ lived experiences during the pandemic were elicited via 59 ethnographic interviews conducted over the phone either in English, Spanish, or Cantonese. Using a qualitative content analysis approach, interview transcripts were analyzed to identify codes and themes.

Results
Qualitative analysis of transcripts revealed 5 themes: (a) fear generated by the pandemic, (b) distress stemming from feeling extremely isolated, (c) belief in misinformation, (d) strategies for coping during the pandemic, and (e) the importance of access to essential services.

Discussion and Implications
This pandemic put a spotlight on the precarity and unmet needs of older adults living alone with cognitive impairment. Findings underscore the need to expand access to home care aides and mental health services for this population.
Noncoding RNAs as Promising Diagnostic Biomarkers and Therapeutic Targets in Intestinal Fibrosis of Crohn’s Disease: The Path From Bench to Bedside
Authors: Zhou Long-Yuan , Lin Si-Nan , Rieder Florian , Chen Min-Hu , Zhang Sheng-Hong , Mao Ren 
Published: December 2020

Abstract
Fibrosis is a major pathway to organ injury and failure, accounting for more than one-third of deaths worldwide. Intestinal fibrosis causes irreversible and serious clinical complications, such as strictures and obstruction, secondary to a complex pathogenesis. Under the stimulation of profibrotic soluble factors, excessive activation of mesenchymal cells causes extracellular matrix deposition via canonical transforming growth factor-β/Smads signaling or other pathways (eg, epithelial-to-mesenchymal transition and endothelial-to-mesenchymal transition) in intestinal fibrogenesis. In recent studies, the importance of noncoding RNAs (ncRNAs) stands out in fibrotic diseases in that ncRNAs exhibit a remarkable variety of biological functions in modulating the aforementioned fibrogenic responses. In this review, we summarize the role of ncRNAs, including the emerging long ncRNAs and circular RNAs, in intestinal fibrogenesis. Notably, the translational potential of ncRNAs as diagnostic biomarkers and therapeutic targets in the management of intestinal fibrosis is discussed based on clinical trials from fibrotic diseases in other organs. The main points of this review include the following:
• Characteristics of ncRNAs and mechanisms of intestinal fibrogenesis
• Wide participation of ncRNAs (especially the emerging long ncRNAs and circular RNAs) in intestinal fibrosis, including transforming growth factor-β signaling, epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition, and extracellular matrix remodeling
• Translational potential of ncRNAs in the diagnosis and treatment of intestinal fibrosis based on clinical trials from fibrotic diseases in other organs
Overview of Factors Associated with HIV Viral Load Suppression in Transgender Women
Authors: Goldstein Zil G 
Published: December 2020

Abstract

Background
Transgender women face a significantly higher HIV burden than their cisgender counterparts around the world with worse treatment outcomes in almost all categories.

Content
A mini-review of the available literature discussing HIV risk and factors associated with HIV viral load suppression in transgender women.

Summary
This review discusses the disparities transgender women face that contribute to both of these factors including race as well as social determinants of health and how they affect the HIV treatment cascade in this population.