bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effective and Evidence-Based: How the 4Ms Age-Friendly Framework Can Result in Improved Care in a Rural Primary Care Clinic
Authors: Tobey Leah , McAtee Robin 
Published: December 2020

Abstract
As healthcare providers struggle to reframe aging, framing Age-Friendly care is also occurring. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with an objective to improve clinical health outcomes of older adults (OA) in primary care settings. As a member of the 2020 Institute for Healthcare Improvement (IHI) Age-Friendly cohort, the AGEC has partnered with ARcare, an AR federally qualified healthcare clinic network, to implement the 4Ms in 4 rural clinics over 3 years. AGEC’s first goal of working with rural primary care clinics is to improve their knowledge of best practices of caring for OA. This was started by providing Geriatric Interdisciplinary Team Training to clinic staff, obtaining baseline data of common health related indicators for OA and starting regular geriatric focused training. Training on the 4Ms (Matters, Medication, Mentation Mobility) framework was next and completed followed by planning and implementation. The process was well received and results are promising. Year 1 data in one clinic show incremental improvements over baseline data in several areas including assessing Mobility with fall screens which has improved over 50% in one year and annual wellness visits (where all 4Ms are reviewed) have increased 30%. However, several areas of opportunities for improvement have also been noted and turned into quality improvement projects (QI). This includes an opportunity to improve depression screens for the clinic’s Mentation measure, which dropped almost 30% in one year. QI projects are ongoing to improve each of the elements of becoming age-friendly.
High Occurrence of Dementia in Older Adults Returning to Community From Prison
Authors: Byers Amy , Li Yixia , Barry Lisa 
Published: December 2020

Abstract
Very little is known about Alzheimer’s Disease and related dementias (AD/ADRD) and diseases (e.g., Parkinson’s/PD) in older adults returning to community from prison (“older reentry adults”). We utilized a national sample of older veterans to conduct the first study documenting the occurrence (prevalence/incidence) of AD/ADRD and related diseases in older reentry adults. We examined 28,235 reentry veterans who were aged 50 years and older at their most recent release date and Medicare beneficiaries, 2008 through December 31, 2017. AD/ADRD and related diseases were identified by ICD-9/10 codes in the electronic health record from Medicare and inpatient/outpatient Veterans Health Administration data. We examined distributions of AD/ADRD and related diseases across 4 age categories (sample %): 50-64 (55%), 65-74 (37%), 75-84 (7%), and 85+ (0.7%). Of the 28,235 veterans 50 years and older, 17% (n=4,725) had dementia (defined by AD/ADRD based on NIA criteria) or mild cognitive impairment (MCI) and 3% (n=794) had PD. Of those with dementia/MCI, 18% had AD and 26% MCI. Nearly 40% of dementia diagnoses occurred prior to/on most recent release date, and 40% of PD diagnoses occurred prior to/on most recent release date. Differences were significant across age groups (P&lt;.001), with very high rates of diagnoses across all age groups, as well as indicative of high occurrence of early onset dementia and “accelerated aging” [50-64, 14%; 65-74, 18%; 75-84, 33%; and 85+, 53%]. This study is a first step in filling a major research gap by describing AD/ADRD, MCI and related diseases in reentry adults.
Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype
Authors: Odasso Manuel Montero , Speechley Mark , Camicioli Richard , Kamkar Nellie , Tian Qu , Ferrucci Luigi , Bray Nick , Pieruccini-Faria Frederico 
Published: December 2020

Abstract
BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.
Exploring the Experiences of Persons Living With Dementia and Their Care Partners in a Memory Café-Style Program
Authors: Bunting Morgan , Antonsdottir Inga , Bailey Marti , Samus Quincy 
Published: December 2020

Abstract
Community-based supportive care interventions are needed to address unmet needs and maximize quality of life for persons living with dementias and their care partners (care dyad). Memory cafés and similar programs serve as a potentially important vehicle to reduce dementia stigmatization, improve inclusiveness, promote well-being, socialization and meaningful activity engagement, and disseminate dementia-related education and knowledge. Despite gaining popularity, little is known about how these programs impact participants or how they work best. The Club Memory® program in Washington, D.C. is an enhanced memory café-style program that delivers a normalizing environment, decreased negative stigma and a chance to experience a catalyst for change despite disease progression. Using qualitative methods, we investigated the perceived impact, benefits, and weaknesses of Club Memory from multi-stakeholder perspective, to explore how this program might be improved and standardized for broader implementation. We conducted two focus groups, one of care partners and one of persons living with dementia (N=12). Upon analyzing transcriptions, five common themes emerged among the focus groups: Atmosphere, Sense of Community, Skill-Building, Tools and Strength in Staff. Integrating perspectives from the care dyad revealed congruent thoughts on program perception, benefits and strengths, and opportunities for improvement. Club Memory® appears to be a valuable model that creates a stigma-free supportive environment, educates and engages the care dyad to foster understanding, confidence, curiosity and empowerment. Our findings contribute to a deeper understanding of the impact community-based strategies can positively impact the care dyad’s life.
Stigmatizing Beliefs About Alzheimer’s Disease in Diverse Ethnic Groups of Asian Americans
Authors: Liang Jiaming , Jang Yuri 
Published: December 2020

Abstract
Cumulative studies have investigated Alzheimer’s disease (AD)-related issues among Asian Americans, but few have considered ethnic diversities within the Asian group. Using an ethnic-diverse Asian American sample, the present study explored the prevalence, ethnic variations, and predictors of stigmatizing beliefs about AD: (1) AD is a normal process of aging, (2) it is embarrassing to have a family member with AD, and (3) social interactions with an AD patient should be avoided. Inspired by the sociocultural health beliefs model, a focus was given on the role of immigration and culture-related variables. Using data from the 2015 Asian American Quality of Life survey (N = 2609, age range = 18-98) that includes Chinese, Asian Indian, Korean, Vietnamese, Filipino, and other Asians, logistic regression was conducted to examine how each of the three stigmatizing beliefs would be predicted by (1) demographic variables and (2) immigration and culture-related variables. Results indicate that the prevalence of the stigmatizing beliefs about AD varied across ethnicities. More than 63% of Vietnamese associated AD with a normal process of aging, and about 10% of Chinese reported that they would feel embarrassed if their family member had AD. Logistic regression models demonstrated that advanced age, male gender, low education, and limited English proficiency increased the odds of reporting one or multiple stigmatizing beliefs about AD. The findings suggest a varying degree of AD-related misconceptions and stigmatization and call attention to the need for culturally sensitive community education on AD in Asian communities.
Effects of fNIRS Processing Methods on Prefrontal Hemodynamics During Single and Dual Task Walking in Older Adults
Authors: Izzetoglu Meltem , Holtzer Roee 
Published: December 2020

Abstract
functional near infrared spectroscopy (fNIRS) has been increasingly used to assess changes in the hemodynamic response during active walking in aging and disease populations. Key findings revealed that HbO2 in the prefrontal cortex (PFC) increased from single-task-walk (STW) to dual-task-walk (DTW) due to the greater cognitive demands inherent in the latter condition. However, previous studies utilized a limited and inconsistent number of algorithms and filters to remove artifacts from fNIRS-derived brain activation data. Critically, there is no gold standard for artifact removal at the present time, which reduces replicability and generalizability. To address this critical limitation, we have reanalyzed a large dataset of older adults (n=83) who underwent our walking protocol by using different hemodynamic conversion parameters (molar extinction coefficients and age and wavelength dependent differential pathlength factors) and applying different filters having various cut-off frequencies for artifact removal. On the extracted hemodynamic responses, namely oxygenated-hemoglobin (HbO2) and deoxygenated-hemoglobin (Hb), linear mixed effect model results indicated that task effects showed similar significant increases in HbO2 from STW to DTW (range of effect sizes was 0.59 to 0.64) and as well as the expected decline in Hb from STW to DTW (range of effect sizes was 0.18 to 0.32) irrespective of the methods used. In addition, the intraclass correlations suggested excellent reliability across methods (HbO2 range = 0.982 to 0.996; Hb range = 0.883 to 0.984). In conclusion, these findings provide strong support to previously published articles but also highlight the need to establish a gold standard for fNIRS processing.
Mediators of the Relationship Between Functional Limitations and Loneliness Among Homebound African Americans
Authors: Dowling Maritza , Dodge Hiroko , Puente Antonio , Lunsford Beverly 
Published: December 2020

Abstract
Physical/functional limitations are known to lead to loneliness, but there is little research on protective factors that may mediate their adverse association, particularly in vulnerable populations. This study used cross-sectional survey data from 147 (aged 58-90 years; 75% females) predominantly low-income African American homebound community dwellers to investigate the role of resilience and social connectedness in mediating the effect of physical/functional limitations on loneliness. Items from validated instruments were used to measure four latent variables (physical/functional limitations, resilience, loneliness and social connectedness). Structural parallel mediator models estimated each path in the mediation analysis controlling for gender, education, and age. Confidence intervals for mediation effects were generated via bias-corrected bootstrapping with 10,000 replications. The total effect of physical/functional limitations on perceived loneliness was significant. Social connectedness and resilience fully and significantly mediated the relationship between physical/functional limitations and loneliness. The indirect effect (B =.143; 95% CI = .047, .280) for the physical/functional limitations-resilience-loneliness pathway indicated that the positive effect of physical/functional limitations on loneliness was approximately 0.143 points lower as mediated by higher resilience. The indirect path of physical/functional limitations on loneliness through the mediation of social connectedness (B =.077; 95% CI = .010, .168) yielded a reduction of .077 points. The total amount of variance in feelings of loneliness accounted for by the overall model, which included the proposed mediators and control variables, was 48.6%. Interventions to build resilience and social interactions may attenuate the effects of physical/functional disability and loneliness on health outcomes in individuals at risk.
Financial Decision Making and Survey Responses of Older Couples
Authors: Curl Angela , Molina Estevan Tobias 
Published: December 2020

Abstract
The Health and Retirement Study (HRS) asks mid-life and older couples to identify the person most knowledgeable about household finances to provide responses to financial questions (“financial respondent” [FR]). The purpose of this study is to analyze predictors of a female FR, with a focus on gendered financial decision making. This study analyzed HRS data from 2012 to 2018. Our sample consisted of 5,038 married/partnered couples over the age of 50 (at baseline), after eliminating cases with missing data on study variables. Using HLM 6.08 software, we computed the odds of couple households having a female FR. Our main predictor was the amount of female financial decision making power, as measured using eight Likert scale items (0=male always makes this decision, 4=female always makes this decision), for purchases (e.g., cars, major appliances) and financial activities (e.g., paying bills, buying groceries); summed into a scale (range: 0-32). Our models controlled for race, ethnicity, education, income, age, health, cognitive ability, and depressive symptoms. Results indicate that men were more likely to be the FR, but when the female makes more household financial decisions then she is more likely to be the FR (OR = 1.16, p&lt;.01). Black race, lower income, and time also increased the odds of a female FR. This study highlights women’s historical and ongoing limited power in financial matters of married couples. Financial knowledge and decision making skills should be encouraged for both partners in couple households.
The development of seismic anisotropy below south-central Alaska: evidence from local earthquake shear wave splitting
Authors: Karlowska E , Bastow I D , Rondenay S , Martin-Short R , Allen R M 
Published: December 2020

SUMMARYThe Transportable Array in south-central Alaska spans several subduction zone features: backarc, forearc and volcanic arc, making it an ideal tool to study subduction zone anisotropy. Shear wave splitting analysis of 157 local earthquakes of mb ≥ 3.0 that occurred between 2014 and 2019 yields 210 high-quality measurements at 23 stations. Splitting delay times (δt) are generally small (δt ≈ 0.3 s), increasing with distance from the trench. Arc-parallel fast directions, ϕ, are only seen in the forearc, but rotate to arc-perpendicular ϕ in the backarc. Observed ϕ values generally do not parallel teleseismic SKS splitting results, implying that the latter is sensitive primarily to subslab mantle flow, not mantle wedge dynamics. The forearc local-earthquake signal likely originates from anisotropic serpentinite in fractures atop the subducting Pacific Plate, with possible additional signal coming from fractures in the North American crust. Mantle wedge corner flow, potentially with additional arc-perpendicular anisotropy in the subducting slab, explains backarc anisotropy.
COVID-19 and the proliferation of urban networks for health security
Authors: Boyce Matthew R , Katz Rebecca 
Published: December 2020

Abstract
Recent years have witnessed cities establishing themselves as major players in addressing global issues, often taking collective action through international city networks and organizations. These networks are important, as they amplify the voices of municipal officials, who are often excluded from high-level decision-making, and can also provide a platform for officials from low- or middle-income nations to participate in higher-level political forums. The global response to the COVID-19 pandemic has included traditional public health stakeholders—including supranational organizations, international non-governmental organizations and national authorities—but has also featured mayors and city networks, in an unprecedented fashion. Existing networks without an explicit focus on health have shifted their focuses to prioritize pandemic response and several new networks have been created. These developments are significant, not only because they represent a shift in health governance and policy, but also because cities and urban networks more broadly have exhibited a nimbleness and pragmatism unmatched by higher levels of governance. These characteristics could prove beneficial for addressing the current pandemic, as well as future health issues and emergencies. Furthermore, given the relative lack of engagement with health security issues before the COVID-19 pandemic, the drastic health and economic impacts associated with it, and the demonstrable value added by strong city leadership, there are an open policy window and a compelling case for continued city engagement in health security.
SPEG binds with desmin and its deficiency causes defects in triad and focal adhesion proteins
Authors: Luo Shiyu , Li Qifei , Lin Jasmine , Murphy Quinn , Marty Isabelle , Zhang Yuanfan , Kazerounian Shideh , Agrawal Pankaj B 
Published: December 2020

Abstract
Striated preferentially expressed gene (SPEG), a member of the myosin light chain kinase family, is localized at the level of triad surrounding myofibrils in skeletal muscles. In humans, SPEG mutations are associated with centronuclear myopathy and cardiomyopathy. Using a striated muscle-specific Speg-knockout (KO) mouse model, we have previously shown that SPEG is critical for triad maintenance and calcium handling. Here, we further examined the molecular function of SPEG and characterized the effects of SPEG deficiency on triad and focal adhesion proteins. We used yeast two-hybrid assay, and identified desmin, an intermediate filament protein, to interact with SPEG and confirmed this interaction by co-immunoprecipitation. Using domain-mapping assay, we defined that Ig-like and fibronectin III domains of SPEG interact with rod domain of desmin. In skeletal muscles, SPEG depletion leads to desmin aggregates in vivo and a shift in desmin equilibrium from soluble to insoluble fraction. We also profiled the expression and localization of triadic proteins in Speg-KO mice using western blot and immunofluorescence. The amount of RyR1 and triadin were markedly reduced, whereas DHPRα1, SERCA1 and triadin were abnormally accumulated in discrete areas of Speg-KO myofibers. In addition, Speg-KO muscles exhibited internalized vinculin and β1 integrin, both of which are critical components of the focal adhesion complex. Further, β1 integrin was abnormally accumulated in early endosomes of Speg-KO myofibers. These results demonstrate that SPEG-deficient skeletal muscles exhibit several pathological features similar to those seen in MTM1 deficiency. Defects of shared cellular pathways may underlie these structural and functional abnormalities in both types of diseases.
Declining mortality in older people with type 2 diabetes masks rising excess risks at younger ages: a population-based study of all-cause and cause-specific mortality over 13 years
Authors: Sacre Julian W , Harding Jessica L , Shaw Jonathan E , Magliano Dianna J 
Published: December 2020

Abstract

Background
Excess mortality in people with vs without type 2 diabetes (T2DM) has fallen, but it is unclear whether men/women at all ages have benefited and which causes of death have driven these trends.

Methods
All-cause and cause-specific mortality rates and excess mortality [by mortality rate ratios (MRRs) relative to the non-diabetic general population] were examined in 1 268 018 Australians with T2DM registered on the National Diabetes Services Scheme (2002–2014).

Results
Age-standardized mortality decreased in men (−2.2%/year; Ptrend &lt; 0.001) and women with T2DM (−1.3%/year; Ptrend &lt; 0.001) throughout 2002–14, which translated to declines in the MRRs (from 1.51 to 1.45 in men; 1.59 to 1.46 in women; Ptrend &lt; 0.05 for both). Declining mortality rates in T2DM were observed in men aged 40+ years and women aged 60+ years (Ptrends &lt;0.001), but not at younger ages. However, the only age group in which excess mortality declined relative to those without diabetes was 80+ years (Ptrends &lt; 0.05); driven by reductions in excess cancer-related deaths in men and cardiovascular disease (CVD) in women. Among age groups &lt;80 years, CVD and cancer MRRs remained similar or increased over time, despite falls in both CVD and cancer mortality rates. MRRs for non-CVD/non-cancer-related deaths increased in 60–79 year-olds, but were otherwise unchanged.

Conclusions
Declining excess mortality attributable to T2DM from 2002–14 was driven entirely by reductions in those aged 80+ years. Declines in total mortality among those with T2DM were apparent in more age groups, but often to a lesser extent than in the general population, thereby serving to increase the excess risk associated with T2DM.
Reaction–subdiffusion systems and memory: spectra, Turing instability and decay estimates
Authors: Yang Jichen , Rademacher Jens D M 
Published: December 2020

Abstract
The modelling of linear and nonlinear reaction–subdiffusion processes is more subtle than normal diffusion and causes different phenomena. The resulting equations feature a spatial Laplacian with a temporal memory term through a time fractional derivative. It is known that the precise form depends on the interaction of dispersal and reaction, and leads to qualitative differences. We refine these results by defining generalized spectra through dispersion relations, which allows us to examine the onset of instability and in particular inspect Turing-type instabilities. These results are numerically illustrated. Moreover, we prove expansions that imply for one class of subdiffusion reaction equations algebraic decay for stable spectrum, whereas for another class this is exponential.