bluuebunny/crossref_metadata_2025_split huggingface dataset:
Going Viral: Understanding Medical Misinformation and Older Adults’ Vaccine Hesitancy
Authors: Mirza Raza , Hull James , Peng Siyu , Mousavi Yalda , Mustafa Muhammad Ibrar , Papageorgiou Peter , Rotgaus Eric , Hsieh Jessica 
Published: December 2020

Abstract
Influenza persists as a common communicable disease and remains a significant cause of disease burden across the world. Despite preventative therapies, such as influenza vaccination to reduce its spread and transmission, influenza continues to be a source of morbidity and mortality, even in developed countries. For the population over the age of 65, the effects of influenza virus may be more severe when they are compounded by pre-existing conditions and reduced natural immune function. In light of plateauing vaccination rates, a scoping review was conducted to map the literature and determine why seniors aged 65 and above refuse or fail to receive seasonal influenza vaccination. Nine peer-reviewed academic databases covering both social sciences and medical research were searched, along with the grey literature. A total of 6,562 references were identified; after the screening process, 118 references were included in the final review. Thematic analysis focused on the broad areas that positively or negatively influence older adults’ decision-making regarding influenza vaccination, and this resulted in five main themes: (1) barriers to obtaining vaccination; (2) social factors; (3) personal characteristics; (4) individual subjectivity; and (5) direct clinical interventions. This review aims to identify gaps in knowledge and synthesize currently available information to make recommendations for future research, policy development and clinical practice. Increasing the vaccination rate among Canadian older adults will contribute to ongoing efforts to reduce the spread of the influenza virus among the population, reducing influenza-associated hospital admissions and deaths.
Sense of Belonging, Religious Activity, and Well-Being in Long-Term Care Residents
Authors: Shryock Kelly , Meeks Suzanne 
Published: December 2020

Abstract
Residence in a long-term care (LTC) facility poses numerous challenges to psychological well-being and rates of depression are high. Sense of belonging (SoB) has been linked with measures of well-being in all age groups and interventions focused on improving SoB have been successful with college-age adults. It is unclear if SoB improves in LTC residents as they adjust to living in this environment or what factors predict poor SoB in this population. As part of a larger study of care preferences in LTC residents, participants (n= 76) completed measures of SoB, well-being, religious activity, and demographic information. SoB did not vary significantly based on duration of stay, age, gender, ethnicity, marital status, number of children, education, facility, cognitive functioning, or physical health. SoB was found to be significantly and positively correlated with participation in religious activities (r= .388, N=76, p=.001), private religious practices (r= .275, N=71, p=.020), and spirituality (r= .263, N=70, p=.028). There was also a significant positive correlation between SoB and positive affect (r= .450, N=74, p&lt;.001) and SoB and life satisfaction (r= .393, N=74, p=.001). These results suggest that connections formed before admission to a LTC facility, including religious networks, are important to SoB and well-being and that individuals without or with low religious involvement may benefit most from interventions focusing on improving SoB in LTC residents.
Increasing Adoption and Utility of Smartwatches in Older Adults
Authors: Roberts Mitchell , Sappington Erica , Yalcin Ali , Lowenkron Jeffrey , Amzallag David , VandeWeerd Carla 
Published: December 2020

Abstract
Older adults (55+) represent one of the fastest growing groups adopting wearable devices (e.g. smartwatches). However, questions remain as to how older adults, healthcare providers and researchers can maximize the ability of these devices to maintain and improve health. The objective of this study was to understand the needs and preferences of older adults in wearable devices, as part of a Florida High Tech Corridor Matching Grant between The Villages Health, Aviv/Xtend Scientific, and The University of South Florida. Six focus groups were conducted with older adults (n=36) living in The Villages, Florida, and were stratified by gender. Topics such as adoption, benefits/concerns, usability, and potential gender differences were explored. Heart rate monitoring, calories burned, and step counting features were most often utilized by current wearable users (43%). Participants reported that the most important benefits of wearables were atrial fibrillation identification, fitness tracking and fall detection. Concerns included privacy, the “learning curve” and too frequent of notifications by the device. Across both genders, choice resonated strongly as a theme. Male and female participants desired personalized, easy to understand outcomes and control over data sharing preferences. Men were interested in continual access to wearable health data, whereas females were interested in daily or weekly summaries. Further, men reported higher on-going use and comfort with smartwatches as compared to females. Participants suggested “low, medium, and high-tech savvy” user profiles and supporting resources (e.g. 1-1 training, paper manuals) to enhance adoption. Recommendations for policy and practice are shared, in light of the findings.
Moving Toward Age-Diverse Universities: Perspectives of Admission and Career Service Professionals
Authors: Morrow-Howell Nancy , Galucia Natalie , Swinford Emma , Meyer Tanner 
Published: December 2020

Abstract
As age diversity in universities increases in response to demographic shifts, changes in educational practices, programs and policies are needed. To inform these transformations, this research focuses on opportunities and challenges of increasing age-diversity. We conducted 5 focus groups and included 31 professional staff at Washington University in St Louis who work in admissions and career services. A thematic content analysis revealed themes in two main categories: challenges of serving non-traditionally aged students (fitting in, career concerns, acclimating to learning environment and technology, ROI, and ageism) and benefits of older students (intentional students, experienced students, and classroom diversity). Recommendations emerged, including affinity groups, social opportunities which include families, community engagement for job placement, financial aid, targeted outreach to older students, academic flexibility, and administrative support. Findings will be used to advocate for increasing age-diversity among students at Washington University and other institutions in the Age-Friendly Global Network..
The Influence of Mental, Physical, and Social Activity on Episodic Memory of Americans Aged 50 and Older
Authors: Malatyali Ayse , Gordon Shirley , Morris John , Wiese Lisa , Williams Christine 
Published: December 2020

Abstract
The aim of this study was to describe the relationship between mental, physical, and social activity and episodic memory (EM) and further examine whether the relationship between these activities and EM is moderated by each activity type and demographics such as gender, marital status, and race. Participants were 3,903 cognitively intact persons who completed the 2016 Health and Retirement Study core interview and the 2015 Consumptions and Activities Mail Survey. Preliminary results showed no significant relationship between EM and mental, physical, and social activity. Mental activity significantly moderated the relationship between physical activity and EM, revealing a positive association between physical activity and EM for participants reporting low mental activity levels and a negative but non-significant association for participants with high mental activity scores. Although women demonstrated higher EM scores than men, there was a negative association between mental activity and EM for women. A significant reduction of EM performance was observed in participants who were divorced and widowed, compared to participants who were married. There was a positive relationship between physical activity and EM only for participants who were widowed. Furthermore, race significantly related to EM: African Americans had lower EM scores than Whites/Caucasians, but no significant association was found for the other race groups. Effect sizes were small throughout the analyses. Results emphasize the underlying relationship between different activity types and demographics in terms of EM performance. Further investigation is needed to explore changes over time in this relationship for persons who are cognitively intact or impaired.
Media Image Landscape: Age Representation in Online Images
Authors: Thayer Colette , Skufca Laura 
Published: December 2020

Abstract
This study looked at the extent to which the 50-plus population is portrayed in media images online. A random sample of images was drawn from 2.7 million images downloaded from professional and semiprofessional domains and social distributions for brands and thought leaders. Natural language processing technology was employed to find images using topical guides chosen to be reflective of online images. Results of this study showed that while some media has moved toward more positive visual representation of older people, the 50-plus population is still not accurately portrayed in the media. For example, while nearly half of the U.S. adult population is age 50-plus, only 15% of images containing adults include people this age. In addition, when the 50-plus are shown, they are more likely to be portrayed negatively than those under age 50. The 50-plus population is often portrayed as dependent and disconnected from the rest of world although most are actively engaged in their communities. They are rarely shown with technology and in work settings. Furthermore, while a myriad of vibrant personalities come across in images of adults under age 50, the representation of people 50-plus starts to homogenize and exaggerate stereotypical and outdated physical appearance characteristics. This study demonstrates the need for visual representations that reflect greater diversity and authenticity of the 50-plus population as these images affect the attitudes, expectations, and behaviors of older and younger people alike. Keywords: ageism, reframing aging, media image representation
Converting Physical Function Testing to the Remote Setting: Adapting Our Research Protocol During COVID-19
Authors: Winters-Stone Kerri , Lipps Colin , Guidarelli Carolyn , Herrera-Fuentes Pablo 
Published: December 2020

Abstract
Objective measurement of physical function can be a more sensitive predictor of future disability and changes over time than self-report measures. However, objective measures require in-person assessments which can limit their use in hard-to-reach populations. During the COVID-19 pandemic, laboratory assessment of physical functioning in our two large randomized controlled exercise trials in older adults with cancer was temporarily suspended. We adapted testing protocols for administering the short physical performance battery (PPB), including chair stand (CS; sec) and 4m usual walk (4MW; m/s) tests, and timed-up-and go (TUG; sec) tests of physical functioning for remote assessment by video conferencing technology. We report on interim assessments of inter and intra-rater reliability and validity against newly resumed in-person tests. Repeat assessments were conducted on the same participant 1-2 weeks apart, by the same assessor (intra-rater reliability) or by another assessor (inter-rater reliability) for remote visits and by the same assessor for in-person tests (validity). Pearson-product moment correlations are provided for PPB, CS, 4MW and TUG, in that order. Intra-rater reliability values are: 0.97, 0.88, 0.90, and 0.96; Inter-rater reliability values are: 0.79, 0.14, 0.40, and 0.99; Validity values (no TUG) are: 0.66, 0.81, 0.78. Reliability of conducting remote PPB by video is very high when using the same assessor, while TUG reliability is high within and between assessors. Remote PPB administration has a good correlation with in-person visits, but the two modes of delivery should not yet be used interchangeably in longitudinal studies until sources of error can be determined and minimized.
Loneliness among Rural and Underserved Older Adults During the COVID-19 Pandemic
Authors: Wilkinson Lindsay , Masters Julie , Kelly Christopher , McKelvey Miechelle , Saidi Ladan Ghazi , Hill Toni 
Published: December 2020

Abstract
During the COVID-19 pandemic, older adults are among the most vulnerable populations to the medical complications of COVID-19; however, they are also deeply affected by the unintended consequences of social distancing and sheltering in place. Social distancing effectively mitigates the spread of COVID-19, but this practice can also lead to social isolation and loneliness. Drawing on a sample of adults age 60 or older receiving Meals on Wheels/Grab and Go Meals in the state of Nebraska, this study investigates loneliness among rural and underserved older adults during the COVID-19 pandemic. Surveys were distributed to 3725 meal recipients across Nebraska’s eight Area Agencies on Aging in July 2020 (response rate = 50%), and a stratified random subsample was selected for preliminary analysis (N = 240). Logistic regression models were used to estimate the effects of COVID-19 and its associated safety precautions on loneliness. The findings reveal that 1 in 10 older adults have not left their home in over a month, and 38 percent feel lonelier due to the impact of COVID-19. Older adults who engaged in more community activities before the pandemic, reported leaving their home less, and experienced a longer absence of social interaction since the pandemic all had significantly increased odds of feeling lonelier in the COVID-19 era. Longer duration of sheltering in place was marginally associated with increased loneliness. The findings from this study show the consequences of social distancing on rural and underserved older adults, which calls for coordinated intervention.
Inhibition of Kynurenine Metabolism and Its Effect in Mitochondrial Function in Hepatocellular Carcinoma
Authors: Castro-Portuguez Raul , Freitas Samuel , Sutphin George 
Published: December 2020

Abstract
Hepatocellular carcinoma (HCC) is the most prevalent cancer in the liver. The majority of ingested tryptophan is processed in the liver through the kynurenine pathway, the endpoint of which is de novo NAD+ biosynthesis. Dysregulation of tryptophan-kynurenine metabolism and NAD+ synthesis may promote mitochondrial malfunction, tumor reprogramming, and carcinogenesis. Using a publicly available gene expression dataset from liver hepatocellular carcinoma (LIHC) samples available through The Cancer Genome Atlas (TCGA; n = 371), we employed Principal Component Analysis (PCA), hierarchical clustering, gene-pattern expression profiling, and survival analysis to cluster patients and determine overall survival. Our analysis of genes encoding kynurenine pathway enzymes determined that patients with high QPRT expression had a poor prognosis with decreased median survival, with no effect on the maximum survival. There is a significant difference in the survival between patients with high QPRT expression relative to patients with high HAAO/AFMID expression (HR = 1.2, [95% CI 0.5-1.8] P = 0.0181, Gehan-Breslow-Wilcoxon Test). Patients with high QPRT expression have higher survival rates compared with low QPRT expression (HR = 1.4, [95% CI 0.9-2.2] P = 0.0344, Gehan-Breslow-Wilcoxon Test). To test the consequences of kynurenine-pathway inhibition in mitochondrial function and morphology we use 4-Cl-3HAA, an irreversible HAAO inhibitor, and observed a small increase in mitochondrial fragmentation in HepG2 cells after 24 hours of treatment. We conclude that kynurenine metabolism may be useful as a biomarker to predict patient prognosis among HCC patients. In ongoing work, we are testing QPRT inhibitors in cell culture as a potential adjuvant for chemotherapies.
Annual Foot Exams and Incident Amputation
Authors: Allen Latricia , Khakharia Anjali , Phillips Lawrence , Johnson Theodore , Uphold Constance , Perkins Molly , Vaughan Camille 
Published: December 2020

Abstract
Diabetes-related lower extremity amputations (LEA) are high cost and high prevalence. Individuals with complications such as neuropathy, foot deformity, history of diabetic foot ulcer or LEA increased morbidity and mortality.1 Current national recommend a foot exam for individuals with diabetes annually or more often depending on risk for LEA.2, The purpose of this pilot study was to examine the relationship between annual foot exams and incident lower extremity amputation in a large Veteran cohort. We conducted a secondary analysis of a national VA Diabetes administrative dataset registry for Veterans with diabetes aged 65 and older during the period of fiscal year 2002-2014 (n=1,544,654; mean age 77.6 years; 97.9 % male). Using logistic regression, we examined the association between annual foot exams and incident LEA. Our analysis was adjusted for demographics, comorbidities, and LEA foot risk. The study included 18,759 (1.21%) Veterans with incident LEA and foot exams, 2,234 (0.14%) Veterans with incident LEA without foot exams. Median age range was 65-75 years old. Gangrene, osteomyelitis, foot ulcers, and neuropathy were the covariates with the highest risk of incident LEA with foot exam. Foot exams did not reduce the risk of LEA when examining Veterans with incident LEA (unadjusted OR of 1.62 (CI 1.56 - 1.69), p&lt;.0001 and adjusted OR was 1.77 (CI 1.69 -1.86), p&lt;.0001. Annual foot exams were not protective for LEA in Veterans with foot exams and incident LEA. Additional research is warranted to examine this relationship considering the effect of early intervention on LEA risk.
Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care
Authors: Curtis Laura , Opsasnick Lauren , Benavente Julia Yoshino , Nowinski Cindy , O’Conor Rachel , Stoeger Jordan , Wolf Michael , Gershon Richard 
Published: December 2020

Abstract
Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of &lt;7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.
Severity of Cognitive Impairment Moderates the Effect of Depression on Motivation
Authors: Growney Claire , Zhu Xianghe , Sorensen Julia , Smith Emily , Neupert Shevaun 
Published: December 2020

Abstract
Motivation to engage in cognitive activities is a critical feature of cognitive health, especially for older adults. A growing body of literature demonstrates that personal resources such as mental health contribute to older adults’ motivation. However, little is known about factors that contribute to motivation for cognitive engagement in older adults already experiencing significant decline, a population for whom engagement may be uniquely consequential. In the present study, older adults (age 61-85) with cognitive impairment (Short Blessed scores of 7+) and/or dementia diagnoses completed a series of assessments of cognitive ability, well-being, and motivation to engage in cognitively demanding activities as a part of a larger project. Linear regression analyses revealed that cognitive ability moderated the effect of depression on motivation to engage in cognitively demanding activities. For those with relatively mild levels of cognitive impairment, depression was associated with lower levels motivation, whereas depression was unrelated to motivation for those with more severe cognitive impairment. Notably, results were unchanged when controlling for physical health, suggesting that depression has unique effects on motivation for these individuals. Results contribute to a growing body of literature demonstrating that mental health is particularly consequential for individuals in earlier stages of cognitive decline. We suggest that interventions targeting mental health in individuals beginning to experience cognitive decline may be effective in increasing motivation to engage in activities that are beneficial for cognitive health and that such interventions may be most effective when implemented at the earliest stages of dementia.
Measuring Supreme Court Case Complexity
Authors: Goelzhauser Greg , Kassow Benjamin J , Rice Douglas 
Published: December 2020

Abstract
Case complexity is central to the study of judicial politics. The dominant measures of Supreme Court case complexity use information on legal issues and provisions observed postdecision. As a result, scholars using these measures to study merits stage outcomes such as bargaining, voting, separate opinion production, and opinion content introduce posttreatment bias and exacerbate endogeneity concerns. Furthermore, existing issue measures are not valid proxies for complexity. Leveraging information on issues and provisions extracted from merits briefs, we develop a new latent measure of Supreme Court case complexity. This measure maps with the prevailing understanding of the underlying concept while mitigating inferential threats that hamper empirical evaluations. Our brief-based measurement strategy is generalizable to other contexts where it is important to generate exogenous and pretreatment indicators for use in explaining merits decisions. (JEL K00, K40)