bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cloud Infrastructure for Large Scale Health Monitoring in Older Adult Care Facilities
Authors: Noh Yeonsik , David Uchechukwu 
Published: December 2021

Abstract
Technology development in the sub-field of older adult care has always been on the back-burner compared to other healthcare areas. But with increasing life expectancy, this is poised to change. With the increasing older adult population, the current older adult care facilities and personnel are struggling to keep up with demand. To address this matter, we proposed a distributed system infrastructure that will enable large-scale monitoring of vital signals and early detection of emergency situations in nursing homes and assisted living communities in this study. The system is mainly comprised of node devices and cloud infrastructure. The node device collects data from multiple users and forwards this data to the cloud service. Communication between the vital-sensing devices on the users and the node device is accomplished using Bluetooth Low-Energy (BLE). The Node device is implemented on a Raspberry Pi Model 3b+ which has built-in BLE capability. A cloud server consists of back-end and front-end components. The back-end handles all the data processing and logical decisions that drive the front-end. The front-end is the interface provided to the end-users, which can monitor all patients in nursing homes at the same time. We examined our system in terms of scalability, real-time operation, cost, and usability and then found that our system provides not only a smart remote monitoring solution that can provide a better aging experience for older adults and their families, but also increase automation in nursing homes leading to a reduction in running cost and an increase in capacity.
Lessons On Using Health Research & Technology To Broaden Resources For Older Adults Across The State
Authors: Hunt Jennifer , Travis Alexis 
Published: December 2021

Abstract
The vision of the Michigan state unit on aging is for residents to live well and thrive as they age. The COVID-19 pandemic exacerbated the existing problem of older adult social isolation. Social engagement and community involvement are keys to healthy aging. Combining state resources with the GetSetUp virtual community allowed for statewide connections and extended resources, creating an almost around-the-clock virtual senior center. Through customized courses the state was able to offer vaccine navigation sign-up classes, among other classes, to help older adults interact with essential health and aging services. As Michigan continues to work to address health equity and social determinants of health beyond the pandemic, technology designed specifically for older adults is an important component of programmatic offerings. It also allows for a public-private partnership opportunity to support older adults as they age.
Association of Dementia Severity and Assistances Needs on Missed Home Health Visits.
Authors: Knox Sara , Downer Brian , Haas Allen , Ottenbacher Kenneth 
Published: December 2021

Abstract
Individuals with Alzheimer’s Disease and Related Dementias (ADRD) experience barriers to accessing health care services, including services provided during home health care. Additionally, it is not clear if people with ADRD who are admitted to home health care receive all the services needed to maximize their outcomes. Barriers to receiving the optimal care can include the presence or absence of a care giver, behavioral and psychological symptoms of ADRD, or therapists lacking the skills needed to effectively engage patients in therapy sessions. These barriers may vary dependent on the patient’s ADRD severity. The purpose of this study was to examine the relationship between dementia severity and early discharge from home health care. This was a retrospective study of 142,376 Medicare beneficiaries with ADRD who received home health care between October 2016 and September 2017. Early discharge was defined as discharge from home health with more than two missed visits. Early discharge rates were calculated, and multilevel logistic regression was used to estimate the relative risk (RR) of early discharge, by dementia severity level, adjusted for patient and clinical characteristics. 10.4% of beneficiaries had an early discharge. Dementia severity was not associated with risk of early discharge. However, level of medication assistance needed was found to be associated with risk of early discharge (RR=0.849; 95% CI 0.759 - 0.948). Medication management may impact a patient’s ability to adequately attend and engage in home health therapy services. Further studies are needed to better delineate the interaction between medication management and early discharge.
Confirming a Drosophila Melanogaster Model of Huntingtin Aggregation
Authors: Biritwum Akosua , Levy Simon , Frost Bess , Duttaroy Atanu 
Published: December 2021

Abstract
For decades, doctors, psychologists, and psychiatrists alike have struggled to treat the symptomatic effects of Huntington’s disease. Huntington’s disease is an autosomal dominant brain disease that results in the deterioration of a person’s physical and mental state. Once a person inherits the disease, they end up dying from it more often than not. At present, there are 41,000 Americans with symptomatic Huntington’s disease, and 200,000 more are currently at-risk of inheriting the disease. Given its 50/50 chance of inheritance, there seems to be no end in sight to this degenerative ailment. My research study, however, will show that with a more robust approach, finding a cure for this disease is possible. Ultimately, the aim of this project was to test an already established model in Drosophila melanogaster regarding the “huntingtin” protein responsible for Huntington’s disease. This was achieved by first demonstrating that the flies which were modified to produce huntingtin could, in fact, produce the protein. Secondly, an experimental process was created to configure a system through which the amount of protein produced by each fly could be quantified. This quantification was vital in creating a baseline that would allow for the identification of potential therapeutic treatments in the future. In short, by establishing a quantifiable model for huntingtin, this study will pave the way to new insights on huntingtin aggregation and the identification of possible treatments for Huntington’s disease in the future.
Convergent and Construct Validity of a Conversation Difficulties Outcome Measure in Primary Progressive Aphasia
Authors: Santos Haylie , Gill Nathan , Salley Elizabeth , Zhang Hui , Rogalski Emily , Roberts Angela 
Published: December 2021

Abstract
Cognition and language changes, and their impacts on functional communication, are central to many dementias. Thus, functional communication, including conversation difficulties, is an important endpoint for clinical trials. To develop robust outcomes in primary progressive aphasia (PPA), a dementia characterized by communication impairments, we examined the convergent and construct validity of the Perception of Conversation Difficulties-Dementia Alzheimer’s Type (PCI-DAT; Orange et al., 2009). The PCI-DAT is a care partner reported measure of conversation difficulties. Eighty-two care partners with a mean age of 64.8 years (SD=10.61; 85% spouses, 5% adult children, 10% friends/siblings) whose mean relationship duration to the person with PPA was 39.1 (SD=15.1) years completed the study. Pearson’s correlation indicated a significant, modest correlation (r=-0.54, p&lt;0.0001) between the PCI-DAT Perception of Conversation Difficulties subscale and the Communication Effectiveness Index (Lomas et al., 1989) suggesting strong convergent validity. A Rasch analysis conducted on the same PCI-DAT subscale showed high person (0.92) and item (0.95) reliability indicating a robust overall scale structure that adequately evaluates various levels of conversation difficulty severity in PPA. Six items (27%) had minor ‘fit’ issues (defined by Wright and Linacre, 1994 as having infit statistics &lt; 0.6 or &gt; 1.4) relative to the underlying construct. Results suggest strong convergent and construct validity of the PCI-DAT in PPA and indicate items that will benefit from further development. Overall, our results suggest that the PCI-DAT holds promise for use as a functional communication endpoint in PPA clinical trials. Data for all five PCI-DAT subscales will be presented.
COVID-19 Silver Linings - Experience of Spousal Caregivers of Persons with Dementia Engaged in Support Program
Authors: Nguyen Andrew , Stevenson Elizabeth , Mittelman Mary , Nicholson Roscoe , Donley Tiffany , Salant Rebecca , Shirk Steven , O'Connor Maureen 
Published: December 2021

Abstract
Caring for a person with dementia (PWD) has been consistently associated with negative effects on health, including increases in caregiver depression, anxiety, and burden. Emerging studies have shown that the COVID-19 pandemic has increased these factors due to reported increases in caregiver workload and cognitive and behavioral symptoms of the PWD. We interviewed 10 spousal caregivers of PWD from the NYU Langone Alzheimer’s Disease and Related Dementias Family Support Program in Summer 2020 during the COVID-19 pandemic in order to gain feedback about their experiences during the pandemic and the transition from in-person to videoconferencing that could be used to improve services and support. Caregivers discussed the challenges faced during the pandemic but also the unique opportunities the situation presented. We report here on those positive aspects of COVID-19 from the perspective of the caregivers we interviewed. Methods: Interviews of caregivers residing with their spouses in the New York City area were conducted via videoconferencing, transcribed, deidentified, and analyzed using framework analysis methods. Results: We found that caregivers reported some positive reaction to videoconferencing that included increased support group cohesion, increased convenience, feeling less obligated to participate in events, and new opportunities for social contact. Participants also discussed positive inter-couple relationship changes such as increased quality time spent together. Our findings resonate with a body of literature focused on understanding the positive aspects of caregiving. Understanding the full presentation of the caregiver experience, including both positive and negative aspects, is important for developing interventions and resources for this unique group.
Exploring How Neighborhood Characteristics and Psychosocial Resilience Affect Cognition Among Older Black Adults
Authors: Farmer Heather , Thierry Amy , Armendariz Marina , Kirven Sydney , Sherman-Wilkins Kyler 
Published: December 2021

Abstract
Black older adults are at greater risk for poor cognitive health than Whites, and adverse neighborhood conditions may contribute to this disparity. Moreover, limited research examines how resilience is implicated in the relationship between neighborhoods and cognition among Blacks. Using 2006-2016 waves of the Health and Retirement Study, we examine how perceived neighborhood characteristics (physical disorder and social cohesion) and psychosocial resilience (social support, mastery, and sense of purpose) contribute to cognitive functioning among 1,655 Black adults ages 65+. Results from multilevel linear regression models show that greater physical disorder was associated with worse cognitive functioning, and this was attenuated after adjustment for socioeconomic status. We found a positive association between purpose and mastery with cognitive functioning, even after accounting for socioeconomic, psychosocial, and health-related characteristics. Thus, high levels of purpose and mastery may be protective for cognitive functioning among Black older adults in spite of experiencing negative neighborhood contexts.
Foot Mechanics Define Directional Changes in Curved-Path Walking: New Methods to Assess the Motor Skill of Walking
Authors: Hicks Haley , McBroom Anthony , Roscher Patrick , VanSwearingen Jessie , Lowry Kristin 
Published: December 2021

Abstract
Although it is essential to navigating the world, curved path walking is a challenge to mediolateral balance control. The focus of previous curved-path walking research was in spatiotemporal characteristics. We quantified the foot-ground interaction, center of pressure (COP) characteristics during non-linear (eg curved-path) walking important to understand the functional mechanics of directional changes for curved paths. We hypothesized the foot mechanics differ between older adults with better versus poorer curved-path walking (Figure of 8 Walk Test, F8W). Twenty-five older adults (mean age 71.8 ± 8.9 years) completed the F8W on an instrumented walkway (Protokinetics, LLC.) The derived metrics of the foot mechanics included medial/lateral movement of the COP for inside and outside steps, maximum medial and lateral COP excursions, and total medial/lateral COP range. Pearson correlations were used to examine relations F8W (time and steps) and COP metrics; ANOVAs were used to examine differences in COP metrics between older adults grouped by median-split of F8W time. Longer F8W time and more steps were related to lesser total COP range and outside foot lateral maximum excursion (r range -0.415 to -0.706, p&lt;0.04). Older adults with stronger F8W performance compared to poorer F8W performance had larger outside foot total COP ranges (3.61cm vs 4.39cm, p=0.016) and greater lateral excursion (1.60cm vs 2.12cm, p=0,003). Foot-ground interactions offer new insights into control of curved path walking and methods for evaluating efficacy of interventions focused on improving walking skill in older adults.
Latent Classes of First Incident Difficulty in Instrumental Activities of Daily Living
Authors: Feger Danielle , Deal Jennifer , Gross Alden 
Published: December 2021

Abstract
Ability to perform instrumental activities of daily living (IADLs) deteriorates during prodromal Alzheimer’s disease (AD), eventually leading to impaired everyday functioning and dementia. Ordering and timing of IADL difficulty onset may identify individuals at greater risk of cognitive impairment, but most studies only consider total number of difficult tasks. Leveraging longitudinal data from the Advanced Cognitive Training in Independent and Vital Elderly (ACTIVE) Study who entered free of any IADL difficulty (N=1266), we hypothesized that a latent class analysis based on timing of first reported IADL task difficulty would reveal class differences in cognitive functioning . Participants were followed until they self-reported at least one IADL difficulty, study completion (10 years), or loss to follow-up. Discrete-time multiple event process survival mixture (MEPSUM) models were used to simultaneously estimate hazards of incident IADL task difficulty across 7 task groups. Two, 3, 4, and 5 latent class models were fit to the data. Both unadjusted and covariate-adjusted models (adjusted for age, sex, race, education, marital status, and general health rating) were fit. Using the 2-class solution as the most parsimonious model, model entropy was 0.855. The model was able to distinguish a class of participants with lower global cognitive factor scores at baseline (Cohen’s D = 0.23, P = 0.04). We conclude that first incident IADL difficulty may be a useful measure in identifying individuals with worse cognitive functioning.
Perceptions of Medical Cannabis Packaging and Labeling among Middle-Aged and Older Canadians
Authors: O'Connor Melissa , Christiuk Vanessa , Pedersen Megan 
Published: December 2021

Abstract
The use of cannabis for therapeutic purposes is becoming more popular in many countries, including the United States and Canada. In Canada, middle-aged and older adults make up the largest proportion of medical cannabis users. Canadian legislation mandates that medical cannabis be packaged in plain-looking containers with small labels, childproof caps, and required health warnings. This is meant to standardize the way cannabis products are distributed, as well as protect children from accidental ingestion. However, there is limited research on how these regulations affect cannabis users over age 45. In the present study, residents of Winnipeg, Manitoba, Canada aged 45 and older (n=40) were surveyed regarding their experiences with medical cannabis packaging and labeling. Half of the participants (50%) felt they had a hard time opening their medical cannabis container. A majority (60%) thought having an easy-open lid would be helpful. Most participants (78%) reported experiencing difficulties reading the label on their container, and 75% thought it would be helpful to have a printout of the label in a larger font. In addition, 89% of participants who took more than one kind of medical cannabis favored a symbol on their medication bottle that would indicate the type of medical cannabis contained inside. Implications for policy makers and future research are discussed.
Phase 2b Study of an Ad26.RSV.preF Vaccine for Prevention of RSV-mediated Respiratory Tract Disease in Older Adults
Authors: Falsey Ann , Williams Kristi , Gymnopoulou Efi , Bart Stephan , Ervin John , De Paepe Els , Comeaux Christy , Heijnen Esther 
Published: December 2021

Abstract
Respiratory syncytial virus (RSV) may cause serious lower respiratory tract disease (LRTD) in older adults, and there is currently no licensed vaccine. CYPRESS (NCT03982199) is a randomized, double-blind, placebo-controlled Phase 2b proof-of-concept trial of an Ad26.RSV.preF-based vaccine for the prevention of RSV-mediated LRTD in older adults. Adults aged ≥65 years were randomized 1:1 before the RSV season to receive Ad26.RSV.preF-based vaccine or placebo. Acute respiratory infection symptoms were collected through a patient eDiary and/or clinician assessment until the end of the RSV season. The primary endpoint was the first occurrence of RTPCR-confirmed RSV-mediated LRTD according to any of 3 case definitions: (1) ≥3 symptoms of lower respiratory tract infection (LRTI), (2) ≥2 symptoms of LRTI, or (3) ≥2 symptoms of LRTI or ≥1 symptom of LRTI with ≥1 systemic symptom. Immunogenicity was assessed in a subset of approximately 200 participants. A total of 2891 participants in each study arm received study treatment. Vaccine efficacy was 80% (94.2% CI, 52.2-92.9%), 75% (50.1-88.5%), and 69.8% (43.7-84.7%) for case definition 1, 2, and 3, respectively (all P &lt;0.001). In the vaccine arm, geometric mean fold increase in antibody titers 14 days after vaccination was 13.5 for RSV neutralizing antibodies and 8.6 for RSV prefusion F-specific binding antibodies, and median frequency of RSV-F-specific INFγ T-cells increased from 34 to 444 SFC/10^6 PBMC; no relevant changes were observed in the placebo arm. The Ad26.RSV.preF-based vaccine was highly effective against RSV-mediated LRTD through the first RSV season and elicited robust immune responses in older adults.
Sex Differences in Cardiovascular Markers and BDNF between Cerebral Palsy and Mild Cognitive Impairment
Authors: Ng Ted , Carollo James , Tagawa Alex , Pan Zhaoxing , Heyn Patricia 
Published: December 2021

Abstract
Adults with cerebral palsy (CP) have higher risk of developing geriatric syndromes. Mild cognitive impairment (MCI) is an intermediate stage between healthy aging and dementia, often co-morbid with cardiovascular disease (CVD). We recently showed an “accelerated aging model”, where CP shares similar CVD risk factors with MCI, potentially accounting for CP’s increased risk of dementia. In this study, we further examined sex differences between CP and MCI (aim 1) and within CP (aim 2). From an accredited clinical motion analysis laboratory at Children’s Hospital Colorado (CP) and a university in Singapore (MCI), we recruited 72 adults with CP [mean (SD) of age=20 (5.3), Sex: men=47.2% and women=52.8%] and MCI [mean (SD) of age=71.28 (6.03), Sex: men=29.2% and women=70.8%]. We analyzed blood Pressure (BP), Framingham Heart Study Score (FHSS), and brain-derived neurotrophic factor (BDNF). Compared to MCI, women with CP had lower BDNF (β=-3.550, 95% CI=-5.659 to -1.441, p=0.001), while men with CP had lower diastolic BP (β=-28.204, 95% CI=-52.148 to -4.260, p=0.022). Both women and men with CP also had lower FHSS, compared to MCI (β=-2.515, 95% CI=-3.721 to -1.309, p&lt;0.001; β=-3.724, 95% CI=-5.561 to -1.888, p&lt;0.001, respectively). Women in the CP cohort showed lower FHSS (β=-0.172, 95% CI=-0.310 to -0.033, p=0.016). We found sex-related differences in BDNF and CVD markers. Comparing across and within cohorts, although having lower BDNF levels, women with CP had better FHSS. These findings support our accelerated aging hypothesis, and further suggest sex differences in aging-related risk factors in CP, supporting sex-related precision medicine approach.
Single cell analysis reveals stochastic cell-to-cell variation in stress response and senescence program
Authors: Burnaevskiy Nikolay , Mendenhall Alexander 
Published: December 2021

Abstract
Cells have various means to respond to molecular stress. Upon stress, proliferating cells can adopt different fates, e.g. commit to apoptosis, go into senescence or recover from stress and resume proliferation, depending on severity of the stress. Proper balance between these modes of response is critical for maintaining tissue homeostasis with age, as both exacerbated and insufficient response can result in pathology. Remarkably, even genetically identical cells of the same type in the controlled environment can exhibit a spectrum of responses to the same stress challenge. We hypothesized that analyzing response of individual cells in controlled environment can help better understand the mechanisms that ensure a balanced response to molecular stress. We used large scale single cell RNA-sequencing to analyze response of individual human fibroblasts to oxidative stress. Consistent with various fates adopted by individual cells upon stress, we observed different transcriptional signatures, that correspond to those fates. Surprisingly, when we specifically analyzed ß-gal+ senescent cells, we still observed transcriptional heterogeneity, with only a subset of cells exhibiting pro-senescent transcriptional signature (e.g. activated p53 and TNF-a pathways) while another subset exhibits a gene expression signature of senescent-like arrest. Hence, we find that in addition to known stress-related fates (apoptosis, senescence, recovery) senescence-like response is heterogeneous with only subset of cells exhibiting expected pro-senescent gene expression signature. Further characterization of heterogeneity of stress response and senescent-like fates will help better understand the mechanisms of homeostatic control in the face of molecular stress and aging.