bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competition of insect decomposers over large vertebrate carrion:Necrodesbeetles (Silphidae) vs. blow flies (Calliphoridae)
Authors: Matuszewski Szymon , MĄdra-Bielewicz Anna 
Published: December 2021

AbstractLarge carrion is inhabited by highly variable and interactive communities of insects. Positive interactions in carrion insect communities have been recently the focus in carrion ecology. In contrast, competition between carrion insects is rather undervalued. Here we provide evidence that blow flies (Calliphoridae) and Necrodes beetles (Silphidae), dominant decomposers of large carcasses in terrestrial habitats, compete over carrion. By reanalyzing the results from 90 pig carcasses, we demonstrated that the contribution of the flies and the beetles to the decay was negatively related. The greater part of the large carrion pool was monopolized by blow flies, whereas Necrodes beetles abundantly colonized carcasses, on which blow flies were less effective as decomposers. In behavioral assays, we found that adult beetles killed 4 times more frequently feeding than postfeeding third instar larvae of the flies, with the large decrease in the killing frequency after the larvae reached the age of early third instar. Therefore, adult Necrodes beetles preferentially killed the larvae that were before or in their peak feeding. The study provides evidence that the interaction between blow flies and Necrodes beetles is a combination of indirect exploitative effects of the flies and direct interference effects of the beetles (the mixed competition).
Disparities in esophageal cancer care based on race: a National Cancer Database analysis
Authors: Okereke Ikenna C , Westra Jordan , Tyler Douglas , Klimberg Suzanne , Jupiter Daniel , Venkatesan Rohit , Brooks Kaelyn , Kuo Yong-Fang 
Published: December 2021

Summary
Esophageal cancer is one of the most common cancer killers in our country. The effects of racial disparities on care for esophageal cancer patients are incompletely understood. Using the National Cancer Database, we investigated racial disparities in treatment and outcome of esophageal cancer patients. The National Cancer Database was queried from 2004 to 2017. Logistic regression and survival analysis were used to determine racial differences in access, treatment and outcome. A total of 127,098 patients were included. All minority groups were more likely to be diagnosed at advanced stages versus Caucasians after adjusting for covariates (African American OR—1.64 [95% confidence interval 1.53—1.76], Hispanic OR—1.19 [1.08—1.32], Asian OR—1.78 [1.55—2.06]). After adjustment, all minorities were less likely at every stage to receive surgery. Despite these disparities, Hispanics and Asians had improved survival compared with Caucasians. African Americans had worse survival. Racial disparities for receiving surgery were present in both academic and community institutions, and at high-volume and low-volume institutions. Surgery partially mediated the survival difference between African Americans and Caucasians (HR—1.13 [1.10–1.16] and HR—1.04 [1.02–1.07], without and with adjustment of surgery).There are racial disparities in the treatment of esophageal cancer. Despite these disparities, Hispanics and Asians have improved overall survival versus Caucasians. African Americans have the worst overall survival. Racial disparities likely affect outcome in esophageal cancer. But other factors, such as epigenetics and tumor biology, may correlate more strongly with outcome for patients with esophageal cancer.
Percutaneous extraction of a large device-related thrombus on a Watchman™ device: a case report
Authors: Vyas Rhea , Kohler Cassidy , Pershad Ashish 
Published: December 2021

Abstract

Background
Left atrial appendage occlusion devices are commonly used to prevent stroke in patients with persistent atrial fibrillation who are unable to tolerate anticoagulation. However, certain patient- and device-related characteristics increase the risk for the development of a device-related thrombus (DRT). The presence of a DRT increases the risk of stroke and should be treated. Management of DRT lacks consensus but is mostly focused on anticoagulation. In patients with large thrombi that need to be managed urgently, percutaneous extraction may be a viable option.

Case summary
In this report, we describe the successful management of a DRT via percutaneous thrombus extraction technology in an 81-year-old woman with a large thrombus attached to a WATCHMAN™ device. The patient initially presented with shortness of breath, and on imaging a pedunculated thrombus was detected. The thrombus was extracted using a Penumbra Lightning 12™ (Penumbra Inc., Alameda, CA, USA) catheter with a Sentinel™ (Boston Scientific, Marlborough, MA, USA) cerebral embolic protection device. The patient had no neurologic sequelae and was started on anticoagulation.

Discussion
Percutaneous thrombectomy can be safely performed to extract large left atrial occlusion DRT that require urgent management, without any neurologic sequelae. We believe this can be used in patients with a large DRT who would not be adequately managed with anticoagulation and in whom surgery is not feasible.
Is the contemporary care of the older persons with acute coronary syndrome evidence-based?
Authors: Mills Greg B , Ratcovich Hanna , Adams-Hall Jennifer , Beska Benjamin , Kirkup Emma , Raharjo Daniell E , Veerasamy Murugapathy , Wilkinson Chris , Kunadian Vijay 
Published: December 2021

Abstract
Globally, ischaemic heart disease is the leading cause of death, with a higher mortality burden amongst older adults. Although advancing age is associated with a higher risk of adverse outcomes following acute coronary syndrome (ACS), older patients are less likely to receive evidence-based medications and coronary angiography. Guideline recommendations for managing ACS are often based on studies that exclude older patients, and more contemporary trials have been underpowered and produced inconsistent findings. There is also limited evidence for how frailty and comorbidity should influence management decisions. This review focuses on the current evidence base for the medical and percutaneous management of ACS in older patients and highlights the distinct need to enrol older patients with ACS into well-powered, large-scale randomized trials.
Risk factors for postoperative delirium after cardiac surgical procedures with cardioplegic arrest
Authors: Andrási Terézia B , Talipov Ildar , Dinges Gerhard , Arndt Christian , Rastan Ardawan J 
Published: December 2021

AbstractOBJECTIVESThe pathophysiology of delirium after cardiac surgery is complex. The present study aims to determine perioperative risk factors and construct a scoring system for postoperative delirium based on the type of surgery.METHODSThree hundred patients undergoing coronary artery bypass grafting (CABG; n = 150) or valve and/or aortic surgery ± CABG (n = 150) were retrospectively evaluated.RESULTSThe incidence of delirium (32%) was similar in subgroups (28.7% and 33.33%, P = 0.384). Delirium patients were older [71.3 (standard deviation: 8.5) vs 66.6 (standard deviation: 9.5), P &lt; 0.001; 70.0 (standard deviation: 9.6) vs 62.5 (standard deviation: 12.6), P &lt; 0.001] and required more packed red blood cell units [2.1 (standard deviation: 2.1) vs 4.2 (standard deviation: 4.0), P &lt; 0.001; 2.4 (standard deviation: 3.3) vs 5.4 (standard deviation: 5.9), P &lt; 0.001] and fresh frozen plasma units [6.1 (standard deviation: 2.9) vs. 8.0 (standard deviation: 4.2), P &lt; 0.001; 6.3 (standard deviation: 3.4) vs 10.8 (standard deviation: 7.2), P &lt; 0.001] in CABG and valve/aortic subgroups, respectively. Delirium was associated with longer operation time [298.3 (standard deviation: 98.4) vs 250.6 (standard deviation: 67.8) min, P &lt; 0.001], cardiopulmonary bypass (CPB) time [171.5 (standard deviation: 54.9) vs 140.98 (standard deviation: 45.8) min, P &lt; 0.001] and cardiac arrest time [112 (standard deviation: 35.9) vs 91.9 (standard deviation: 28.6), P &lt; 0.001] only in the valve/aortic group (versus non-delirium). Multivariate regression analysis identified an association between delirium and age [odds ratio: 1.056 (95% confidence interval: 1.002–1.113), P = 0.041], CPB time [odds ratio: 1.1014 (95% confidence interval: 1.004–1.025), P = 0.007], fresh frozen plasma transfusion [odds ratio: 1.127 (95% confidence interval: 1.006–1.262), P = 0.039] and atrial fibrillation [odds ratio: 4.801 (95% confidence interval: 1.844–12.502), P &lt; 0.001] after valve/aortic surgery (area under the curve 0.835, P &lt; 0.001) and between delirium and age [odds ratio: 1.089 (95% confidence interval: 1.023–1.160), P = 0.007] and ventilation time [odds ratio: 1.068 (95% confidence interval: 1.026–1.113), P = 0.001] after isolated CABG (area under the curve 0.798, P &lt; 0.001). The cross-validation of the results by k-fold logistic regression revealed for the entire patient cohort an overall average accuracy of the prediction model of 0.764, with a false-positive rate of 0.052 and a false-negative rate of 0.18.CONCLUSIONSAge, CPB time, ventilation, transfusion and atrial fibrillation are differently associated with delirium depending on the operative characteristics. Optimization of intraoperative parameters and use of risk calculators may enable early institution of pharmacotherapy and improve overall outcome after cardiac surgery.
Novel Functional, Health, and Genetic Determinants of Cognitive Terminal Decline: Kuakini Honolulu Heart Program/Honolulu-Asia Aging Study
Authors: Margrett Jennifer A , Schofield Thomas , Martin Peter , Poon Leonard W , Masaki Kamal , Donlon Timothy A , Kallianpur Kalpana J , Willcox Bradley J 
Published: December 2021

Abstract
To investigate interindividual differences in cognitive terminal decline and identify determinants including functional, health, and genetic risk and protective factors, data from the Honolulu Heart Program/Honolulu-Asia Aging Study, a prospective cohort study of Japanese American men, were analyzed. The sample was recruited in 1965–1968 (ages 45–68 years). Longitudinal performance of cognitive abilities and mortality status were assessed from Exam 4 (1991–1993) through June 2014. Latent class analysis revealed 2 groups: maintainers retained relatively high levels of cognitive functioning until death and decliners demonstrated significant cognitive waning several years prior to death. Maintainers were more likely to have greater education, diagnosed coronary heart disease, and presence of the apolipoprotein E (APOE) ε2 allele and FOXO3 G allele (SNP rs2802292). Decliners were more likely to be older and have prior stroke, Parkinson’s disease, dementia, and greater depressive symptoms at Exam 4, and the APOE ε4 allele. Findings support terminal decline using distance to death as the basis for modeling change. Significant differences were observed between maintainers and decliners 15 years prior to death, a finding much earlier compared to the majority of previous investigations.
Family Caregiver Needs and Preferences for Virtual Training to Manage Behavioral Symptoms of Dementia
Authors: Ramirez Maggie , Duran Miriana , Pabiniak Chester , Hansen Kelly , Ralston James , McCurry Susan , Teri Linda , Penfold Robert 
Published: December 2021

Abstract
STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is adapted from an evidence-based, in-person program that teaches family caregivers to manage behavioral and psychological symptoms of dementia (BPSD). The study objective was to understand the needs of family caregivers for improving BPSD management and the extent to which caregivers perceived that STAR-VTF could address those needs. We conducted 15 semi-structured interviews with family caregivers of people with dementia. We showed caregivers prototypes of STAR-VTF online self-directed materials. We obtained caregiver feedback, focusing on needs and preferences and perceived barriers to using STAR-VTF. We used a hybrid approach of inductive and deductive coding and aggregated codes to develop themes. The idea of a virtual training program for learning to manage BPSD appealed to caregivers. They said healthcare providers did not provide adequate education in the early disease stages about the personality and behavior symptoms that can affect people with dementia. Caregivers found it unexpected and frustrating when the person with dementia began experiencing BPSD, symptoms they felt unprepared to manage. Accordingly, caregivers expressed a strong desire for the healthcare organization to offer programs such as STAR-VTF much sooner. Many were interested in the virtual aspect of the training due to the convenience of receiving help from home and the perception that help from a virtual program would be timelier than traditional service modalities. Given caregivers’ limited time, they suggested dividing the STAR-VTF content into chunks to review as time permitted. Caregivers reported a preference for having the same coach for the program duration.
The Effects of Remote Activity Monitoring on Family Caregivers of People Living With Dementia Over an 18-Month Period
Authors: Gaugler Joseph , Zmora Rachel , Mitchell Lauren , Finlay Jessica , Rosebush Christina , Peterson Colleen , Nkimbeng Manka , Baker Zachary 
Published: December 2021

Abstract
Technology interventions for older persons and long-term care are generally utilized as real-time data capture tools to complement clinical or family care for older persons or as interventions themselves designed to improve important dementia care outcomes. Although research on novel technological interventions for people with Alzheimer's disease and related dementias (ADRD) and their family caregivers has grown considerably in the past two decades, much of this work continues to focus on design, feasibility, and acceptability (with a need for conceptual refinement in these areas) and less on controlled outcome studies. The objective of this experimental mixed methods demonstration was to determine the 18-month effectiveness of remote activity monitoring (RAM) technology in improving outcomes among family caregivers of community-dwelling persons with dementia. We used an embedded experimental mixed methods design, collecting qualitative data within the structure of a traditional randomized controlled trial ([QUAN+qual]→QUAN) over an 18-month period for 171 dementia caregivers. Change in caregiver self-efficacy, sense of competence, and caregiver distress served as the main quantitative outcomes of interest. Individual growth curve models indicated that the RAM technology did not have direct effects on caregiving outcomes, and although the qualitative findings indicated several potential moderators of RAM effectiveness on caregiving outcomes, the inclusion of these qualitatively-identified moderators did not result in statistically significant (p &lt; .05) effects. Ensuring effective human care management alongside RAM technology may help to overcome the barriers reported by dementia caregivers in this demonstration study.
Technology Innovations in Dementia Care: Improvements in Functional Assessments Through Background Sensing
Authors: Smith Matthew , Ory Marcia , Han Gang , Wilson Ashley , Foster Zane , Fitch John 
Published: December 2021

Abstract
Technological innovations are becoming commonplace in research among persons living with dementia (PLWD) and their caregivers. However, few studies attempt to validate technology’s ability to appropriately monitor functional assessment in dementia care research. Bringing together industry, academia, and health care, we demonstrate the feasibility of using a novel in-situ sensor system to continuously and accurately assess daily functions for PWLDs in home or assisted care settings. Phase1 revealed a high accuracy (~85%) of detecting and classifying ADLs between sensors and human loggers across 26 defined activities. Phase 2, which will target 140 PLWDs, has already demonstrated the value of such sensors in detecting safety concerns (e.g., no heat). Technology-driven research for PLWD and their caregivers have practical applications for assessing diverse forms of functional assessment and environmental conditions which can improve measurement precision over time and space and the ability to better tailor care plans for PLWDs and their caregivers.
Deep Longitudinal Proteomics Profiling Reveals Biological Pathways Responding to GRF6019 in Two AD Clinical Trials
Authors: Lehallier Benoit , Nanasi Tibor , Hannestad Jonas , Braithwaite Steven 
Published: December 2021

Abstract
Blood has been widely investigated to discover biomarkers and gain insights into the biology of aging and age-related diseases. Its protein composition provides insights into complex biological processes, as proteins are often direct regulators of cellular pathways. In clinical trials, selected proteins have been used as primary and secondary endpoints, but recent methodological developments allow the measurement of thousands of proteins with very high sensitivity and specificity. In two phase 2 clinical trials testing the safety, tolerability, and feasibility of infusions of the plasma fraction GRF6019 in Alzheimer's disease (AD), we measured more than 7000 proteins in plasma over the course of the clinical trials. Differential trajectories analysis revealed groups of proteins and pathways that were responding to GRF6019. Several pathways were relevant to the biology of aging and AD and our study suggests that deep proteomics profiling can inform on specific biological processes responding to treatment in clinical trials.
Changing Time Horizons and Trust: Experiences of Aging With Hemophilia
Authors: Perry Tam , Schwartz Sara 
Published: December 2021

Abstract
Trust among those who have experienced a lifetime of medical encounters warrants attention to how trust is both cumulative and complex. This study of a historically isolated cohort incorporates interviews (n=25 older adults/professionals) and focus groups uses a lens of trust to highlight the experiences of those aging with hemophilia, individuals who never expected to age. Understood through the lens of trust, the data show evidence of the absence of safe spaces particularly during the early 80s - blood contamination concerns and homophobia-leading often to social withdrawal. Over time, however, some individuals and families created trusted venues to begin demanding research, treatment and policy change. Advocacy re-engaged the community to organize, educate and advance safety protocols for blood product manufacturing and distribution. This presentation will illuminate how experiences with medical providers, contaminated blood supplies, stigma and uncertain in other spheres of one’s life make trust a co-constructed, fragile concept.
Factors Related to COVID-19 Vaccine Uptake in Black American Communities
Authors: Johnson Julene , Harris Orlando , Hill Carl V , Lichtenberg Peter , Keiser Sahru , Perry Tam , Portacolone Elena 
Published: December 2021

Abstract
Black/African Americans represent 13% of the population, yet account for about a quarter of COVID-19 deaths. Black Americans receive COVID-19 vaccines at lower rates than whites. To address this gap, we examined effects of the COVID-19 pandemic among Black Americans, emphasizing understanding trust and vaccines. Data were collected (July to September 2020) using 8 virtual focus groups in Detroit and San Francisco with 33 older Black Americans and 11 caregivers. Content analysis was used to identify themes. The first theme pointed to a sense of feeling abandoned by healthcare providers and the government, which exacerbated uncertainty and fear. The second theme emphasized distrust towards healthcare providers and government. The third theme pointed to a reluctance in receiving the vaccine because of distrust of pharmaceutical companies and government, as well as misinformation. These findings suggest that underlying systemic issues need to be addressed to accelerate vaccine uptake among older Black Americans.
Experiences From Healthcare and Community Organizations Delivering Evidence-Based Dementia Caregiving Programs
Authors: Schaffer Rachel , Ciancibello Alyssa , Bass David , Powers Sara 
Published: December 2021

Abstract
Best Practice Caregiving surveyed 324 healthcare and community organizations that replicated one or more of the 44 evidence-based programs about delivery organization characteristics, delivery staff, caregivers and persons with dementia served, funding sources, delivery challenges, perceived impact, and satisfaction. 211 (65.1%) organizations completed surveys about 30 different evidence-based programs. The most common types of organizations that delivered programs were healthcare organizations (23.8%) and Area Agencies on Aging (23.8%). Results showed on average organizations delivered programs for 49 months and served 68 families/year. The most common program delivery challenges were marketing (69.8%) and engaging participants (66.3%). Organizations generally agreed that programs had positive impacts on caregivers (59.5% strongly agree) but were less positive about benefits for persons with dementia (25.1% strongly agree). Discussion provides insights into successes and challenges organizations face when adopting evidence-based dementia caregiving programs in their communities.
Aspects of Grit Among Dementia Family Caregivers
Authors: Savla Jyoti , Roberto Karen , Margrett Jennifer 
Published: December 2021

Abstract
Dementia family caregivers often show deep devotion and a strong sense of purpose and duty toward their relatives needing care. The concept of grit, which includes aspects of commitment, purpose, perseverance, and resilience, is a novel theoretical approach to expanding understanding of dementia family caregiver strengths amidst the challenges they face. Multiple psychosocial and contextual factors are likely to interact with and influence grit among these caregivers. This symposium addresses commitment to the family dementia caregiver role, willingness to embrace the stressful work of caregiving, and perseverance in finding ways to sustain caregiving roles under typical and adverse circumstances. Blieszner focuses on associations between grit and stressors and strains that challenge caregiver well-being and jeopardize continued caregiving. Wilks considers the impact of spiritual support on sustaining resilience among Caucasian and African American dementia caregivers. McCann explores caregivers’ responses to changes in informal support and social interactions available to assist with home care tasks over the course of the COVID-19 pandemic. Albers examines the strengths and resources caregivers draw upon to manage the challenges of caring for and supporting a relative in long-term residential care during the pandemic. Collectively, these presentations provide new insights into the range of influences on aspects of grit and circumstances in which grit sustains caregiving. Discussant Margrett considers the value of the concept of grit for furthering understanding of caregivers’ abilities to manage typical and unique challenges in their caregiver roles and offers suggestions for future research and interventions to enhance grit among dementia family caregivers.