bluuebunny/crossref_metadata_2025_split huggingface dataset:
SEX DIFFERENCES IN MULTI-DIMENSIONAL SLEEP HEALTH AND DEMENTIA RISK: A PROSPECTIVE STUDY IN THE UK BIOBANK
Authors: Huang Tianyi , Beydoun May , Launer Lenore 
Published: January 2025

Abstract
Sex differences in sleep health risk factors may contribute to differences in dementia risk between women and men. There were 409,789 dementia-free UK Biobank participants (55% women) who self-reported 7 sleep-related traits at baseline in 2006-2010. Incident dementia was identified using algorithmically defined outcomes through primary care, hospital admissions, or death records until December 31, 2022. The prevalence of insomnia symptoms and non-restorative sleep was 7-8% higher in women, while snoring, sleepiness and napping were more common in men. Over a median follow-up period of 13.8 years, there were 7,583 incident dementia cases (3,406 Alzheimer’s, 1,651 vascular). After adjusting for potential confounders, the increased dementia risk associated with sleepiness, napping, and evening chronotype was higher in women, whereas the association between non-restorative sleep and dementia risk was stronger in men. For example, the multivariable-adjusted hazard ratio (95% CI) for sleepiness was 1.59 (1.35, 1.86) in women and 1.21 (1.04, 1.40) in men (p-interaction by sex=0.01), and the corresponding estimate for non-restorative sleep was 1.27 (1.17, 1.39) and 1.39 (1.26, 1.52) in women and men, respectively (p-interaction by sex=0.06). U-shaped associations between short/long sleep duration and dementia risk were similar in women and men. Similar sex differences were observed separately for Alzheimer’s and vascular dementia, although the associations were generally weaker for Alzheimer’s disease. In summary, most sleep health dimensions were differentially associated with dementia risk in women and men. Recognizing these sex differences may help develop sex-specific strategies to promote sleep health and moderate the risk for dementia.
RASI’S IN RECOMMENDED HIGHER TARGET DOSES MAY LOWER RISK OF DEATH AND KIDNEY FAILURE IN OCTOGENARIANS WITH HFREF
Authors: Ahmed Ali , Heidenreich Paul , Aronow Wilbert , Allman Richard , Faselis Charles , Sin Mo-kyung , Lam Phillip , Fonarow Gregg 
Published: January 2025

Abstract
Renin-angiotensin system inhibitors (RASIs) reduce the risk of death in patients with heart failure with reduced ejection fraction (HFrEF). National heart failure (HF) guidelines recommend that RASIs be used in higher target doses in patients with HFrEF. However, clinical trials of target vs. below-target dose RASIs did not include octogenarians, and target-dose group had worsening kidney function, but kidney failure (KF) was not examined. Thus, it is unknown whether RASIs in target doses may improve clinical outcomes without causing KF in octogenarians with HFrEF. Of the 311,611 Veterans with HF receiving RASIs, 32,964 were ≥80 years with ejection fraction ≤40% and without KF of whom 6655 (20.2%) received target-dose. Propensity scores for target-dose, calculated for each of 32,964 patients, were used to match 6642 (99.8% of 6655) target-dose patients with 6642 below-target-dose patients. Matched patients (N=13,284) were balanced on 66 baseline characteristics and had mean(SD) age 84.5(3.4) years, ejection fraction 31.3(8.2)%, and estimated glomerular filtration rate 58.5(18.2) mL/min/1.73m2. During 5 years of follow-up, 70.3% of the patients died, 34.1% were hospitalized for HF, and 1.7% developed KF. Target-dose RASI use was associated with a significant 5% (95% CI, 1–9%) lower risk of death (HR, 0.95; 95% CI, 0.91–0.99). There was a trend toward a lower risk of KF (HR, 0.80; 95% CI, 0.61–1.04), and consequently a lower risk of the composite endpoint of KF or death (HR, 0.94; 95% CI, 0.91–0.98). These new findings provide evidence for the use of RASIs in recommended higher target doses in octogenarians with HFrEF.
EXPLORING SUBJECTIVE COGNITIVE DECLINE IN OLDER ADULTS: A MIXED METHODS APPROACH
Authors: Wen Xi , Li Huiling 
Published: January 2025

Abstract

Objective
This study aims to explore the cognitive health of older adults exhibiting SCD by using a mixed methods approach to identify the factors and implications of perceived cognitive decline, thereby contributing to early intervention strategies.

Methods
We employed a convergent parallel mixed-method design. Quantitative data were collected using the Dementia Assessment Sheet for Community-based Integrated Care System 21 items (DASC-21) and the 9-items Subjective Cognitive Decline Questionnaire (SCD-Q9) from 1,458 older adults without clinical dementia in Soochow, China. Qualitative data were gathered through semi-structured interviews to capture detailed narratives on cognitive complaints, their perceived causes, and impacts on daily life.

Results
Quantitative analysis revealed that 48.7% of participants experienced SCD, with significant associations found with advanced age, low education levels, underweight, diabetes, cataract/glaucoma, osteoporosis, hyperlipidemia, and ischemic heart disease. Qualitative thematic analysis identified three primary themes: cognitive complaints, multifactorial attributions of cognitive decline, and the effects on daily life.

Conclusion
Our findings underscore the importance of recognizing SCD in older adults as a possible precursor to more severe cognitive impairment. The mixed methods approach provided a comprehensive understanding, suggesting that both objective and subjective assessments are critical for early detection and intervention. These insights highlight the need for tailored interventions focusing on modifiable risk factors and enhancing quality of life for older adults with SCD.
ADDRESSING THE HIGH RISK OF OPIOID OVERDOSE AMONG OLDER ADULTS: A RETROSPECTIVE CHART REVIEW
Authors: Kleykamp Bethea , Lynch Erin , Smith Hannah 
Published: January 2025

Abstract

Background and Objectives
In Maryland, fatalities due to opioid overdoses are highest among adults aged 55 and over a. This retrospective chart review evaluated 49 adults in outpatient opioid treatment in Baltimore as a function of age. Analyses: Intake characteristics and treatment outcomes were compared between 24 older (ages 55-70) and 25 younger (ages 23-35) adults using ANOVA and χ2 statistics (alpha=0.05).

Results
The cohort was 54% male, and most patients were prescribed methadone (84%). Older adults were more likely to be Black/African American (68% vs. 24%) and had longer histories of opioid (30 vs. 9 years) and tobacco use (45 vs. 14 years) (ps &lt; 0.05). At intake, equal proportions of older and younger adults tested positive for cocaine (49%), fentanyl (61%), and benzodiazepines (27%); cannabis use was less common for older adults (17% vs. 56%; χ2 =8.15). While engaged in treatment, older adults were less likely to test positive for cocaine (26% vs. 77%) and cannabis (16% vs. 60%) (ps &lt; 0.05), with no differences in fentanyl (66%) or benzodiazepine use (29%). Older adults remained in treatment longer (186 vs. 105 days, F=6.7) and had higher retention rates (21% vs. 0%) (χ2 =5.8).

Conclusion
Older adults showed less polysubstance use and longer retention in care. However, continued fentanyl and benzodiazepine use could put older adults at greater risk of overdose due to age-related vulnerabilities and prolonged substance use. These differences highlight the unique clinical characteristics of older adults at risk of overdose, which can inform age-friendly addiction treatment approaches.
PHYSICAL CAPACITY IS ASSOCIATED WITH ATTENTION IN MIDDLE AGED ADULTS
Authors: Iktilat Khalil , Tzemah-Shahar Roy , Agmon Maayan 
Published: January 2025

Abstract
Associations between physical capacity and various aspects of executive function, including attention, have been identified in older and younger cohorts, but the relationship among middle-aged individuals at the gateway of aging is largely understudied. The primary objective of this study was to investigate this relationship in middle-aged Muslims in Israel, a group experiencing chronic health disparities. This cross-sectional study included 255 participants (159 women), aged 51.29±4.26 (45-60), assessed using the six-minute walk test (6MWT) and 30-second sit-to-stand test (30STS) for physical capacity, and the Stroop Test and Trail Making Test (TMT) for selective and alternating attention, respectively. We found a significant positive correlation between the 30STS and Stroop-C scores even when controlling for age, sex, education level, and hemoglobin A1c, indicating that physical capacity is independently and positively associated with selective attention (β=0.132, P=0.057). In contrast, no correlation was found between the 30 STS and TMT (β=-0.107, P=0.107), suggesting that alternating attention is not associated with physical capacity. Interestingly, neither attention assessment was associated with the 6MWT, suggesting that among healthy, free living, middle-aged individuals, more challenging assessments should be used when examining associations between physical capacity and executive function. Our findings analyzed this past month, in time for late-breaking submission, highlight the nuances of the relationship between physical capacity and aspects of executive function middle aged adults. Interventions that include challenging physical tasks may reduce selective attention decline in middle-aged adults.
MODERNIZING CHINA’S PRIMARY HEALTHCARE: REVISITING THE BAREFOOT DOCTOR PROGRAM TO ELEVATE SPECIALIZED NURSING
Authors: Wang Qingwei , Wu Zixuan 
Published: January 2025

Abstract
A persistent challenge in China’s primary healthcare system is the shortage of qualified healthcare professionals, a problem exacerbated by the decline of the Barefoot Doctor (BD) program. The newly innovative introduction of Specialized Nurses (SNs) in 2024 seeks to address physician shortages by equipping nurses with advanced skills, including prescription authority. This article explores how lessons from the BD program can inform the modernization of China’s primary care workforce with a focus on the needs of older adults. Through a comparative analysis, the study examines how both initiatives aim to address the shortage of healthcare professionals by harnessing grassroots power. Three critical themes are explored: 1) Community integration of Specialized Nurses (SNs) may face challenges due to prevailing cultural perceptions of nursing professionalism and the confinement of SNs to tertiary hospitals, which significantly hinder their involvement in community healthcare; 2) The effectiveness of the program is constrained by insufficient financial support and unclear career progression paths; 3) Sustainable caregiving strategies are necessary that address both traditional and contemporary health needs, expanding beyond the BD’s focus on environmental and infectious diseases to include non-communicable diseases. Drawing from the BD model, future efforts should prioritize community-based care, expanding opportunities for home visits, especially for older adults who may face mobility challenges.. Ensuring adequate fiscal funds and active agency involvement from the government and health administrators is crucial for sustaining the primary healthcare system. Additionally, preventive care should adopt a holistic and interdisciplinary approach that integrates diet, exercise, and psychological care.
ASSOCIATION OF HEALTHCARE USE AND EXPENDITURE BASED ON DUAL ELIGIBILITY AND ENROLLMENT IN MANAGED CARE
Authors: Toseef Mohammad Usama , Dharia Aastha , Homayouni Ramin , Tarraf Wassim 
Published: January 2025

Abstract
Individuals enrolled in both Medicaid and Medicare, also known as duals, have complex and high healthcare needs and disproportionately account for higher state and federal spending. In recent years, most of these beneficiaries have been enrolled in some form of managed care plans. In this study, using the 2020-2021 Medical Expenditure Panel Survey, we evaluate the association of dual-eligibility status and different forms of healthcare use and expenditures: inpatient, emergency room and outpatient. We also explore if enrollment in a managed care affects this relationship. We estimate a series of Poisson regressions for use variables and generalized linear models for expenditure variables that account for the interaction between dual-eligibility status and enrollment in managed care. Postestimation, we calculate marginal effects and use analysis of variance contrast tests to estimate the differences in the predicted use events and average expenditure based on managed care and dual-eligibility status. We find that, on average, duals eligibles have a higher use of inpatient and emergency room than non-duals but similar outpatient visits. We also find that non-duals enrolled in managed care have lower outpatient and emergency room visits than their non-managed care counterparts. No significant differences are observed for dual eligibles in terms of their managed care status for both use and expenditures. While more research and years of data are needed to establish whether managed care improves utilization and lowers spending for dual eligibles, we find that managed care affects duals and non-duals differently and stakeholders should consider this to provide equitable health.
IMPLICATIONS OF TIMING, COMMUNITY, AND DIFFUSION FOR IMMIGRANT HEALTHCARE AND TELEHEALTH EXPERIENCES
Authors: Hong Sungjae , Mejia Shannon 
Published: January 2025

Abstract
Inequality in access to healthcare among immigrant older adults can evolve into health disparities, resulting in social burdens on society. This study integrates life course and diffusion of innovations perspectives to examine how the timing of immigration, global events, and interdependence intersect with social systems and communication channels to influence healthcare and telehealth adoption. We interviewed 22 Korean immigrant older adults who immigrated to the Chicago Metropolitan Area. The interviews detailed respondents’ life trajectories, including immigration timing, communication channels, and social relationships. Participants also reported perceptions of and experiences with healthcare and telehealth. To discover how perceptions of and experiences with telehealth varied according to life experiences, we conducted the direct content analysis based on the diffusion of innovations and the life course theories. We coded interviews with predefined codes based on the theories but added new codes if needed. Four main themes emerged: 1) Racial/ethnic communities served as the primary communication channel for healthcare information, 2) The difference between the first and 1.5 generations in the trajectories of healthcare service experience, 3) Adult children as the primary driver of telehealth adoption, and 4) The limited scope of authority innovation diffusion, where telehealth services were adopted within the COVID-19 context, but exchanged for in-person healthcare services due to cultural norms. Our findings provide new insight into the lifelong mechanisms of inequalities in healthcare and telehealth and highlights importance of communication channels and community connections in efforts to improve access to and use of telehealth services in immigrant older adult populations.
Engaging in Lethal Means Safety (ELMS): An Evaluation of a Suicide Prevention Means Safety Training Program for Mental Health First Responders
Authors: Collins Christopher 
Published: January 2025

Abstract
Firearm-related suicide is a preventable yet leading cause of death in the United States, and screening for access to firearms in clinical settings is rare. The lack of screening in clinical practice may be compounded by the fact that clinicians are not often trained to effectively screen for access to lethal means. This article evaluates the effectiveness of the novel Engaging in Lethal Means Safety (ELMS) suicide prevention program. ELMS is a theoretically driven, empirically supported lethal means safety training program that trains mental health first responders in engaging clients in discussions of lethal means safety with a particular focus on firearm access and storage. Pretest, posttest, and one-month follow-up assessments measured knowledge of lethal means, confidence, and comfort in screening for access to lethal means, and future intent to counsel on means safety measures. All constructs increased significantly at posttest. Confidence was sustained at posttest. Comfort and intent to counsel levels decreased at follow-up but not to pretraining levels. Booster sessions are recommended for future iterations of the program to further sustain overall effects. Further, additional research using a treatment control is encouraged.
Constitution-writing rules
Authors: Updike Toler Lorianne 
Published: January 2025

Abstract
The new gold standard for constitution-writing is consensus. Such consensus is grounded on inclusivity and deliberation within the drafting body. Yet such consensus is under-theorized. It does not appreciate the impact of rules on constitutional outcomes. That parliamentary procedure is generally associated with majoritarian politics may explain this deficiency, but it is unjustified, as many procedural rules may facilitate a culture of trust among drafters that makes consensus possible. This study is the first to formulate a theory for how rules can contribute to consensus and identifies specific rules that are most likely to contribute to corporate trust upon which constitutional consensus depends. It then provides a case study in how the US Constitutional Convention deployed rules and benefited from physical strictures and structures that helped produce a high level of consensus.
Clinical application of targeted next-generation sequencing utilizing bronchoalveolar lavage fluid in thoracic surgery ICU patients with suspected pulmonary infections
Authors: Guo Xiaobo , Xie Nianlin , Xi Xiaotong , li Pei , Jia Jianbo , Chen Lianhong , Ren Mingzhi , Wang Yaping , Zhang Peipei , Deng Wanglong , Wang Yan , Jing Pengyu , Ding Ran , Gu Zhongping 
Published: January 2025

Abstract

Aims
The aim of this prospective study was to evaluate the diagnostic value of targeted next-generation sequencing (tNGS) in identifying pathogens from bronchoalveolar lavage fluid (BALF) in thoracic surgery ICU patients, offering additional diagnostic methods for clinical practice.

Methods and results
We collected clinical data from patients with suspected pulmonary infections in the thoracic surgery ICU of the Second Affiliated Hospital of Air Force Medical University. A total of 50 patients were enrolled in this study. Traditional pathogen detection (TPD), involving culture and loop-mediated isothermal amplification assays for 12 pathogens, along with tNGS, was employed for pathogen identification in BALF samples. Our findings demonstrated that the positive rate of tNGS was significantly greater than that of TPD (96% vs. 68%). Among the 50 samples analyzed, tNGS identified a total of 165 pathogens, whereas TPD detected only 48 pathogens. The TPD method primarily detected bacteria and fungi, whereas tNGS exhibited broader capabilities, identifying 104 cases with bacteria, 19 with fungi, 34 with DNA viruses, and 8 with RNA viruses. Notably, tNGS displayed enhanced efficiency in detecting atypical pathogens such as fungi, DNA viruses and RNA viruses. Furthermore, compared with TPD, tNGS demonstrated superior sensitivity (95.83% vs. 68.75%).

Conclusions
tNGS technology, characterized by its high sensitivity, specificity, and cost-effectiveness, holds great promise as a reliable diagnostic tool for assessing pulmonary infections in the thoracic surgery ICU patients.
Metagenomic detection and genome assembly of novel PRRSV-2 strain using Oxford Nanopore Flongle flow cell
Authors: Hodges Arabella L , Walker Lianna R , Everding Talia , Mote Benny E , Vu Hiep L X , Ciobanu Daniel C 
Published: January 2025

Abstract
Porcine reproductive and respiratory syndrome virus (PRRSV) is the causative agent of a syndrome characterized by reproductive failure and respiratory complications (PRRS). Early detection and classification of PRRSV strains are vital for appropriate management strategies to minimize loss following outbreaks. The most widely used classification method for PRRSV is based on open reading frame 5 (ORF5) sequences. However, the effectiveness of the ORF5-based classification system in accurately representing genetic variation is under scrutiny because ORF5 constitutes less than 5% of the 15kb-long genome. In this study, a single Oxford Nanopore Flongle flow cell was used to identify and assemble the genome of a strain sampled in May of 2022 from a Midwest research farm. Based on comparisons with available PRRSV genomes, the assembled genome was determined to be a novel PRRSV-2 strain belonging to the 1-4-4 L1C.5 ORF5-based lineage. Phylogenetic analyses of ORF5 and whole-genome sequences demonstrated differences in clustering between PRRSV strains, supporting the inability of ORF5 to capture genome-wide variation. For example, high levels of variation were observed within ORF1a, which encodes the hypervariable nsp2 protein. Comparison of the newly assembled genome with the genome of a highly characterized strain (VR2332 PRRSV-2) identified a 100 amino acid deletion within nsp2 characteristic of NADC34-like PRRSV. Oxford Nanopore Technologies’ Flongle flow cell has been proven in this study to provide a rapid, cost-effective and accessible approach for whole-genome sequencing of PRRSV strains present within clinical samples necessary for strain-specific genome-wide characterization.
A low cost and labor-efficient method for rearing an invasive beetle, Carpophilus truncatus (Coleoptera: Nitidulidae)
Authors: Bansal Raman , Rijal Jhalendra , Haviland David , Gyawaly Sudan , Wilson Houston 
Published: January 2025

Abstract
The carpophilus beetle, Carpophilus truncatus Murray, 1864 (Coleoptera: Nitidulidae) is an invasive pest recently detected in California’s tree nut crop orchards. Here we report a simple, labor-saving, and cost-effective rearing system for C. truncatus utilizing banana and industrial sand components. Banana slices served as both a larval and adult diet source as well as a moisture source to facilitate pupation within the underlying sand. The combination of banana and sand within a single container successfully supported the development of all C. truncatus life stages over multiple generations. The average developmental times recorded in rearing units placed under environmental conditions of 26°C, 60% relative humidity, and 16:8 h (light:dark) photoperiod were: egg to wandering stage larva, 7.54 days; wandering stage to adult, 11.08 days; and adult longevity, 94.33 days. These banana–sand rearing units facilitated the easy collection of all C. truncatus developmental stages, except for eggs. To address this challenge, standalone oviposition chambers utilizing a lima bean-based agar diet were evaluated. These chambers effectively enabled the collection as well as tracking of eggs for different research purposes. The average developmental time recorded for eggs, from initial oviposition to neonate hatching, was 3.20 days. These rearing as well as egg collection approaches provide cost-effective tool to investigate biology, life-history traits and ecology, as well as evaluate approaches to control this invasive pest.