bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and prognostic significance of ventricular–arterial coupling after myocardial infarction: the RIGID-MI cohort
Authors: Aghezzaf Samy , Coisne Augustin , Bauters Christophe , Favata Francesco , Delsart Pascal , Coppin Amandine , Seunes Claire , Schurtz Guillaume , Verdier Basile , Lamblin Nicolas , Tazibet Amine , Le Taillandier de Gabory Justine , Ninni Sandro , Donal Erwan , Lemesle Gilles , Montaigne David 
Published: December 2023

AbstractAimsThe clinical significance and feasibility of the recently described non-invasive parameters exploring ventricular–arterial coupling (VAC) remain uncertain. This study aimed to assess VAC parameters for prognostic stratification in stable patients with left ventricular ejection fraction (LVEF) ≥40% following myocardial infarction (MI).Methods and resultsBetween 2018 and 2021, patients with LVEF ≥40% were evaluated 1 month following MI using transthoracic echocardiography (TTE) and arterial tonometry at rest and after a handgrip test. VAC was studied via the ratio between arterial elastance (Ea) and end-systolic LV elastance (Ees) and between pulse wave velocity (PWV) and global longitudinal strain (GLS). Patients were followed for major adverse cardiovascular events (MACE): all-cause death, acute heart failure, stroke, AMI, and urgent cardiovascular hospitalization. Among the 374 patients included, Ea/Ees and PWV/GLS were obtained at rest for 354 (95%) and 253 patients (68%), respectively. Isometric exercise was workable in 335 patients (85%). During a median follow-up of 32 months (interquartile range: 16–42), 41 (11%) MACE occurred. Patients presenting MACE were significantly older and had a higher prevalence of peripheral arterial disease, lower GLS, higher Ea, PWV, and PWV/GLS ratio. The Ea/Ees ratio and standard TTE parameters during isometric exercise were not associated with MACE. After adjustment, the PWV/GLS ratio was the only VAC parameter independently associated with outcome. Receiver operating characteristic curve analysis identified a PWV/GLS ratio &gt;0.70 (Youden’s index = 0.37) as the best threshold to identify patients developing MACE: hazard ratio (95% confidence interval) = 2.2 (1.14–4.27), P = 0.02.ConclusionThe PWV/GLS ratio, assessed 1 month after MI, identifies a group of patients at higher risk of MACE providing additional value on top of conventional non-invasive parameters.
Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy
Authors: Dural Muhammet , Ghossein Mohammed A , Gerrits Willem , Daniels Fenna , Meine Mathias , Maass Alexander H , Rienstra Michiel , Prinzen Frits W , Vernooy Kevin , van Stipdonk Antonius M W 
Published: December 2023

Abstract

Aims
Data on repolarization parameters in cardiac resynchronization therapy (CRT) are scarce. We investigated the association of baseline T-wave area, with both clinical and echocardiographic outcomes of CRT in a large, multi-centre cohort of CRT recipients. Also, we evaluated the association between the baseline T-wave area and QRS area.

Methods and results
In this retrospective study, 1355 consecutive CRT recipients were evaluated. Pre-implantation T-wave and QRS area were calculated from vectorcardiograms. Echocardiographic response was defined as a reduction of ≥15% in left ventricular end-systolic volume between 3 and 12 months after implantation. The clinical outcome was a combination of all-cause mortality, heart transplantation, and left ventricular assist device implantation. Left ventricular end-systolic volume reduction was largest in patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs compared with QRS area ≥ 109 μVs and T-wave area &lt; 66 μVs (P = 0.004), QRS area &lt; 109 μVs and T-wave area ≥ 66 μVs (P &lt; 0.001) and QRS area &lt; 109 μVs and T-wave area &lt; 66 μVs (P &lt; 0.001). Event-free survival rate was higher in the subgroup of patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs (n = 616, P &lt; 0.001) and QRS area ≥ 109 μVs and T-wave area &lt; 66 μVs (n = 100, P &lt; 0.001) than the other subgroups. In the multivariate analysis, T-wave area remained associated with echocardiographic response (P = 0.008), but not with the clinical outcome (P = 0.143), when QRS area was included in the model.

Conclusion
Baseline T-wave area has a significant association with both clinical and echocardiographic outcomes after CRT. The association of T-wave area with echocardiographic response is independent from QRS area; the association with clinical outcome, however, is not.
A new membrane anatomy-oriented classification of radical surgery for rectal cancer
Authors: Wang Jiaqi , Liu Hailong , Li Ajian , Jiang Huihong , Pan Yun , Chen Xin , Yin Lu , Lin Moubin 
Published: December 2023

Abstract
For patients with different clinical stages of rectal cancer, tailored surgery is urgently needed. Over the past 10 years, our team has conducted numerous anatomical studies and proposed the “four fasciae and three spaces” theory to guide rectal cancer surgery. Enlightened by the anatomical basis of the radical hysterectomy classification system of Querleu and Morrow, we proposed a new classification system of radical surgery for rectal cancer based on membrane anatomy. This system categorizes the surgery into four types (A–D) and incorporates corresponding subtypes based on the preservation of the autonomic nerve. Our surgical classification unifies the pelvic membrane anatomical terminology, validates the feasibility of classifying rectal cancer surgery using the theory of “four fasciae and three spaces,” and lays the theoretical groundwork for the future development of unified and standardized classification of radical pelvic tumor surgery.
Daily Rumination–Affect Associations in Dyads During the COVID-19 Pandemic
Authors: Zambrano Garza Elizabeth , Murphy Rachel A , Linden Wolfgang , Ashe Maureen C , Madden Kenneth M , Jakobi Jennifer M , DeLongis Anita , Gerstorf Denis , Hoppmann Christiane A 
Published: December 2023

Abstract

Objectives
Negative and repetitive self-oriented thinking (rumination) is associated with lower well-being and health. The social context of rumination remains underexplored and mostly centers on marital relationships. To embrace the diversity of older adult relationships, this study includes a range of different relationships (e.g., spouses, siblings, friends, etc.) and examines the role of rumination by close others on individual well-being during the coronavirus disease 2019 pandemic.

Methods
Using daily diary data from 140 Canadian older adults (M = 72.21 years, standard deviation [SD] = 5.39, range: 63–87 years, 47% women, 71% university educated) and a close other of their choice (M = 59.95 years, SD = 16.54, range: 18–83 years, 78% women, 81% university educated), this project builds on past research examining daily life rumination dynamics from a dyadic perspective. For 10 days, both dyad members reported their daily rumination and affect quality in the evening.

Results
Multilevel models replicate past work showing that individual rumination was associated with higher negative affect (within-person: b = 0.27, p &lt; .001, between-person: b = 0.57, p &lt; .001) and lower positive affect (within-person: b = −0.18, p &lt; .001, between-person: b = −0.29, p &lt; .001). Importantly, we additionally observed that partner rumination was associated with higher negative affect (b = 0.03, p = .038) and lower positive affect (b = −0.04, p = .023), highlighting the social context of rumination.

Discussion
Findings illustrate the significance of rumination for the self and others and underline the merit of taking a dyadic perspective on what is typically viewed as an individual-level phenomenon.
The Impact of Spatial Orientation Changes on Driving Behavior in Healthy Aging
Authors: Morrissey Sol , Jeffs Stephen , Gillings Rachel , Khondoker Mizanur , Patel Martyn , Fisher-Morris Mary , Manley Ed , Hornberger Michael 
Published: December 2023

Abstract

Objectives
Global cognitive changes in older age affect driving behavior and road safety, but how spatial orientation differences affect driving behaviors is unknown on a population level, despite clear implications for driving policy and evaluation during aging. The present study aimed to establish how spatial navigation changes affect driving behavior and road safety within a large cohort of older adults.

Methods
Eight hundred and four participants (mean age: 71.05) were recruited for a prospective cohort study. Participants self-reported driving behavior followed by spatial orientation (allocentric and egocentric) testing and a broader online cognitive battery (visuomotor speed, processing speed, executive functioning, spatial working memory, episodic memory, visuospatial functioning).

Results
Spatial orientation performance significantly predicted driving difficulty and frequency. Experiencing more driving difficulty was associated with worse allocentric spatial orientation, processing speed, and source memory performance. Similarly, avoiding challenging driving situations was associated with worse spatial orientation and episodic memory. Allocentric spatial orientation was the only cognitive domain consistently affecting driving behavior in under 70 and over 70 age groups, a common age threshold for driving evaluation in older age.

Discussion
We established for the first time that worse spatial orientation performance predicted increased driving difficulty and avoidance of challenging situations within an older adult cohort. Deficits in spatial orientation emerge as a robust indicator of driving performance in older age, which should be considered in future aging driving assessments, as it has clear relevance for road safety within the aging population.
FROM THESE ROOTS: THE ROLE OF HBCUS IN PREPARING THE NATION’S GERONTOLOGISTS FOR AN AGING SOCIETY
Authors: Brown Terrell 
Published: December 2023

Abstract
The aging of the U.S. population is creating an increased need for social workers and other helping professionals with training in gerontology. Estimates indicate that less than 3% of MSW students are enrolled in an aging concentration, as compared to 19% enrolled in children/youth concentrations. The phenomenon of a diverse baby boomer generation joining the ranks of persons age 65 and older has created a plethora of scholarship and curriculum development aimed at readying the aging network for the unprecedented growth of older persons. Social work can make unique contributions to the field of gerontology. This study asserts, however, that social work is not adequately prepared to practice in an increasingly diverse aging society. The social work profession has articulated commitments to acknowledging and affirming how diversity and culture shape the human experience and to developing social workers who can competently engage in research-informed practice and practice-informed research. However, there remains a need in social work education for more widespread use of culturally relevant pedagogies that can help achieve these goals. Informed by both the Afrocentric and Black perspectives, this study presents a content analysis of the curricula infused at two historically Black universities. The nature and extent of the contributions of historically Black universities to social work education is the focus of this article. The scope of this investigation also includes the identification of prominent Black social work educators and discusses the implications of these perspectives for more culturally informed gerontology curricula that promote culturally competent gerontological social workers
EMBEDDING EVIDENCE-BASED CAREGIVER SUPPORT IN COMMUNITY-BASED PROGRAMS: THE ADS PLUS PROGRAM
Authors: Gitlin Laura , Gaugler Joseph , Hepburn Kenneth 
Published: December 2023

Abstract
Adult Day Services (ADS) are a community-based option in long-term care, providing a safe, interactive, and managed environment for people with dementia (PWD). ADS also serve racially/ethnically diverse communities, provide respite for family caregivers and help people age-in-place. Nevertheless, research reveals inconsistent benefits of ADS for caregivers of clients and ADS do not typically offer evidence-based caregiver programs as part of routine care. This symposium reports on the results of a novel NIA funded multi-site Hybrid Type I trial with pragmatic elements which evaluated the effectiveness of embedding a caregiver support program, ADS Plus, in ADS and delivered by staff. ADS Plus, provides caregivers with dementia education, stress reduction techniques, validation/support, referrals and linkages, and strategies to address caregiver-identified challenges over 12-months. Reported are the quantitative and cost outcomes, implementation processes, and challenges and lessons learned. Dr. Gitlin will present the main quantitative study outcomes of this multi-site trial involving 34 sites nationally and 234 caregivers, which demonstrated benefits for caregivers and ADS. Next, Dr. Marx will examine implementation findings including session completion and content. Dr. Gaugler will present findings from the qualitative arm examining perceived benefits of ADS Plus by staff and participants. Ms. Prioli will then examine cost savings associated with ADS Plus whereas Dr. Parker will address barriers when partnering with home and community-based services including developing and maintaining partnerships, institutional review board hurdles and staff readiness. To conclude, our discussant, Dr. Kenneth Hepburn, will offer perspectives on moving evidence-based programs into community-based settings such as ADS. This is a Behavioral Interventions for Older Adults Interest Group Sponsored Symposium.
OUTCOMES OF THE ADULT DAY SERVICE PLUS (ADS PLUS) PROGRAM: A HYBRID TYPE I MULTISITE TRIAL DESIGN
Authors: Gitlin Laura , Roth David , Marx Katherine , Parker Lauren , Koeuth Sokha , Dabelko-Schoeny Holly , Anderson Keith , Gaugler Joseph 
Published: December 2023

Abstract
This paper presents the main outcomes of a cluster randomized hybrid trial (type I) involving 34 adult day services (ADS) in the US. Eighteen sites were randomized to control (ADS as usual); 16 sites provided ADS and caregiver support (ADS Plus). Trained staff met with caregivers onsite to provide dementia education, support/validation, referrals/linkages, and strategies for care challenges and self-care over 12-months. Main outcomes included depressive symptoms (CES-D) and well-being at 6-and 12-months, and attendance of clients (people living with dementia) over 12-months. Of 203 caregivers (Intervention=102; Control=101), 5.9% at 3-months, 12.8% at 6-months, and 22.7% at 12-months were lost-to-follow-up. Caregivers were predominantly female (80.3%), with 76.4% identifying as white/Caucasian, 14.8% Black/African American, and 12.3% Hispanic/Latino. Most (88.2%) had &gt;college education and were 65.0 years old (SD=13.46). For those with 6-month data, 40.4% control and 40.2% ADS Plus caregivers had depressed symptoms (&gt;16 CES-D) at baseline. By 6-months, 43.6% control versus 34.2% ADS Plus caregivers had &gt;16 scores (odds ratio=0.38, p=0.072). By 12-months, after covariate adjustments, ADS Plus caregivers reported reduced total depression scores versus controls (p=0.013) and lower depressed affect scores (p=0.015). Of 18 sites providing 12-month client attendance data, nine intervention sites reported 126.05 days attended versus 78.49 days for nine control sites (p=0.079). Compared to ADS alone, by 12-months ADS Plus improved caregiver mood and increased ADS utilization by 60.6%. Results support ADS staff delivering evidence-based caregiver support to enhance benefits for clients, caregivers and ADS.
COST ANALYSIS OF THE ADULT DAY SERVICES PLUS TRIAL
Authors: Pizzi Laura , Prioli Katherine , Jutkowitz Eric , Molinari Alexa , Gitlin Laura 
Published: December 2023

Abstract
We assessed costs associated with ADS Plus vs. control from payer and societal perspectives using trial data. Costs were valued in $US 2021 and included ADS Plus program delivery, direct healthcare utilization (HCU), formal care and social services (FCSS), and indirect caregiver time (CGT). Payer perspective analyses included HCU and FCSS costs, with and without ADS Plus program delivery costs; societal perspective included these plus CGT costs. Analysis consisted of the mean per-dyad difference in change for ADS Plus (n=102) vs. control (n=101) at 6 and 12-months. ADS Plus program delivery costs were $671. At 6-months, comparing ADS Plus to control, there were mean savings in HCU ($79), FCSS ($1,038), and CGT ($6,426). Payer perspective total savings for ADS Plus were $446 and $1,117 with and without ADS Plus program delivery respectively; societal perspective savings were $6,872 and $7,543, with vs. without AD Plus program delivery, respectively. At 12-months for ADS Plus vs. control, HCU savings were $1,686 and FCSS savings were $290. CGT was $76 higher for ADS Plus. Payer perspective savings were $1,305 and $1,976 with and without ADS Plus program delivery respectively; societal perspective savings were $1,228 with ADS Plus delivery and $1,899 without it. ADS Plus costs were lower than control thus representing potential savings from both the payer and societal perspectives. Savings were primarily driven by lower costs in healthcare utilization including inpatient hospitalizations, outpatient visits, and home health aide services. Though favorable, findings were not statistically significant and should be interpreted with caution.
RURAL–URBAN DIFFERENCES IN POSTSURGICAL SERVICE USE AND OUTCOMES AMONG VETERANS WITH DEMENTIA
Authors: Davila Heather , Gao Yubo , Jacobs Michael , Hadlandsmyth Katherine , Duncan Carly , Strayer Andrea , Hall Daniel , Vaughan-Sarrazin Mary 
Published: December 2023

Abstract
Adults with dementia have worse post-surgical outcomes than those without dementia, including readmission and death. The use of home health or facility-based skilled nursing after discharge may prevent poor outcomes. We know little about rural-urban differences in post-discharge services or outcomes among individuals with dementia. We examined the relationship between post-discharge service use and 30-day readmission or mortality using retrospective data for Veterans Affairs patients aged 65+ with dementia who underwent inpatient surgery between 2013-2019. We used merged VA and Medicare claims to categorize patients as discharged to home without services, home with home health, or skilled nursing/rehabilitation facility [SNF]. We excluded individuals who were transferred to another acute hospital, transferred to hospice, died or were readmitted within 3 days of discharge, or were not enrolled in Medicare. We used multivariable logistic regression to assess associations between rurality, discharge location, and outcomes, while controlling for demographics, frailty, comorbidities, surgical specialty, and surgical complexity. The analytic sample included 4534 Veterans; 48.7% discharged to a SNF, 40.1% to home without services, and 10.4% to home with home health. We did not find rural-urban differences in risk-adjusted readmission or mortality overall. Among those discharged to home (n=2324), receipt of home health was modestly associated with decreased readmission risk overall (OR=0.52; p=0.07), and lower risk of morality among urban Veterans (OR=0.34; p=0.05) but not rural Veterans. Although we did not find rurality disparities in outcomes, further research may identify reasons home health decreases post-surgical mortality among urban but not rural adults with dementia.
AARP PUBLIC POLICY INSTITUTE PRESENTS THE LONG-TERM SERVICES AND SUPPORTS STATE SCORECARD, 2023
Authors: Reinhard Susan , Reinhard Susan 
Published: December 2023

Abstract
This symposium will present and explore in-depth the 2023 Long-Term Services and Supports (LTSS) State Scorecard. With funding from The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation, this Scorecard is the fifth edition from the AARP Public Policy Institute. The Scorecard ranks states across five key dimensions that comprise a framework for high-performing LTSS system performance: affordability and access, choice of setting and provider, quality and safety, support for family caregivers, and community and integration. In this symposium, speakers will discuss the Scorecard’s history, its most recent findings, and the implications of the COVID-19 pandemic for state LTSS system performance. In addition, the Scorecard explores LTSS equity, and we will discuss how policymakers, practitioners, the private sector, and other actors can further realize equitable systems of supports.
RACIAL/ETHNIC DISPARITIES IN HOSPITAL READMISSION AND FREQUENT HOSPITALIZATIONS AMONG PEOPLE WITH DEMENTIA
Authors: Mahmoudi Elham 
Published: December 2023

Abstract
People 65+ must choose between traditional Medicare (TM) and Medicare Advantage (MA). This study has two aims: (1) examine 30-day readmission and frequent hospitalizations in TM vs. MA; (2) examine racial/ethnic disparities in noted outcomes. We used a 20% random sample of TM and MA insurance claims (2018-2019). Participants included individuals 65+, with a diagnosis of Alzheimer’s disease and related dementia (ADRD), and two years of continuous enrollment in TM (n=129,177) or MA (n=119,130). Our explanatory variables included age, sex, race/ethnicity, comorbidities, frailty index, continuity of care index, and discharge location. Generalized linear models were applied. There were a higher percentage of Black (13.1% vs 8.2%) and Hispanic (11.9% vs. 7.0%) people in MA vs. TM (p &lt;.001). MA enrollees had lower rates of chronic conditions and were less frail (31.4 vs. 33.6; p&lt; .001), but a higher percentage of them had an annual wellness visit (38.8% vs. 32.3%; p &lt;.001) than TM enrollees. Our matched and adjusted models show that TM increased the odds of readmission [OR=1.16 (95% CI: 1.06-1.26)] and 2+ hospitalizations [OR=1.25 (95% CI: 1.19-1.40)] compared to MA. Hispanic-White disparities in 30-day readmission [OR=1.23 (95% CI: 1.06-1.43)] and 2+ hospitalizations [1.42 (95% CI: 1/31-1.56)] were higher in TM vs. MA. Black people had higher readmission risks [OR=1.18 (95% CI:1.08-1.28)] and frequent hospitalizations [OR=1.26 (95% CI:1.19-1.33)] without any significant difference between MA and TM in Black-White disparities. MA vs. TM enrollees had lower risks of readmission and frequent hospitalizations. Moreover, MA lowered Hispanic-White disparities compared with TM.