bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMPOWERING BETTER END-OF-LIFE DEMENTIA CARE (EMBED-CARE): A DIGITAL CLINICAL DECISION SUPPORT FRAMEWORK
Authors: Davies Nathan , Sampson Elizabeth , Aworinde Tofunmi , Gillam Juliet , Kenten Charlotte , Phillips Bethan , Evans Catherine , Ellis-Smith Clare 
Published: December 2023

Abstract
People with dementia experience a variety of unmet palliative care needs. There is a need to empower people with dementia, family carers and professionals, to be able to better assess and monitor needs, and manage symptoms. We aimed to co-design and evaluate acceptability, feasibility and implementation of an integrated model of palliative dementia care to support holistic assessment, decision making and management of needs for those living in community and residential care (EMBED-Care Framework).We used a co-design approach, using framework analysis to synthesize data from evidence reviews, routine data, and cohort study, we presented findings to a series of co-design workshops, to produce the Framework. The Framework consists of a holistic assessment; priority setting; and decision support using clinical decision support tools, delivered on an app. The holistic assessment identifies areas of concern and identify priorities of care, through a process of shared decision making. Each concern is linked to a decision support tool to support decision making and to address priorities. App alerts and reminders communicate concerns among teams and carers. We are testing the Framework in a 6-month feasibility study with two residential homes and two community settings in England. We are collecting outcomes including decisional conflict, satisfaction with care, and unmet needs. We are interviewing all users to explore acceptability and implementation. We will present development of the EMBED-Care Framework and preliminary findings from our feasibility study, focusing on the acceptability and lessons for implementation which can be applied to the wider dementia community and similar interventions.
EXPLORING THE IMPLEMENTATION OF THE STRENGTHENING A PALLIATIVE APPROACH IN LONG-TERM CARE PROGRAM IN A CLINICAL TRIAL
Authors: Kaasalainen Sharon , Hunter Paulette , Thompson Genevieve , Wickson-Griffiths Abigail 
Published: December 2023

Abstract
Despite the high mortality rates in long-term care (LTC) homes, most do not have a formalized palliative program. Hence, our research team developed the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) program. This presentation will address how the SPA-LTC intervention was designed to be scaled up in a large randomized control trial, related implementation issues and strategies used to address them during the trial. This study used a cross-jurisdictional, effectiveness-implementation type II hybrid cluster design to evaluate the SPA-LTC program in 18 LTC homes across three provinces in Canada. The implementation component was designed as a formative evaluation to explore how to adapt the SPA-LTC program in real time. The SPA-LTC intervention leveraged both internal (palliative champion team) and external supports (palliative consultants) to build capacity within the LTC home to support and prepare residents and families for end-of-life decision making. Due to staff shortages and their inability to attend lengthy education sessions, we held four one-hour education sessions for the palliative champion team that were led by external palliative consultants over three months. Reach of the intervention was compromised as approximately 10% of participating residents died before a palliative care conference could be held. As a result, we prioritized residents who had lower Palliative Performance Scale (PPS) scores when planning a care conference. Clearly, efforts are needed to evaluate both the implementation and effectiveness of complex interventions, such as a palliative program, within a pragmatic approach given the real-life challenges that currently exist in this sector.
ANTIDIABETIC THERAPIES METFORMIN AND TRODUSQUEMINE MODULATE MIRNAS INVOLVED WITH LIVER METABOLISM
Authors: Ashiqueali Sarah , Schneider Augusto , Zhu Xiang , Juszczyk Ewelena , Zhu Yun , Bartke Andrzej , Siddiqi Shadab , Masternak Michal 
Published: December 2023

Abstract
Type II diabetes mellitus (T2DM) afflicts approximately 33% of individuals over the age of 65 increasing susceptibility to dyslipidemia, a hallmark of non-alcoholic fatty liver disease (NAFLD). Due to the idiopathic nature of NAFLD, there is no standard of care with only lifestyle intervention strategies available to improve hepatic function. Although dietary modifications and physical activity can prevent the pathogenesis of NAFLD, poor compliance has sparked an urgent need for pharmacological options to achieve glycemic control and prevent the onset of comorbidities. Metformin (MF) is commonly used medication to treat T2DM and has recently gained attention as an anti-aging intervention in non-diabetic individuals. Trodusquemine (MSI-1436) is a drug that induces fat loss by inhibiting the protein tyrosine phosphatase 1B (PTP1B), an enzyme that impairs leptin and insulin signaling. Using miRNA sequencing, we identified a cohort of miRNAs that are influenced by MF and MSI-1436 in the livers of UMHET3 mice. Our in-depth analysis and RT-PCR validation indicated groups of miRNAs regulating the processes of de novo lipogenesis, fatty acid oxidation, very-low-density-lipoprotein and cholesterol transport. Importantly, miR-379-5p, a known modulator of cholesterol metabolism, reported to be inhibited in the livers of patients with NAFLD and in mouse models of diabetes, was found to be upregulated by MSI-1436 in both sexes when comparing with both CTL and MF groups. In summary, our study showed that MSI-1436 more potently inhibits mechanisms involved with liver homeostasis relative to MF yielding insight on its therapeutic potential in concurrent liver diseases resulting from T2DM.
SUPPRESSION OF MICROBIOME SENSING—FREE FATTY ACID RECEPTOR 2 (FFAR2) SIGNALING EXHIBITS EARLY AGING
Authors: Mishra Sidharth , Prajapati Santosh Kumar , Jain Shalini , Yadav Hariom 
Published: December 2023

Abstract
Abnormalities in gut microbiome contribute to age-related diseases, causal to unhealthy aging, and early mortality, but mechanisms still remain largely unknown. Our recent research shows that old microbiota lacks the capacity to produce beneficial metabolites like short-chain fatty acids (SCFAs), which in turn promote gut permeability and systemic inflammation. SCFAs activates free fatty acid receptor 2 and 3 (FFAR2/3) signaling, at least in part, to exhibit their benefits on host cells; however, the role of these signaling in aging process is not well understood. We discovered that in addition to gut the brains of old mice show lower expression of FFAR2. Further, FFAR2 deletion in the intestine shows a shorter life span compared to wild-type mice. They also show a higher cognitive decline at early age. Similarly, intestine specific FFAR2 KO in APP/PS1 (Alzheimer’s disease [AD] model) background shows higher progression of AD including amyloid beta (A-beta) and tau accumulation, linked with higher blood brain barrier (BBB) permeability and neuroinflammation. These changes are associated with increased gut permeability and systemic inflammaging. Interestingly, a newly discovered natural FFAR2 agonist- Fenchol reduces these abnormalities in gut-brain and prevented the progression of cognitive decline and AD pathology. These results show that microbiome sensing FFAR2 signaling deficiency develops an early aging phenotype in mice, while its agonism using natural compound can delay/ prevent the progression of early aging.
IN THE PRESENT AND IN THE FUTURE: HOW TIME PERCEPTION AND TIME ORIENTATION SHAPE WELL-BEING ACROSS ADULT LIFE
Authors: Choi Yoonseok , Chu Li , Carstensen Laura 
Published: December 2023

Abstract
Individuals are able to maintain or even improve their wellbeing well into older adulthood. Socioemotional selectivity theory describes such age-related improvement in terms of motivational shifts toward emotionally meaningful goals with shrinking future time horizons. However, the association between future time perceptions and well-being is in need of being further clarified. In this symposium, four presentations will shed light on three different aspects of future time perceptions — time savoring, future preoccupation, thinking about the future — and their associations with wellbeing. Growney et al will present a study that utilizes a day reconstruction method to examine if time savoring is associated with psychosocial wellbeing and helping behaviors in workplaces. Pauly et al will discuss the potential benefits of time savoring for how solitude is experienced, by examining the buffering role of time savoring in depressive mood and somatic symptoms during solitude. Chu et al offers an alternative conceptualization of future time horizons, future preoccupation, capturing the worries and fixation on future preparation, and discusses its role in wellbeing across the life span. Choi et al discuss the role of thinking about the future for age-related differences in everyday experiences of happiness of varying arousal levels. The symposium will end with a discussion by Laura Carstensen integrating these findings into research on future time perspective and wellbeing across the life span. By elucidating more specific time-related experiences, our findings contribute to a more comprehensive understanding of how age-related changes in future time perspectives shape wellbeing trajectories across the life span.
EVERYDAY SOLITUDE, TIME SAVORING, WELL-BEING, AND HEALTH IN OLDER ADULTHOOD
Authors: Pauly Theresa , Wallimann Miriam , Peleg Shira 
Published: December 2023

Abstract
Despite the significance of social relationships, solitude (being alone and without social interaction) forms an essential part of older adults’ lives. The current study aimed to examine the role of time savouring (i.e., the ability to attend to positive experiences and up-regulate positive feelings) for mitigating associations of solitude with indicators of negative well-being and health in old age. For this purpose, a sample of 108 older adults aged 65–92 years took part in a daily diary study. Over 14 days, participants reported daily amount of time spent in solitude, extent of time savouring, levels of depressive mood, and somatic symptoms in an end-of-day diary. Data were analysed using multi-level models controlling for study day, age, gender, education, and living alone. Participants reported higher depressive mood but not more somatic symptoms on days on which they spent more time in solitude than usual. On days on which participants indicated higher time savouring than usual, they reported lower depressive mood and lower levels of somatic symptoms. Importantly, associations of solitude with depressive mood and somatic symptoms were weaker on days with increased time savouring. There were no person-level associations between solitude or time savouring with depressive mood or somatic symptoms. The study’s findings highlight the importance of everyday time savouring in attenuating negative health-related aspects of solitude in older adults. Preserving and promoting time savouring in older adulthood may thus promote health and well-being in this age group.
AGE-RELATED DIFFERENCES IN DAILY EXPERIENCES OF HAPPINESS: THE ROLE OF THINKING ABOUT THE FUTURE
Authors: Choi Yoonseok , Lay Jennifer , Lu Minjie , Jiang Da , Fung Helene , Graf Peter , Hoppmann Christiane 
Published: December 2023

Abstract
We examined the role of future time perspective (thinking about the future) in shaping age-related differences in time-varying experiences of happiness. Older adults’ experience of happiness is more strongly associated with low-arousal than with high-arousal positive affect. Low-arousal positive affective states may be conducive to engaging in meaningful social interactions with close others (e.g., listening, adjusting to others) and therefore serve key socio-emotional goals that are prioritized when future time is perceived as limited. We hypothesized that thinking less about the future would be related to stronger associations between happiness and low-arousal positive states in older than younger adults. We used daily life assessments from 258 participants (M = 48.4 years; 68% female; 77% Asian; 73% post-secondary education), which comprised older (M = 63.4 years) and younger (M = 20.1 years) adult samples collected at two locations (Vancouver, Canada; Hong Kong). Participants reported on their momentary affective states and thinking about the future (0-100 scales) up to 30 times over 10 days. Results replicate previous findings by showing that momentary happiness was more strongly associated with momentary calmness and more weakly associated with momentary excitement among older as compared to younger adults. Younger adults reported thinking more about the future than older adults. Thinking less about the future was related to stronger happiness-calmness and weaker happiness-excitement associations in daily life for older participants, only; for younger participants, it was associated with weaker happiness-calmness associations. Age and future thinking-related contours of happiness are discussed in the context of emotional aging theories.
METHODOLOGICAL CHALLENGES AND OPPORTUNITIES FOR STUDYING RESILIENCE
Authors: Varadhan Ravi , Bandeen-Roche Karen , Kuchel George 
Published: December 2023

Abstract
Many older adults experience a major stressor at some point in their lives. The ability to recover and live well after a major stressor is known as resilience. An important goal of geriatric research is to identify factors which influence resilience to stressors, and ultimately, to devise strategies to enhance the resilience of older adults. In order to accomplish these worthy aims, several methodological challenges need to be addressed. Methodologies for studying resilience in clinical settings are only recently being developed. Investigators at Duke, Johns Hopkins, and Radboud Universities are studying cohorts of older individuals who are undergoing invasive clinical procedures using longitudinal designs. These studies collect a vast array of information on each participant including socio-demographics, health status, physical, cognitive, psychological, and biological functions. Also, large amount of experimental data is collected on the dynamics of select physiological systems as probes of resilience (“deep phenotyping”). Deep phenotyping leads to several challenges in the conduct and analysis of the study including selective participation (selection bias), informatively missing data, characterizing resilient responses based upon trajectories of multidimensional measures before and after stressor, modeling dynamical systems experimental data, and quantification of resilience capacity and its determinants. In this symposium, we will discuss some of the critical methodological challenges of studying resilience and present approaches to address them. At the end of this symposium, the audience members should understand the importance of designs and analytic challenges in studying resilience, and become knowledgeable on the approaches to overcome methodological challenges.
APPROACHES TO QUANTITATIVELY EXAMINE RESILIENCE IN OLD AGE
Authors: Melis Rene , Kok Almar , Huisman Martijn 
Published: December 2023

Abstract
Resilience is a complex system’s ability to maintain or recover in function following a perturbation. The concept is generic and can be applied to any complex system going from a cell, a person, to their support networks. By applying a resilience approach, we can better understand why people respond differently to a similar exposure. While most people have an intuitive understanding of what resilience is, it’s definition and application is not straightforward. Therefore, it is important to carefully define the stressor, system and (functional) outcome(s) and how it is studied using e.g., the TransNIH resilience framework. Quantitative examination of resilience can focus on predictors, mechanisms, trajectories and/or outcomes and each aspect requires a different analytical approach. This talk will review different quantitative approaches to examine resilience in the context of aging. These approaches can be categorized based on the statistical methods that are used to operationalize resilience: the effect modification approach to study how hypothesized resilience factors modify the outcome following perturbation, scale construction in the psychometric approach, comparison of characteristics between groups based on predefined prospective resilience responses in the a priori approach, data-driven subgroup identification based on resilience outcome (trajectories) in the clustering approach, analyzing predictors of adversity-outcome residual values in the residual approach, and analyzing stressor-response patterns in intensive longitudinal data to better understand resilience mechanisms. The approaches are not mutually exclusive. Researchers may choose to combine multiple approaches and may analyze the same data using multiple approaches to compare the findings between them.
STATISTICAL MODELS FOR ESTIMATING RESILIENCE
Authors: Pieper Carl , Colon-Emeric Cathleen , Sloane Richard , Peskoe Sarah , Whitson Heather 
Published: December 2023

Abstract
One important component of the Resilience paradigm is the degree of initial change and rapidity of recovery after a stressor. Resilience is determined by both the degree of response, if any, to an insult and, subsequently, the process of return to the initial state. Modeling the recovery process requires use of longitudinal analysis which can incorporate the underlying non-linear trajectory of change, and the multiple systems impacted by the stressor. We will show the models we have employed for one common stressor, surgery. First, we will define and show findings on the Expected Predicted Differential (ERD), the difference between predicted and observed recovery. Second, we will show multivariate trajectories of recovery to demonstrate methods to (1) define typologies of recovery, using PCA, and (2) typologies of individuals in type of recovery, using latent class analysis of trajectories. Second, given the state of the emerging art in resilience research, we will provide a statistician’s view on enhancing the resilience research through design (increasing number and timing of measurements, the number of subjects, and expanding use of the EHR), data structures (incorporating measurements from a greater number of diverse sources, using timing of measures to allow for assessment of dynamic mediation and moderation effects in defining the process), and analysis - extending the ERD to modeling non-linear recovery, incorporating causal analysis, including dynamic mediating and moderating effects into the analytic structure, use Area Under the Curve as a metric for recovery, latent class analysis, and use of multivariate trajectory analysis.
MECHANISMS UNDERLYING SLEEP AND DEVELOPMENT OF CHRONIC CONDITIONS IN OLDER ADULTS
Authors: Kaufmann Christopher , Lee Soomi , McCrae Christina 
Published: December 2023

Abstract
Mounting evidence suggests poor sleep is associated with the development of chronic conditions. Numerous mechanisms for these links have been proposed, including inflammation, metabolic function, and brain structure. In this symposium, we will present five studies focused on links between poor sleep and subsequent development of chronic disease across adulthood. Specifically, we will examine this relationship at multiple levels from the cellular to the clinical level with the ultimate goal of identifying potential mechanisms and consequences of links between poor sleep and chronic conditions. Paper 1 will identify within-person patterns of various sleep experiences and link them to incident chronic conditions over a 10-year period. Paper 2 will examine associations between sleep parameters, measured via wrist actigraphy, and levels of adipokines, which are adipose-derived cytokines associated with development of metabolic disease. In Paper 3, we will shift our focus to examine the association between poor sleep and inflammatory biomarkers, specifically C-reactive protein, circulating and lipopolysaccharide-stimulated cytokines. Paper 4 will assess the impact of poor sleep health on fear of falling and actual falls. Paper 5 will focus on the effects of poor sleep and arousal with cognition and brain structure, specifically within a population of patients with chronic pain. As Discussant, Dr. Christina McCrae will integrate these findings and suggest directions for future research. In summary, our symposium will elucidate biological and psychological mechanisms linking poor sleep to manifestation of chronic disease. Better understanding of these mechanisms will inform the development of interventions to promote successful aging.
SLEEP TIGHT, STAY HEALTHY? MULTIDIMENSIONAL SLEEP HEALTH AND CHRONIC CONDITION DEVELOPMENT OVER ONE DECADE
Authors: Smith Claire , Lee Soomi 
Published: December 2023

Abstract
Chronic conditions affect half of adults and are the leading cause of death in the United States. Healthy sleep is a modifiable risk factor, but greater information is needed about specific sleep experiences linked to chronic condition development. The present study aims to (1) identify within-person patterns of various sleep experiences (i.e., sleep health phenotypes describing sleep duration, regularity, sleep onset latency, insomnia symptoms, daytime tiredness, and nap frequency) and (2) understand the connection between transitions in sleep health phenotypes and chronic condition development. We use self-report data from a national sample of adults (N=5,026) taken from the Midlife in the United States (MIDUS) study across two waves (II and III) separated by about ten years. Latent transition analysis revealed four sleep phenotypes: good sleepers (optimal sleep across dimensions), insomnia sleepers (short duration, long sleep onset latency, high daytime tiredness, frequent insomnia symptoms), weekend catch-up sleepers (long sleep duration on weekends compared to weekdays), and nappers (frequent naps). For cardiovascular conditions, consistent insomnia sleepers (i.e., insomnia sleeper -&gt; insomnia sleeper) were at 72% higher risk (CI:[1.04, 2.82]) than consistently good sleepers. For diabetes, consistent insomnia sleepers again were at higher risk (188%; CI:[1.72,4.79]) as were consistent nappers (128%; CI:[1.26,4.09]) and weekend catch-up sleepers -&gt; nappers (137%; CI:[1.21,4.60]). For cancers, only nappers -&gt; insomnia sleepers exhibited higher risk (45%; CI:[1.16,1.83]). We newly identify two sleep health phenotypes (napper and, especially, insomnia sleeper) as risks for developing life-threatening chronic conditions.