bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived Stress and Prediction of Worse Disease Activity and Symptoms in a Multiracial, Multiethnic Systemic Lupus Erythematosus Cohort
Authors: Patterson Sarah , Trupin Laura , Hartogensis Wendy , DeQuattro Kimberly , Lanata Cristina , Gordon Caroline , Barbour Kamil E. , Greenlund Kurt J. , Dall'Era Maria , Yazdany Jinoos , Katz Patricia 
Published: December 2022

ObjectiveStudies have suggested a potential link between traumatic experiences, psychological stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in systemic lupus erythematosus (SLE) remains unclear. The present study was undertaken to examine whether increases in perceived stress independently associate with worse SLE disease outcomes over 3 years of follow‐up.MethodsParticipants were drawn from the California Lupus Epidemiology Study (CLUES). Stress was measured annually using the 4‐item Perceived Stress Scale (PSS). Participants with increases of ≥0.5 SD in PSS score were defined as having an increase in stress. Four outcomes were measured at the year 3 follow‐up visit: physician‐assessed disease activity (Systemic Lupus Erythematosus Disease Activity Index); patient‐reported disease activity (Systemic Lupus Activity Questionnaire); pain (Patient‐Reported Outcomes Measurement Information System [PROMIS] pain interference scale); and fatigue (PROMIS fatigue scale). Multivariable linear regression evaluated longitudinal associations of increase in stress with all 4 outcomes while controlling for potential confounders.ResultsThe sample (n = 260) was 91% female, 36% Asian, 30% White, 22% Hispanic, and 11% African American; the mean ± SD age was 46 ± 14 years. In adjusted longitudinal analyses, increase in stress was independently associated with greater physician‐assessed disease activity (P = 0.015), greater self‐reported disease activity (P < 0.001), more pain (P = 0.019), and more fatigue (P < 0.001).ConclusionIn a racially diverse sample of individuals with SLE, those who experienced an increase in stress had significantly worse disease activity and greater symptom burden at follow‐up compared to those with stress levels that remained stable or declined. Findings underscore the need for interventions to bolster stress resilience and support effective coping strategies among individuals living with lupus.
A Novel Approach to Open “Dead Space” and Modify Interfacial Features of Carbon Nanotube Assemblies by a Microwave Shock
Authors: Lin Dewu , Zhou Ying , Kobashi Kazufumi , Chen Guohai , Futaba Don N. , Hata Kenji 
Published: December 2022

AbstractDespite 30‐year development of carbon nanotube (CNT) based materials, harnessing the outstanding nanoscale properties of individual CNT for macroscale applications remains challenging. High specific surface area, a crucial feature of CNTs, often suffers from the formation of tightly packed bundles with inaccessible “dead space”. Herein, a novel “microwave shock” approach to open the “dead space” trapped within bundles is reported. Employing N2 ambient during microwave irradiation, CNT bundles undergo an efficient structural alteration and interfacial modification simultaneously due to the strong radiative coupling, while the graphitic structure remains undamaged. In this way, a 15‐fold increase (from 42 to 648 m2 g−1) in the interstitial surface area as well as the lithiophilic functionalization (≈1 atom% nitrogen doping) are achieved without the degradation of other properties. Furthermore, to highlight the merits of this microwave shock process, the treated CNT films are applied as a host material for the anode in a lithium metal battery and demonstrate the suppression of dendritic lithium growth and improve cycling stability. This microwave shock approach provides an efficient avenue to modify nanocarbon‐based materials for further applications.
Many‐Body Correlations and Exciton Complexes in CsPbBr3 Quantum Dots
Authors: Zhu Chenglian , Nguyen Tan , Boehme Simon C. , Moskalenko Anastasiia , Dirin Dmitry N. , Bodnarchuk Maryna I. , Katan Claudine , Even Jacky , Rainò Gabriele , Kovalenko Maksym V. 
Published: December 2022

AbstractAll‐inorganic lead‐halide perovskite (LHP) (CsPbX3, X = Cl, Br, I) quantum dots (QDs) have emerged as a competitive platform for classical light‐emitting devices (in the weak light–matter interaction regime, e.g., LEDs and laser), as well as for devices exploiting strong light–matter interaction at room temperature. Many‐body interactions and quantum correlations among photogenerated exciton complexes play an essential role, for example, by determining the laser threshold, the overall brightness of LEDs, and the single‐photon purity in quantum light sources. Here, by combining cryogenic single‐QD photoluminescence spectroscopy with configuration‐interaction (CI) calculations, the size‐dependent trion and biexciton binding energies are addressed. Trion binding energies increase from 7 to 17 meV for QD sizes decreasing from 30 to 9 nm, while the biexciton binding energies increase from 15 to 30 meV, respectively. CI calculations quantitatively corroborate the experimental results and suggest that the effective dielectric constant for biexcitons slightly deviates from the one of the single excitons, potentially as a result of coupling to the lattice in the multiexciton regime. The findings here provide a deep insight into the multiexciton properties in all‐inorganic LHP QDs, essential for classical and quantum optoelectronic devices.
Synthesis of Complex Dihydroisoquinolin Derivatives via Cobalt‐Electrocatalyzed C−H Activation
Authors: Huang Yin‐Hui , Dong Lin 
Published: December 2022

AbstractWe developed a cost‐effective cobalt‐catalyzed electrochemical annulation to generate diversified novel complex dihydroisoquinolin derivatives from amides and alkenes in a simple and maneuverable undivided cell. The reaction proceeded C−H/N−H activation, and the catalyst was regenerated by anodic oxidation. Notably, the strategy of electrocatalysis avoided the consumption of stoichiometric chemical oxidants.magnified image
Primary palliative care education in emergency medicine residency: A mixed‐methods analysis of a yearlong, multimodal intervention
Authors: Benesch Tara D. , Moore Justin E. , Breyre Amelia M. , DeWitt Raizel , Nattinger Caroline C. , Dellinger Elaine , Anderson Erik S. , Bulman Linda 
Published: December 2022

AbstractBackgroundEmergency medicine (EM) physicians frequently care for seriously ill patients at the end of life. Palliative care initiated in the emergency department (ED) can improve symptom management and quality of life, align treatments with patient preferences, and reduce length of hospitalization. We evaluated an educational intervention with digital tools for palliative care discussions in an urban EM residency using the reach, effectiveness, adoption, implementation, and maintenance (RE‐AIM) framework.MethodsOur intervention, conducted from July 2020 to August 2021, included education on palliative care techniques, digital tools, and incentives for participation. We tracked goals of care conversations and palliative care consults using electronic medical record data, conducted pre‐ and posttraining surveys, and used semistructured interviews to assess resident perspectives on palliative care conversations in the ED. Outcomes included number of goals of care conversations recorded by EM residents, consults to palliative care from the ED, and resident perspectives on palliative care in EM.ResultsThe results were as follows: reach—45 residents participated in the intervention; effectiveness—89 goals of care conversations were documented by 23 ED residents, and palliative care consults increased from approximately four to 10 monthly; adoption—over half the residents who participated in the intervention documented goals of care discussions using an electronic dotphrase; implementation—by the completion of the intervention, residents reported increased comfort with goals of care conversations, saw palliative care as part of their responsibility as EM physicians, and effectively documented goals of care discussions; and maintenance—at 2‐month follow up, palliative care consults from the ED remained at approximately 10 monthly, and digital tools to prompt and track palliative care discussions remained in use.ConclusionsAn integrated palliative care training for EM residents with technological assists was successful in facilitating goals of care discussions and increasing palliative care consults from the ED.
Systemic barriers to reporting work injuries and illnesses in contexts of language barriers
Authors: Premji Stephanie , Begum Momtaz , Medley Alex 
Published: December 2022

AbstractBackgroundWorkers who experience language barriers are at increased risk of work‐related injuries and illnesses and face difficulties reporting these health problems to their employer and workers' compensation. In the existing occupational health and safety literature, however, such challenges are often framed in individual‐level terms. We identify systemic barriers to reporting among injured workers who experience language barriers within the varying contexts of Ontario and Quebec, Canada.MethodsThis study merges data from two qualitative studies that investigated experiences with workers' compensation and return‐to‐work, respectively, for injured workers who experience language barriers. We conducted semi‐structured interviews with 39 workers and 70 stakeholders in Ontario and Quebec. Audio recordings were transcribed and coded using NVivo software. The data was analysed thematically and iteratively.ResultsAlmost all workers (34/39) had filed a claim, though most had initially delayed reporting their injuries or illnesses to their employer or to workers' compensation. Workers faced several obstacles to reporting, including confusion surrounding the cause and severity of injuries and illnesses; lack of information, misinformation, and disinformation about workers' compensation; difficulties accessing and interacting with care providers; fear and insecurity linked to precarity; claim suppression by employers; negative perceptions of, and experiences with, workers' compensation; and lack of supports. Language barriers amplified each of these difficulties, resulting in significant negative impacts in economic, health, and claim areas.ConclusionImproving the linguistic and cultural competence of organizations and their representatives is insufficient to address under‐reporting among workers who experience language barriers. Efforts to improve timely reporting must tackle the policies and practices that motivate and enable under‐reporting for workers, physicians, and employers.
Two‐stage cost‐sensitive clinical decision support system for detecting Alzheimer’s disease
Authors: Kleiman Michael J 
Published: December 2022

AbstractBackgroundA two‐stage clinical decision support pipeline was developed to first recommend individuals for further testing based on easily administered screening tests, followed by a more robust identification of impairment based on additional cognitive testing and neuroimaging. The ultimate goal of the pipeline is to recommend further in‐depth diagnostic assessment for those identified as “likely impaired” and reduce the incidence of healthy controls needing to undergo costly diagnostic assessments.MethodThe first stage of the paradigm used easily‐collected demographic and questionnaire data with simple trail‐making and word recall, while the second stage introduced volumetric MRI and full cognitive testing from the MoCA and both the verbal learning and verbal fluency tasks. Both stages of the paradigm utilized gradient‐boosted ensemble classifiers trained on 1181 participants from the ADNI dataset (517 controls and 522 MCI, 142 AD) and evaluated on our cohort of 105 participants (23 controls, 59 MCI, 23 AD).ResultIn the first selection stage, all dementia patients (23/23), 93.2% of MCI patients (55/59), and 43.5% of controls (10/23) were selected for further testing. After the second stage, 73.9% of controls (17/23) were ruled out, and “likely impairment” was identified in all dementia patients (23/23) and 83.1% MCI patients (49/59) with overall 87.8% sensitivity after 50 repeats of a stochastic cross‐validation procedure.ConclusionThe ability of this two‐stage paradigm to rule out controls prior to costly in‐depth diagnostic assessment can be useful to reduce the staffing and time costs associated with appropriately identifying dementia. Overall detection was similar between a dual‐stage and single‐stage paradigm, suggesting that the dual‐stage paradigm is effective at reducing screening costs without compromising efficacy.
Towards emotionally aligned social robots for dementia: perspectives of care partners and persons with dementia
Authors: Dosso Jill A , Bandari Ela , Malhotra Aarti , Hoey Jesse , Michaud Francois , Prescott Tony J , Robillard Julie M. 
Published: December 2022

AbstractBackgroundPersons living with dementia and their care partners place a high value on aging in place and maintaining independence. Socially assistive robots – embodied characters or pets that provide companionship and aid through social interaction – are a promising tool to support these goals. There is a growing commercial market for these devices, with functions including medication reminders, conversation, pet‐like behaviours, and even the collection of health data. While potential users generally report positive feelings towards social robots, persons with dementia have been under‐included in design and development, leading to a disconnect between robot functions and the real‐world needs and desires of end‐users. Furthermore, a key element of social and emotional connectedness in human relationships is emotional alignment – a state where all partners have congruent emotional understandings of a situation. Strong emotional alignment between users and robots will be necessary for social robots to provide meaningful companionship, but a computational model of how to achieve this has been absent from the field. To this end, we propose and test Affect Control Theory (ACT) as a framework to improve emotional alignment between older adults and social robotics.MethodUsing a Canadian online survey, we introduced respondents to three exemplar social robots with older adult‐specific functionalities and evaluated their responses around features, emotions, and ethics using standardized and novel measures (n=171 older adults, n=28 care partners, and n=7 persons living with dementia).ResultOverall, participants responded positively to the robots. High priority uses included companionship, interaction, and safety. Reasoning around robot use was pragmatic; curiosity and entertainment were motivators to use, while a perceived lack of need and the mechanical appearance of the robots were detractors. Realistic, cute, and cuddly robots were preferred while artificial‐looking, creepy, and toy‐like robots were disliked. Most importantly, our evidence supported ACT as a viable model of human‐robot emotional alignment.ConclusionThis work supports the development of emotionally sophisticated, evidence‐based, and user‐centered social robotics with older adult‐ and dementia‐specific functionality.
Premature Cardiovascular Disease and Brain Health in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Jiang Xiaqing , Allen Norrina , Lewis Cora , Sidney Stephen , Yaffe Kristine 
Published: December 2022

AbstractBackgroundCardiovascular disease (CVD) is associated with cognitive impairment and dementia risk in late life, yet little is known about the role of premature (defined younger than 60 years) CVD events with cognition and brain health earlier in the life course, including in midlife. As part of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, we investigated the association of premature CVD events in young and middle adulthood with cognition and white‐matter health in midlife.MethodsWe studied 3,146 Black and White participants (57% women, 48% Black) aged 18‐30 years at baseline (1985‐86) who were followed up to Year 30 (mean age 55.1±3.6 years) when 5 cognitive tests measuring different domains were administered. A subset (656 participants) had brain MRI with measures of white matter hyperintensity (WMH) burden and white matter integrity. Premature CVD events were adjudicated based on participants' history and medical records of coronary heart disease, stroke/TIA, cardiac revascularization, congestive heart failure, carotid artery disease, and peripheral artery disease. We conducted linear regression to determine the association of premature CVD with cognitive and structural brain measures.ResultsFive percent (n = 147) of participants had premature CVD events over the 30 years. Having premature CVD events was associated with lower cognitive function in all domains. After adjustment for demographics, education, depressive symptoms, physical activity, diet, APOE ε4, and cardiovascular risk factors (CVRFs), premature CVD was associated with lower cognition (z‐standardized) except for verbal fluency: global cognition (‐0.19, 95% CI ‐0.35 to ‐0.03), verbal memory (‐0.24, 95% CI ‐0.41 to ‐0.07), processing speed (‐0.46, 95% CI ‐0.63 to ‐0.30), and executive function (‐0.38, 95% CI ‐0.56 to ‐0.20). Premature CVD was also associated with greater WMH volumes (total, frontal, temporal, and parietal lobes) and alternations of white matter integrity (higher total and temporal lobe mean diffusivity and lower parietal lobe fractional anisotropy) after adjusting for demographics, total intracranial volume, and CVRFs.ConclusionPremature CVD is associated with worse midlife cognition and white‐matter health independent of CVRFs. Young and middle adulthood is a critical time for CVD prevention, the efforts of which may delay the onset of cognitive decline and dementia later in life.
Brain energy rescue with ketones improves cognitive outcomes in MCI
Authors: Cunnane Stephen 
Published: December 2022

AbstractBackgroundAn emerging strategy to delay the onset of Alzheimer disease (AD) is to use ketones to overcome the progressive brain energy deficit caused by deteriorating brain glucose metabolism in mild cognitive impairment (MCI). Ketones (acetoacetate and beta‐hydroxybutyrate) are the brain’s main alternative fuel to glucose; in contrast to glucose, ketone metabolism by the brain is now known to be unaffected in MCI and AD. Successful brain energy rescue with ketones in MCI was recently reported.MethodsIn the 6‐month, randomized, placebo‐controlled Benefic Trial (NCT02551419), the active arm was a ketogenic medium chain triglyceride (kMCT) supplement in a lactose‐free skim milk emulsion (15 g kMCT twice/day; n = 39 completers). The placebo arm was a non‐ketogenic iso‐energetic vegetable oil (n = 44 completers). Brain ketone and glucose metabolism were assessed by PET.ResultsPerformance on all five cognitive domains improved significantly over 6 months in the kMCT group: (i) Episodic memory (trial 1, Free and Cued Recall Test) increased by 1 word (+0.5 Δ Z‐score); (ii) Executive function (Verbal Fluency Test) correct answers increased by 2 words (+0.3 Δ Z‐score) but decreased by 1 word on placebo (‐0.1 Δ Z‐score), time taken on the Stroop Colour Naming Test decreased by 1 sec (p = 0.09), and errors on the Trail Making Test increased by 0.8 on placebo (p = 0.02); (iii) Language (Boston naming test) correct answers increased by 1.3 words. (iv) Processing speed increased directly with higher brain ketone uptake in several white matter tracts. (v) Improved attention was directly associated with increased ketone uptake and functional connectivity in the dorsal attention network.ConclusionsImproved cognition correlating positively with improved brain energy supply by ketones suggests a direct link to brain energy status. The moderate effect size of this kMCT intervention indicates a clinically meaningful benefit on certain cognitive outcomes, some of which relate directly to risk of MCI progressing to AD. Other potential ketogenic interventions that have been less well studied in MCI or AD include a ketogenic diet and ketone salts or esters. Whether brain energy rescue with ketones can delay the onset or progression of AD should now be assessed.
Brain endothelial dysfunction in AD
Authors: de Vries Helga E 
Published: December 2022

AbstractIncreasing evidence suggests that neurovascular dysfunction and neuro‐inflammation is associated with early stages of Alzheimer’s disease (AD). The neuroprotective blood‐brain barrier (BBB) is indispensable for the maintenance of brain homeostasis and proper neuronal functioning. Dysfunction of the BBB and inflammation thereof significantly contributes to the pathogenesis of AD. Amyloid‐β deposition in the microvasculature of the brain, a process referred to as capillary cerebral amyloid angiopathy (capillary CAA), propagates vascular remodeling, which results in impaired function of the blood‐brain barrier and inflammation thereof. While improving vascular function and dampening neuro‐inflammation may be an attractive new way to fight capillary CAA, the underlying factors that mediate vascular alterations in Alzheimer’s disease and capillary CAA pathogenesis remain largely unknown.Our earlier work indicated that hypoxia is a key mediator of vascular dysfunction, which resulted in the induction of angiopoietin like‐4 (ANGPTL4), a hypoxia‐induced factor, in reactive astrocytes in well characterized post‐mortem tissues of patients with capillary CAA. In vitro studies indicated that ANGPTL4 stimulate endothelial cell migration and sprouting in a 3D spheroid model of human brain endothelial cells. Our more recent work now indicates that bioactive lipids and receptors thereof, like the liver‐X‐receptors, may also affect vascular function. In particular, sphingolipids and ceramides play a crucial role in the neuro‐inflammatory process and was associated with vascular dysfunction. The work on how bioactive lipids affect BBB dysfunction in AD will be discussed during this presentation.