bluuebunny/crossref_metadata_2025 huggingface dataset:
“Every Day Is a Battle”: The Impact of COVID-19 on Physical Activity Behavior Among a Group of Rural Older Adults Living with Parkinson’s Disease
Authors: Skinner Jared W. , Fasczewski Kimberly S. , Bramblett Paige N. , Ristanovic Maya
Published: November 2024

Background: The closure of fitness and rehabilitation centers during the COVID-19 pandemic significantly impacted the rural Parkinson’s disease (PD) population, a population already vulnerable due to limited access to healthcare, rehabilitation services, and social support. Objective: This study aimed to assess the psychological, social, and physical impact of COVID-19 restrictions on older adults living with PD in a rural region of the southeastern US to better inform future practices. Methods: Participants (5 female, 6 male, age 78.7 ± 2.3 years) were recruited from PD support groups in rural communities across northwestern North Carolina, USA. Structured interviews focused on the impact of COVID-19 on daily physical activity (PA), quality of life, mental health, and social support. Thematic analysis was used to identify key themes. Results: Seven main themes emerged: mental health, life changes, the importance of group/social support, motivation for PA, COVID-19 adaptations/impact on PA, and functioning. These themes reflected increased social isolation, reduced motivation for PA, and negative impacts on quality of life. Conclusions: The study underscores the challenges faced by rural PD communities during isolation events and emphasizes the need for programs that prioritize social interactions to support physical and mental health, with plans to maintain these connections during future isolations.
Book review: Taniya Roy, Representations of Marriage and Beyond: An Investigation of Early Buddhist Textual Traditions (c. Sixth Century bce to Fifth Century ce)
Authors: Tyagi Jaya S.
Published: November 2024

Taniya Roy, Representations of Marriage and Beyond: An Investigation of Early Buddhist Textual Traditions (c. Sixth Century bce to Fifth Century ce) (New Delhi: Primus Books), 2022, x + 233 pp., ₹1050 (Hb).
Book review: Krishna Mohan Shrimali, History, Archaeology and Ideology: Essays on Intellectual and Social History of Early India
Authors: Mahalakshmi R.
Published: November 2024

Krishna Mohan Shrimali, History, Archaeology and Ideology: Essays on Intellectual and Social History of Early India (Delhi: Manohar Publishers & Distributors), 2024, xi + 559 pp., ₹2995 (Hb).
Making of Merchant Chiefdoms in Early Medieval Kerala: Aspects of Political Economy
Authors: Gurukkal Rajan
Published: November 2024

The article has, as its basic source, three royal charters of the ninth- to thirteenth-century period from Kerala. The royal need for precious metals to issue currency alone explains the rulers’ anxiety to give concessions to merchants engaged in overseas trade. The article examines how this policy was conducted and how far it was successful. Inscriptions form our major source for the period thirteenth century, and these form the main source for the following study.
Book review: Ubaidur Rahman Siddiqui, Ghazipur: A Journey through Political–Cultural History, From Ancient Times to Pre-independence
Authors: Habib Irfan
Published: November 2024

Ubaidur Rahman Siddiqui, Ghazipur: A Journey through Political–Cultural History, From Ancient Times to Pre-independence (Published by Author: Ghazipur), 946 pp., ₹1850 (Hb).
Book review: Brian C. Wilson, City of Façades: Archaeology, History and Urbanism in Velha Goa
Authors: Malekandathil Pius
Published: November 2024

Brian C. Wilson, City of Façades: Archaeology, History and Urbanism in Velha Goa (New Delhi: Primus Books), 2022, xvii + 338 pp., ₹1595 (Hb).
Calcutta Docks, Indentured Labour Migration and the Girmitya Experience: Stories from British Guyana (Part 1)
Authors: Basu Rajsekhar
Published: November 2024

This article deals with the dislocations in the agrarian world of northern and eastern India in the nineteenth century. The causes clearly emanated from the exploitative nature of the colonial revenue system. The rigid revenue structure along with the initiatives towards ‘modernisation’, mainly through the expansion of railway networks, contributed to rising rural poverty and despair. A substantial section of the propertied peasants thereby lost their earlier social status and swelled the ranks of the rural proletariat in this region. Here the Calcutta Docks are taken as the entry point of a larger discussion, since Calcutta was the principal port of transit abroad for the rural population of eastern and northern India. Despite the claimed official surveillance over this migration, it remained replete with fraud, deceit and repression. The men and women, usually young and middle-aged, who migrated under indenture, too often used the term girmit, which was later used by them to showcase their distinct cultural identity as ‘girmityas’. The ‘girmitya’ narratives, largely based on memory, reconstruct a past, hardly to be traced in government documents. Using these sources with British Guyana and Fiji as case studies, an effort is made to reconstruct girmitya histories that remain inseparable parts of our own national narrative.
Endoscopic Management of Efferent Loop Syndrome and Its Complications: Lessons Learnt
Authors: Pemmada Vikas , Ganga Deepak , Jain Parvesh Kumar
Published: November 2024

Both afferent and efferent loop syndromes are rare complications that can develop post-gastro-jejunostomy. Although the incidence of afferent loop syndrome is ~0.3% to 1%, efferent loop syndrome is extremely rare with only limited case reports. We report a case of malignant efferent loop obstruction which was successfully managed by an endoscopic luminal self-expanding metal stent. This led to an unusual complication of obstructive jaundice with cholangitis secondary to a mechanical afferent loop syndrome requiring an additional endoscopic luminal stenting of the afferent loop. Endoscopic management of afferent or efferent loop syndromes is technically challenging and a consecutive occurrence of the dual-loop syndromes should be expected by the interventional endoscopist.
Sonographic Evaluation of an Urachal Remnant: A Case Report
Authors: Gushi Courtney
Published: November 2024

Urachal anomalies are rare and often identified incidentally during diagnostic imaging examinations, such as sonography. These anatomical anomalies are being detected with increasing frequency due to advancements in cross-sectional imaging. Early detection facilitates effective management and treatment options. When these anomalies go undetected and persist into adulthood, patients are at an increased risk for adverse health outcomes. Urachal anomalies have the potential to undergo pathological changes, leading to inflammation, infection, and even malignancy. Therefore, it is imperative for sonographers to be proficient in identifying and understanding sonographic characteristics of urachal abnormalities. This is crucial, given that sonography continues to be a key diagnostic technique due to its lack of radiation, cost-effectiveness, and widespread availability.
Melatonin ameliorates age-related sarcopenia by inhibiting fibrogenic conversion of satellite cell
Authors: Zhu Guo-Zheng , Zhao Kai , Li Hong-Zhou , Wu Di-Zheng , Chen Yun-Biao , Han Dong , Gao Jia-Wen , Chen Xing-Yu , Yu Yong-Peng , Huang Zhi-Wei , Tu Chen , Zhong Zhao-Ming
Published: November 2024

The fibrogenic conversion of satellite cells contributes to the atrophy and fibrosis of skeletal muscle, playing a significant role in the pathogenesis of age-related sarcopenia. Melatonin, a hormone secreted by the pineal gland, exhibits anti-aging and anti-fibrotic effects in various conditions. However, the effect of melatonin on satellite cell fate and age-related sarcopenia remains under-explored. Here, we report that melatonin treatment mitigated the loss of muscle mass and strength in aged mice, replenished the satellite cell pool and curtailed muscle fibrosis. When primary SCs were cultured in vitro and subjected to aging induction via d-galactose, they exhibited a diminished myogenic potential and a conversion from myogenic to fibrogenic lineage. Notably, melatonin treatment effectively restored the myogenic potential and inhibited this lineage conversion. Furthermore, melatonin attenuated the expression of the fibrogenic cytokine, transforming growth factor-β1, and reduced the phosphorylation of its downstream targets Smad2/3 both in vivo and in vitro. In summary, our findings show melatonin's capacity to counteract muscle decline and inhibit fibrogenic conversion in aging SCs and highlight its potential therapeutic value for age-related sarcopenia.

Graphical Abstract
Biphasic cartilage repair implant versus microfracture in the treatment of focal chondral and osteochondral lesions of the knee: a prospective, multi-center, randomized clinical trial
Authors: Tseng Tzu-Hao , Chen Chao-Ping , Jiang Ching-Chuan , Weng Pei-Wei , Chan Yi-Sheng , Hsu Horng-Chaung , Chiang Hongsen
Published: November 2024

Background

Autologous minced cartilage is a method for cartilage defect repair, and our study focuses on a newly developed biphasic cylindrical osteochondral construct designed for use in human knees. We aimed to compare its clinical effectiveness and safety with microfracture, the commonly utilized reparative treatment for knee chondral or osteochondral defects.

Materials and methods

Conducted as a prospective multicenter, randomized controlled, non-inferiority trial across nine hospitals, the study involved 92 patients with International Cartilage Repair Society (ICRS) grade 3 to 4 chondral or osteochondral lesions on femoral condyles. Patients were evenly randomized to receive either the biphasic cartilage-repair implant (BiCRI) or microfracture. Functional outcomes and safety assessments were conducted at postoperative intervals of 6 weeks and 3, 6, and 12 months. Primary and secondary endpoints included International Knee Documentation Committee (IKDC) 2000 Subjective Knee Evaluation Form score improvement, the grade distribution in the IKDC 2000 Knee Examination Form, and various assessments, such as the Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scales (VASs) for pain, MRI findings, and arthroscopic findings at 12 months.

Results

Out of the initial participants, 47 in the BiCRI group and 45 in the microfracture group completed the follow-up. At 12 months, the mean change in IKDC total score was 25.56 ± 18.48 for BiCRI and 27.51 ± 23.65 for microfracture. The 95% confidence interval (CI) for the score difference (BiCRI minus microfracture) was − 6.95, exceeding the non-inferiority margin of − 12. Secondary endpoints indicated comparable functional outcomes, and arthroscopic findings demonstrated more fully regenerated cartilage in the BiCRI group.

Conclusion

Based on the IKDC 2000 Subjective Knee Evaluation Form score, BiCRI proved non-inferior to microfracture at 12 months. Short-term functional outcomes were comparable to those with microfracture, while arthroscopic findings showed more complete cartilage regeneration in the BiCRI group. Consequently, BiCRI emerges as a viable alternative for treating chondral or osteochondral defects.

Level of evidence

Level 2, multi-center, randomized clinical trial.

Trial registration: Name of the registry: ClinicalTrials.gov. Trial registration number: NCT01477008. Date of registration: 11/14/2011. URL of trial registry record: clinicaltrials.gov/study/NCT01477008
The potential role of exercise in mitigating fertility toxicity associated with immune checkpoint inhibitors (ICIs) in cancer patients
Authors: Jamrasi Parivash , Tazi Mia , Zulkifli Nur Afiqah , Bae Jun Hyun , Song Wook
Published: November 2024

Over the last decade, therapeutic advances in cancer immunotherapy have rapidly progressed, leading to an expansion of clinical trials and the development of novel immune checkpoint inhibitors (ICIs) and combination treatments. While ICIs offer substantial clinical benefits, they are also associated with various side effects, notably concerning endocrine function and potential gonadal damage following the initiation of immunotherapy. Exercise has demonstrated promise in enhancing treatment efficacy, including symptom reduction in cancer patients. Research has also established the benefits of exercise in managing fertility and reproductive health. However, there is limited data on the effectiveness of exercise in mitigating fertility-related side effects specifically in patients undergoing ICIs therapy. Given that a significant number of cancer patients are of reproductive age, it is crucial to address potential sexual side effects and offer fertility preservation options. Ensuring that patients are well-informed and supported in their reproductive health decisions is vital. This review reports the prevalence of immune-related adverse effects linked to fertility in cancer patients undergoing ICIs, explores the potential mechanisms by which ICIs may impact reproductive health, and emphasizes the role of exercise in mitigating these adverse effects.

Graphical Abstract
Coronary Artery Disease Empowerment Scale (CADES): Persian translation and psychometric properties
Authors: Jalali Amir , Naghibzadeh Amirhossein , Rostami Mojgan , Ahmadi Yasin , Khodamorovati Mahbod , Vatandost Salam , Darvishi Niloufar , Moradi Khalil
Published: November 2024

Introduction

Coronary artery disease (CAD) is a leading cause of global mortality and a prevalent health issue in Iran. Assessing the empowerment of CAD patients during treatment and care is essential. However, no scale is available to measure empowerment in CAD patients in Iran. Therefore, this study aimed to evaluate the validity and reliability of the Persian version of the "Coronary Artery Disease Empowerment Scale" (CADES).

Method

This methodological and cross-sectional study was conducted on patients with CAD from June 2022 to April 2023 in Kermanshah City, Iran. The scale was translated using the forward–backward translation method. Construct validity was examined using Exploratory Factor Analysis (EFA) with 190 samples and Confirmatory Factor Analysis (CFA) with 344 samples, both selected through convenience sampling. Internal consistency was assessed using Cronbach's alpha coefficient, and reliability was evaluated using the test–retest method. SPSS version 27 and LISREL version 8 software were utilized for data analysis.

Results

The EFA and CFA results confirmed the instrument with three factors and 25 items. The model's main indicators in factor analysis were all above 0.9, indicating a good fit for the model. The Pearson correlation coefficient between the items and subscales with the main scale showed a direct and significant relationship. Additionally, Cronbach's alpha coefficient (0.813) and test–retest reliability (0.763) confirmed the reliability of the Persian version of the CADES.

Discussion

The study's results suggest that the Persian version of CADES is both practical and acceptable for evaluating the empowerment of CAD patients. This tool can be relied upon as a valid and reliable method for assessing these patients' empowerment.
FallFitness exercise program provided using the train-the-trainer approach for community-dwelling older adults: a randomized controlled trial
Authors: Arkkukangas Marina , Bååthe Karin Strömqvist , Hamilton Julia , Hassan Ali , Tonkonogi Michail
Published: November 2024

Background

Falls and fall-related injuries remain a global challenge and threat to the health of older adults. Specific strength and balance exercises are effective in preventing falls among community-dwelling older adults. Nevertheless, provision of evidence-based fall prevention interventions to a broad population represents a healthcare challenge, indicating that new models for promoting exercise among community-dwelling older adults need to be addressed. Here, we aimed to evaluate the effects of a peer-led group-based exercise intervention provided using the train-the-trainer approach and targeting physical performance, activity level, handgrip strength, quality of life, fall-related self-efficacy, fear of falling, and falling techniques compared with a control group at 8-week follow-up.

Methods

This randomized controlled trial (RCT) included trainers and participants who were recruited from four collaborating regional organizations for retired persons. The intervention was planned to be provided in five municipalities in Sweden, depending on the location of the registered trainers.

Eligible participants included adults aged ≥ 60 years who could walk independently and understand written and oral information in Swedish. The FallFitness multicomponent exercise program delivered weekly strength, balance, and falling techniques over eight weeks. It was evaluated using the train-the-trainer approach. Fourteen older adults were eligible for trainer education, and 101 participants were randomly allocated for the FallFitness exercise (n = 50) or a control group (n = 51).

Results

After 8 weeks of peer-led training, the short multicomponent exercise program significantly improved the physical activity levels (p = 0.036) and backward and sideways falling techniques (p < 0.001) compared to those in the control group. Fear of falling significantly decreased in the exercise group (p = 0.009). Other outcomes in this study showed to be non-significant.

Conclusions

The multicomponent exercise program provided in eight sessions using the train-the-trainer approach may be effective in promoting physical activity and the learning of motor skills and safe landing strategies. Furthermore, the FallFitness exercise program may reduce the fear of falling and may be both time- and cost-effective.

Trial registration

ClinicalTrials.gov, NCT06265480 (20240208).
NeoVault: empowering neonatal research through a neonate data hub
Authors: Pigueiras-del-Real Janet , Ruiz-Zafra Angel , Benavente-Fernández Isabel , Lubián-López Simón P. , Shah Syed Adil Hussain , Shah Syed Taimoor Hussain , Gontard Lionel C.
Published: November 2024

Background

Stability during early postnatal life in preterm infants is related to better outcomes. Although vital signs are monitored continuously in Neonatal Intensive Care Unites, this monitoring does not include all physiological parameters nor data such as movement patterns. Although there are scattered sources of data, there is no centralized data hub for neonates information.

Results

We have created the first neonate data hub for easy and interactive access to upload or download postural, physiological, and medical data of neonates: NeoVault. NeoVault is a platform that provides access to information through two interfaces: 1) via a Web interface (designed for medical personnel, data scientists, researchers); and 2) via a RESTful API (Application Programming Interfaces) -designed for developers-, aiming to integrate access to information into third-party applications. The web access allows searching and filtering according to specific parameters, visualization of data through graphs and images, and generation of datasets in CSV format. Access through the RESTful API is described in OpenAPI, enabling access to information from any device, facilitating it in an interoperable format. Currently, it contains nearly 800,000 postural records and 3.000 physiological data entries. The physiological and postural data stored for each neonate in NeoVault are collected through the NRP (Neonates Recording Platform) tool, which allows for the automatic and reliable collection of data.

Conclusion

NeoVault is an open platform for simple access to postural, physiological, and medical data of neonates that can be utilized by researchers, data scientists, medical personnel, and programmers. It enables integration into third-party applications and the generation of customized datasets.
Management of obesity with semaglutide or metformin in patients with antipsychotic-induced weight gain (MOSA): a non-randomised open-label pilot study
Authors: Campforts Bea , Drukker Marjan , van Amelsvoort Therese , Bak Maarten
Published: November 2024

Background

Antipsychotic-induced weight gain (AIWG) represents a significant clinical challenge for both patients and clinicians, requiring appropriate interventions to prevent or reverse weight gain in patients using antipsychotics. Glucagon-like peptide 1 (GLP-1) agonists represent a novel approach to the management of obesity that has recently attracted considerable attention. Semaglutide (a GLP-1 agonist) has been demonstrated to result in notable weight loss. The present study investigates whether semaglutide is equally effective in achieving weight loss in patients with AIWG.

Methods

A prospective, non-randomised cohort study was conducted with the objective of evaluating the efficacy and safety of oral semaglutide for the treatment of AIWG in routine outpatient clinical practice. Subsequently, the results were compared with those of a control group of AIWG patients taking metformin.

Results

After 16 weeks, the mean body weight loss was 4.5 kg (95% confidence interval (CI), -6.7 to -2.3 kg; p < 0.001) in the semaglutide group (n = 10) versus 2.9 kg (95% CI, -4.5 to -1.4 kg; p < 0.001) in the metformin group (n = 26). This corresponds to an average body weight loss of 4% for semaglutide, and 2.5% for metformin. The respective reductions in body mass index (BMI) and waist circumference were -1.7 kg/m2 (95% CI, -2.4 to -1.0 kg/m2; p < 0.001) and -6.8 cm (95% CI, -9.7 to -3.8 cm; p < 0.001) for semaglutide. The observed reductions for metformin were -0.8 kg/m2 (95% CI, -1.4 to -0.3 kg/m2; p = 0.001) and -3.4 cm (95% CI, -5.4 to -1.3 cm; p = 0.001). The differences between the two groups were not statistically significant. In both groups, adverse effects were typically mild and transient, predominantly nausea. Furthermore, psychiatric symptoms were reduced, and quality of life improved.

Conclusions

Oral semaglutide represents a viable, effective, and safe treatment option for psychiatric patients. However, further investigation is required to corroborate these findings.
Impact of household characteristics on patient outcomes post hip fracture: a Welsh nationwide observational cohort study
Authors: MacRae Clare , Meyer Anna , Mercer Stewart W. , Lone Nazir , Dibben Chris , Duckworth Andrew D. , Modig Karin , Guthrie Bruce
Published: November 2024

Background

Hip fracture is common in older people and has significant health and care implications. This study aimed to examine the impact of household characteristics (living alone or living with someone who is themselves ill) on adverse outcomes following hip fracture.

Methods

A cohort study of hip fracture patients aged ≥ 50 years living alone or with one co-resident using Welsh nationwide data between January 2013 and December 2018. Outcomes were emergency hospital admission within 30 days and care-home admission and mortality within one year of hospital discharge. Analysis used cause-specific Cox proportional hazards models to examine associations with living alone and with co-resident chronic disease status.

Results

Of the 12,089 hip fracture patients discharged, 56.0% lived alone. Compared to hip fracture patients living with a co-resident, those living alone were more commonly women (78.4% versus 65.2%), older (mean 83.1 versus 78.5 years), and had more long-term conditions (mean 5.7 versus 5.3). In unadjusted analyses, compared to living with a co-resident with 0–1 long-term condition and no dementia, living alone (hazard ratio [HR] 1.44, 95%CI 1.23–1.68), living with someone with dementia (HR 1.57, 95%CI 1.07–2.30), and living with someone with 4 + physical long-term conditions (HR 1.24, 95%CI 1.03–1.49) were associated with an increase in mortality, but no significant association was found in adjusted analysis. Adjusted for age, sex, socioeconomic position, and long-term condition count of the hip fracture patient, living alone (adjusted HR [aHR] 2.26, 95%CI 1.81–2.81) and living with a co-resident with dementia (aHR 2.38, 95%CI 1.59–3.57) were both associated with more than double the risk of care home admission. There were no significant associations with 30-day hospital admission.

Conclusions

Hip fracture patients who live alone have higher one-year mortality, but associations are explained by the demographic and clinical characteristics of those living alone. However, living alone or living with a co-resident with dementia was independently associated with an additional doubling of the risk of care home admission. Household-based approaches to research and health policy may help target risk groups following hip fracture community discharge and further research is needed to understand the mechanisms by which these associations act.
The association between locomotive function and incidence of proximal junctional kyphosis following adult spine deformity surgery
Authors: Kwon Ohsang , Lee Sanghoon , Zheng Haolin , Ham Dae-Woong , Bang Chungwon , Park Sang-Min , Yeom Jin S. , Kim Ho-Joong
Published: November 2024

Background and objectives

This retrospective review study aimed to determine whether functional mobility test (FMT) results are related to the incidence of proximal junctional kyphosis (PJK) after surgical correction of adult spinal deformity (ASD).

Methods

A total of 157 patients who underwent reconstructive spinal surgery for ASD between July 2019 and December 2021 were included in this study. Three types of FMTs were performed preoperatively: timed-up-and-go (TUG) test, five times sit-to-stand (STS) test, and alternate step (AS) test. The primary outcome measure was the occurrence of PJK at 1 year after surgery. Oswestry disability index (ODI) and EuroQOL-5-dimension (EQ-5D) scores were surveyed as patient-reported outcome measures of the surgery.

Results

The occurrence of PJK was observed in 41 of the 157 patients (26.1%) at 1 year after surgery. Among the three functional mobility tests, STS test results were significantly higher in the patients who developed PJK. The receiver operating characteristics curve drawn with the STS test had an area under the curve of 0.69 and the optimal cutoff value was suggested as 22 seconds. Multivariate logistic regression analysis identified the STS test along with age and preoperative ODI score as the significant predictors of PJK (p = 0.026, 0.005 and 0.001, respectively).

Conclusions

A longer test time on the STS test result was associated with a higher occurrence of postoperative PJK. A cutoff value of 22 s can be suggested. Preoperative surveillance of these patients and providing additional efforts and surgical procedures for the prevention of PJK are anticipated to improve the surgical outcome of ASD correction.
Network analyses of physical and psychological factors of playing-related musculoskeletal disorders in student musicians: a cross-sectional study
Authors: Bruyneel Anne-Violette , Stern Florian , Schmid Audrey , Rieben Nancy , James Clara E.
Published: November 2024

Background

Young musicians starting their professional education are particularly vulnerable to playing-related musculoskeletal disorders (PRMDs). In the context of research on PRMDs, physical and psychological associated factors are frequently highlighted without investigating their complex interrelationships. The objective of this exploratory study was to examine the associations between lifestyle, music practice habits, physical and psychological variables, and PRMDs in student musicians.

Methods

Students of the Geneva University of Music participated in the survey. The primary outcome was students’ PRMDs, measured with the validated Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM). Additionally, to investigate potential associated factors, participants completed free-form questions about lifestyle and practice habits and seven validated questionnaires: physical activity, self-rated health, psychological distress, musical performance anxiety (MPA), perfectionism, fatigue, and personality traits. After performing standard descriptive statistics, network analyses were applied to investigate the links between students' PRMDs experience and all factors.

Results

Two hundred thirty-five student musicians completed the survey. 86 (37%) participants experienced PRMDs over the last 12 months. When considering all participating students, the network analysis showed the strongest association between the presence of PRMDs and the psychological distress factor. In the subgroup with students with PRMDs, the degree of pain interference with musical practice was correlated with psychological distress, MPA, self-rated health, and fatigue.

Conclusion

Psychological distress is the primary factor associated with PRMDs, whereas physical factors like posture and activity show no direct link. Therefore, addressing psychological aspects is crucial for student musicians with physical disorders to provide proper prevention care.
Contactless radar-based heart rate estimation in palliative care – a feasibility study and possible use in symptom management
Authors: Grießhammer Stefan G. , Malessa Anke , Lu Hui , Yip Julia , Leuschner Julie , Christgau Florian , Albrecht Nils C. , Oesten Marie , Tran Thanh Truc , Richer Robert , Heckel Maria , Eskofier Bjoern M. , Koelpin Alexander , Steigleder Tobias , Ostgathe Christoph
Published: November 2024

Background

Heart rate (HR) monitoring is a medical standard to provide information about a patient’s health status. In palliative care, relationship and social engagement are crucial therapeutic concepts. For fear of disrupting communication, social contact, and care, continuous HR monitoring is underutilised despite its potential to inform on symptom burden and therapeutic effects. This study investigates radar-based HR monitoring as an innovative and burden-free approach for palliative care patients, compares its accuracy with conventional ECG methods, and shows potential for therapeutic guidance.

Methods

A single-centre, comparative clinical trial was conducted with palliative care patients at the ward of the Department of Palliative Medicine of the University Hospital of Erlangen. The HR measurements obtained with radar were compared with Holter ECG (study arm I, overnight) and Task Force® Monitor (TFM)-based ECG validation recordings (study arm II, one hour). In addition, long-term radar measurements without validation were analysed in comparison with clinical health records (study arm III).

Results

Both validation methods showed correlation by scatter plot, modified Bland-Altman plot, and equivalence testing. N = 34 patients participated in study arm I. HR of 4,079 five-minute intervals was analysed. Radar measurements and ECG showed high agreement: difference of HRs was within $$\:\pm\:$$5 bpm in 3780 of 4079 (92.67%) and within ±13.4 bpm ($$\:\pm\:$$1.96 times the SD of the mean) in 3979 (97.55%) intervals, respectively. In study arm II, n = 19 patients participated. 57,048 heart beats were analysed. The HR difference was within $$\:\pm\:$$5 bpm for 53,583 out of 57,048 beats (93.93%) and within $$\:\pm\:$$8.2 bpm ( ± 1.96 times the SD of the mean) in 55,439 beats (97.25%), respectively. Arm III showed HR changes extracted from radar data in correlation with symptoms and treatment.

Conclusion

Radar-based HR monitoring shows a high agreement in comparison with ECG-based HR monitoring and thus offers an option for continuous and above all burden-free HR assessment, with the potential for use in symptom management in palliative care, among others. Further research and technological advancements are still necessary to fully realize this innovative approach in enhancing palliative care practices.
Medical students’ perceptions of a community-engaged learning approach to community health in Ghana: the Students’ Community Engagement Programme (SCEP)
Authors: Ampofo Gifty Dufie , Osarfo Joseph , Tagbor Harry Kwami
Published: November 2024

Background

Revitalizing primary health care requires that the health workforce, especially doctors, must appreciate the significance of the socio-cultural environment in health. To achieve this objective, training of medical students must emphasize greater understanding of the community and its role in health through community engagement using community-engaged learning. However, research on this learning method applied in a purely community engagement context is lacking. A medical school in Ghana adapted its fourth-year junior clerkship curriculum in Community Health to include a community-engagement programme. This study reports students’ perceptions of the said programme as a way of evaluating it and helping to improve upon its implementation.

Methods

A cross-sectional survey using a Google form-based questionnaire with open- and closed-ended questions was conducted from May 2022 to December 2023 among 303 current and past medical students of the University of Health and Allied Sciences, Ghana who had experienced the said programme. Based on the first three levels of the Kirkpatrick’s four-level model of training evaluation, data was collected on participants’ socio-demographics, their assessment of the programme content and delivery, subsequent attitudinal changes and their application to practice. Descriptive statistics were performed on quantitative data and thematic content analysis done for responses to the open-ended questions.

Results

More than half of participants were males (188/303). The mean (SD) participant age was 23.9 years (2.4). Over 90% indicated the programme was valuable to their training (277/297) and were satisfied with the facilitators (283/297) despite some anxieties expressed at the start of their clerkship. Participants noted that they acquired other skills including teamwork and leadership aside the reinforced academic content. At least 99% of participants noted they could conduct the processes of community entry and engagement with or without assistance.

Conclusion

Although there is room for improvement, the students’ community engagement programme may have some utility in the training of medical students to enable them better appreciate community interactions that influence health. Further research incorporating objective assessments of learning and behaviour change is needed to comprehensively assess the programme.
The relationship between work-family conflict and missed nursing care; a cross-sectional study in Iran
Authors: Ahmadzadeh-Zeidi Mohammad Javad , Rooddehghan Zahra , Haghani Shima
Published: November 2024

Background & aims

Work–family conflict, an important issue in nursing management, has been examined extensively worldwide among nurses. Nurses’ inability to handle these conflicts affect their quality of care and may lead to missed nursing care. This study aimed to investigate the relationship between work-family conflict and missed nursing care in Iran.

Materials & methods

This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in the study in a targeted and quota sampling after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including: Demographic information form, Carlson’s work-family conflict and Kalisch MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25.

Results

The results of Pearson’s correlation test showed that there is a positive relationship between nurses’ work-family conflict and missed nursing care scores (r = 0.21) (p = 0.001). The mean (SD) score of nurses’ work-family conflict was reported at a moderate level (61.58(11.57)) and the mean (SD) score of missed nursing care was reported at a low level (47.84(16.48)). Nurses under 29 years old and male nurses had more missed nursing care other than their participants. No more relationship was observed between other demographic variables with missed nursing care and nurses’ work-family conflict.

Conclusion

According to the results of this research, it can be concluded that the existence of work-family conflict can be an obstacle for the correct implementation of nursing care. In such a way that nurses exposed to higher work-family conflict level had higher missed nursing care. Based on the findings of this research, it is recommended for health care providers and nursing managers to identify nurses exposed to high work-family conflicts, adopt programs to decrease their conflicts and consequently reduce missed nursing care.
Challenges and executive requirements of advanced health system governance based on general health policies in Iran: qualitative research
Authors: Aboulhallaj Masoud , Mousavi Seyed Masood , Jafari Mehdi , Vosoogh-Moghaddam Abbas , Bahariniya Sajjad , Ghasemyani Shabnam , Far Sedighe Sadat Tabatabaei
Published: November 2024

Objective

The optimal management of the health system depends on its functions. The functional issues of Iran’s health system are organized in a scattered manner and it has many challenges, especially in the field of stewardship. In order to achieve sustainable health-oriented development, bold and smart policy reforms in the main components of the health system are essential. The purpose of this study was to identify challenges and institutional-operational requirements in order to promote stewardship based on the general health policies of the country.

Methods

This study was conducted qualitatively with a framework analysis approach on policy makers and health experts. Purposive sampling was done with maximum diversity. To achieve a comprehensive view, snowball sampling was completed, resulting in the participation of 47 individuals in this study. A semi-structured interview was used to collect data. The analysis was done in MAXQDA software.

Results

Challenges and requirements for the implementation of General Health Policy tasks in promoting the function of stewardship, according to the World Health Organization model, in 3 fields of vital evidence production and policymaking (4 main topics and 20 sub-topics), internal governance (6 main topics and 23 subtopics) and Inter-Sectoral Leadership (2 main topics and 6 subtopics) were categorized. The most important challenges in the field of stewardship included fragmentation, the lack of an integrated information system and coherent and coordinated evidence production institutions, and weakness in the supervisory dimension due to the fatness of the structure, conflict of interests, and lack of transparency in responsibilities.

Conclusion

It seems that the creation of comprehensive governance structures in the form of a network in active interaction with the Secretariat of the Supreme Council of Health and Food Safety, the development of the information system, the coordination of vital evidence production institutions, capacity building to strengthen intra-sectoral governance and inter-sectoral leadership and create a suitable platform be effective for public participation.
Revealing disparities in representation in knowledge generation and guideline development
Authors: Almeida Carlos P. B. , Andom Afom T. , Casseus Alain , Do Jacquelyn-My , Gelin Alain , Lecca Leonid , Luma Maxo , Mazzi Michael , Mitnick Carole D. , Mugunga Jean Claude , Ndayizigiye Melino , Nguyen Natalie , Tamirat Meseret , Tefera Girum , Toussaint Sterman , Tovar Marco , Tzelios Christine
Published: November 2024

Background

Multidrug-resistant tuberculosis (MDR/RR-TB) is a major global health challenge, disproportionately affecting low- and lower-middle-income countries (LLMICs). The World Health Organization (WHO) generates guidance to address the problem. Here, we explore the extent to which guidance and related knowledge are generated by experts living in the most-affected countries and consider the results in the context of the movement to decolonize global health.

Methods

We examined the composition of World Health Organization (WHO) MDR/RR-TB treatment Guideline Development Groups (GDGs) from 2016 to 2022. We classified GDG members according to the MDR/RR-TB burden and World Bank income level of the country of their institutional affiliation. We also searched PubMed to identify peer-reviewed publications from 2016 to 2023 which emanated from individual-patient-data meta-analysis like those done for Guideline review, and classified the publication authors according to the same indicators.

Results

There were 33 high-burden MDR/RR-TB countries during the time period. Of these, 72.1% were LLMICs and none was high-income. In contrast, only 30.3% of WHO GDG members and 10.4% of peer-reviewed publication authors were from LLMICs. Representatives from high-MDR/RR-TB-burden countries comprised 34.3% of WHO GDG members and 14.7% of authors of guideline-related publications.

Conclusions

The important imbalance between the geographical distribution of lived experience with MDR/RR-TB and the distribution of individuals generating knowledge and guidance on treatment of MDR/RR-TB can have clinical and resource implications. Countries may reject or defer guideline adoption because of a mismatch between that guidance and local disease epidemiology. Funding conditioned on compliance with guidelines can exacerbate health inequalities. The movement to decolonize global health considers representation disparities as epistemic injustice, that is unfair treatment in the process of generating, sharing, or receiving knowledge. Reform is possible in many of the institutions involved in generation of global health knowledge, such as: meaningful participation of LLMICs in projects as a requirement for research funding, improved attention to the epistemic and geographical location of journal editorial staff, and broader inclusion in guidelines committees. Better alignment of participation in knowledge generation with burden of disease holds potential for reducing inequality and improving relevance of guidance for the lived experience with MDR/RR-TB.
Association of radiomic features with genomic signatures in thyroid cancer: a systematic review
Authors: Luciano Neila , Orlandella Francesca Maria , Braile Mariantonia , Cavaliere Carlo , Aiello Marco , Franzese Monica , Salvatore Giuliana
Published: November 2024

Background

There is a growing interest on the association of radiomic features with genomic signatures in oncology. Using computational methods, quantitative radiomic data are extracted from various imaging techniques and integrated with genomic information to construct predictive models aimed at advancing diagnostic strategies in cancer patient management. In this context, the aim of this systematic review was to assess the current knowledge on potential application of this association in patients with thyroid cancer (TC).

Methods

A comprehensive literature review was conducted by querying three different databases (PubMed, Scopus and Embase) to identify studies published until June 2024, focusing on the potential association of radiomics and genomics in patients with TC. Pertinent data were subsequently extracted, and the methodological quality was evaluated using the A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR 2).

Results

From the initial analysis, a total of 853 papers were identified. After removing duplicates and applying eligibility criteria, we ultimately evaluated 7 articles. It was observed that the most commonly utilized imaging technique for TC examination was ultrasound (US), followed by computed tomography and magnetic resonance imaging. Regarding genomic techniques, sequencing and polymerase chain reaction were the most commonly employed methods to validate genetic alterations. The association of radiomic features with genomic signatures demonstrated promising performance in predicting metastasis to the cervical lymph nodes or RET/PTC rearrangements. The effectiveness of models based on US-radiomic features in predicting BRAFV600E mutation in patients with TC requires further investigation.

Conclusion

Although this systematic review has several limitations, primarily related to the limited amount of available literature data, the association of radiomic features with genomic signatures demonstrates a potential as non-invasive tool to enhance the accuracy and efficacy of TC diagnosis and prognosis.

PROSPERO registration number: CRD42024572292.
Preoperative cognitive training for the prevention of postoperative delirium and cognitive dysfunction: a systematic review and meta-analysis
Authors: Lau Ka To , Chiu Lok Ching Sandra , Fong Janet Shuk Yan , Chan Albert Kam Ming , Ho Kwok Ming , Lee Anna
Published: November 2024

Background

Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are associated with major morbidity and mortality after surgery. This systematic review and meta-analysis determined whether preoperative cognitive training could reduce POD and POCD in patients undergoing elective surgery.

Methods

Eligible randomized controlled trials were identified from CENTRAL, MEDLINE, EMBASE, Scopus, Web of Science, and CINAHL databases from inception to April 30, 2024. Two independent reviewers extracted data on trial characteristics and risk of bias for each trial. We rated the quality of reporting of cognitive training interventions using the template for intervention description and replication (TIDieR) and evaluated the overall certainty (quality) of evidence using The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Random-effects models were used to summarize the treatment effect of cognitive training. Post hoc trial sequential analyses (TSA) were performed for POD and POCD to differentiate between “no evidence of effect” and “evidence of no effect.”

Results

Seven trials (four high risk and three unclear risk of bias) involving 864 participants (mean or median age between 66 and 73 years old) were considered eligible and subject to meta-analysis. The quality of reporting cognitive training interventions was fair to moderate. Most cognitive prehabilitation programs were home-based, unsupervised, computerized interventions requiring 2.3–10 h over 1–4 weeks before surgery. Cognitive prehabilitation did not reduce POD (risk ratio [RR] 0.82, 95% confidence interval [CI] 0.57–1.18; I2 = 30%; low certainty of evidence in five trials) or early POCD after surgery (RR 0.93, 95% CI 0.58–1.49; I2 = 67%; very low certainty of evidence in four trials) compared to usual care. Nonetheless, TSA suggested that the sample sizes were insufficient to exclude the effectiveness of preoperative cognitive training in reducing POD or POCD. The participants’ compliance rate was either not reported or mostly below 70%.

Conclusions

Current evidence is insufficient to determine the beneficial effect of preoperative cognitive training on POD or POCD. Given the well-established benefits of long-term cognitive training on cognition in the elderly, the design of future cognitive prehabilitation trials should be adequately powered and incorporated with strategies to improve patient compliance.