bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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.