bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of PKM (Community Service Program) on Promoting Vegetable Consumption as a Strategy for Addressing Stunting Risk Groups in Coastal Areas.
Authors: Rumbya Lisri , Salakory Melianus 
Published: February 2025

Indonesia is facing a severe issue of child malnutrition with high rates of stunting among toddlers, particularly in coastal areas like Pulau Osi Maluku. Stunting is caused by inadequate nutritional intake over a long period. The prevalence of stunting in Indonesia remains high, although it is decreasing. Preventive efforts include promoting the habit of eating vegetables, providing health education to parents, and developing hydroponics as a solution for vegetable supply in areas with limited land. Education and collaboration between the government and the community are crucial in addressing stunting and improving the quality of life for children in coastal areas. The research was conducted in Pulau Osi Hamlet, Maluku, using purposive sampling with mothers as subjects. A descriptive qualitative approach was employed, utilizing both primary and secondary data. Data collection was carried out through interviews, observations, and documentation. Data analysis was done using qualitative methods to describe the research findings systematically. In Pulau Osi Hamlet, efforts to combat stunting and meet vegetable needs were undertaken through education using the PBL (Problem-Based Learning) method, involving 35 participants. Vegetable consumption patterns varied and were influenced by knowledge, education, and the availability of vegetables. Land and supply limitations posed challenges. The hydroponic solution increased vegetable availability, diversified food options, and promoted community self-sufficiency. Collaboration between the government and the community was vital. The results were evident from the healthy growth of vegetable plants and successful harvests. This initiative successfully improved knowledge, self-sufficiency, and food security in Pulau Osi Hamlet, helping to address stunting and improve vegetable consumption patterns.
STANDARDIZED ADAPTED CARDIAC REHABILITATION AT AN INPATIENT REHABILITATION FACILITY
Authors: Haught Megan , McKenna Heather , Erby Dr. Matthew , Harmon Dr. Erin 
Published: February 2025

https://youtu.be/hXlMMThneUU

INTRODUCTION
Inpatient rehabilitation facilities (IRFs) serve as an interim level of care for many patients with cardiac dysfunction but are not included among the three phases of cardiac rehabilitation (CR). The education on modifiable risk factors, cardiovascular exercise, and flexibility training given to patients with cardiac diseases are delivered in the acute hospital (phase I) and the outpatient setting (phase II). Our hypothesis was that adapting phase II components to this interim setting would improve outcomes and bridge the gap between phases. In this study, the feasibility of a standardized adapted CR protocol for IRFs and effect on functional outcomes was assessed.

METHODS
This prospective cohort study screened 60 patients over a 6-month period. Patients with primary cardiac diagnoses were screened for inclusion. Both surgical and non-surgical candidates were included. Exclusion criteria were based on the phase II CR criteria of the American College of Sports Medicine (ACSM). Patients received continuous ECG monitoring and physician clearance prior to participation. The standardized adapted CR protocol included individual prescription for cardiopulmonary endurance exercise consistent with ACSM Phase II CR guidelines, flexibility training, and education on modifiable risk factors. Standardized outcome measures included the 6-minute walk test, Borg rating of perceived exertion scale (6-20), EQ-5D-5L quality of life measure, and Section GG (mobility) scores of the Centers for Medicare & Medicaid Services Inpatient Rehabilitation Facility Patient Assessment Instrument. A one-month follow-up evaluated attendance to phase II CR, and quality of life (including maintenance of functional gains). Physical therapy staff were surveyed to identify limitations.

RESULTS
Forty-one patients were deemed eligible to participate. Thirty-two patients participated in at least one endurance session with an average of 3 (+ 1) 20-minute sessions completed. Borg scores (14 + 1) reached the recommended range (somewhat hard to hard) during sessions. Participants demonstrated a statistically significant improvement in their GG mobility scores. Sixty-nine percent reached the 6-minute walk minimal clinically important difference (MCID), and 59% met the quality-of-life MCID, despite their short length of stay in the IRF setting (11 + 4 days). Survey results indicated short length of stay, the need to address functional goals over exercise, inability to tolerate 20 minutes of cumulative aerobic exercise, and compliance of protocol amongst therapists were limiting factors to endurance protocol adherence.

CONCLUSIONS
A standardized adapted CR protocol was feasible within an IRF setting, providing targeted education, increased awareness of phase II CR options, and clear and specific guidelines for creation of individualized exercise programs. Patients demonstrated improvements in functional mobility, cardiovascular endurance, and quality of life.
ASSOCIATIONS OF ACTIGRAPHY-ASSESSED SLEEP AND NIGHTTIME BLOOD PRESSURE IN ADULTS
Authors: Cheruka Caitlin A. , Gibbs Bethany B. , Sanders Rachel M. , Kubala Andrew G. , Egeler Mara E. , Patel Sanjay R. , Perera Subashan , Kline Christopher E. 
Published: February 2025

https://youtu.be/GuuC2itko-8

BACKGROUND
Blood pressure (BP) follows a diurnal rhythm, with higher values in the daytime and lower values at night. Those whose nocturnal systolic blood pressure (SBP) dips less than 10% of daytime values are at greater risk for adverse cardiovascular outcomes. It remains unclear whether disrupted sleep is associated with nocturnal BP dipping.

PURPOSE
To examine the associations between actigraphy-assessed sleep and nocturnal BP dipping in sedentary office workers with elevated BP.

METHODS
Data were collected from 172 participants (SBP= 133.8±9.8mmHg; diastolic BP [DBP]= 81.5±7.1mmHg; 60.1% female; 83.4% White; age=44.5±10.8 y; body mass index [BMI]=31.6±6.6 kg/m2). Sleep was measured using a wrist-worn Actiwatch Spectrum accelerometer concurrently with an Oscar 2 24-hour ambulatory BP monitor on up to 2 occasions per participant. BP was assessed every 30 min during the daytime and 60 min during the nocturnal period (based on participants’ typical bed and wake times). The magnitude of nocturnal dip was calculated as [(daytime SBP – nighttime SBP)/daytime SBP*100]. Linear mixed models were used to examine the associations between sleep and nocturnal SBP dipping, adjusting for age, sex, BMI, race, and daytime SBP. Additional sensitivity analyses accounted for obstructive sleep apnea (OSA) severity in a subsample (n=115).

RESULTS
Across 322 nights of data, participants had a nocturnal SBP=113.3±11.5 mmHg, dipping 13.7±6.5% lower than daytime SBP. Participants had a mean total sleep time (TST)=431.1±70.3 min, sleep efficiency (SE)=90.2±6.2%, wake after sleep onset (WASO)=40.9±30.4 min, and bedtime=23.2±1.2 h. For every 1% increase in SE, the magnitude of nocturnal SBP dip increased by 0.27±0.05% (p&lt;0.001). Each 1-min increase in WASO, the magnitude of nocturnal SBP dip decreased by 0.05±0.01% (p&lt;0.001). TST, bedtime, sleep midpoint, and sleep onset latency were not statistically significantly associated with the magnitude of nocturnal dipping (each p&gt;0.3). After accounting for OSA severity, SE and WASO remained significantly associated with the magnitude of nocturnal SBP dip (each p&lt; 0.001).

CONCLUSION
In sedentary office workers, actigraphy-assessed SE and WASO were associated with nocturnal SBP dipping. Future studies should examine whether improving sleep enhances nighttime BP regulation.
RELIABILITY OF POPLITEAL ARTERY FLOW-MEDIATED DILATION IN THE SEATED POSITION
Authors: AKHTER TASKINA , Wilson Patrick B. , Branch J. David , Reynolds Leryn J. 
Published: February 2025

https://youtu.be/4OD0OwXpzSw

INTRODUCTION
Flow-mediated dilation (FMD) is a noninvasive measure of endothelial function used to assess cardiovascular risks. The popliteal artery is commonly used for FMD measurement in different body positions, which may impact its reliability. This study aimed to examine the reliability of popliteal artery FMD in the seated position, as no previous studies have examined this.

METHODS
Popliteal artery FMD was measured in 20 healthy adults across two visits in seated and prone positions to assess visit-to-visit reliability, with two measurements taken for each body position at each visit for trial-retrial reliability. %FMD was calculated as the percent change from baseline diameter to peak diameter. The reliability of FMD was assessed via intraclass correlation coefficient (ICC).

RESULTS
Popliteal artery %FMD shows moderate-to-good reliability in the seated position (ICC: 0.67 to 0.89) and poor-to-moderate reliability in the prone position (ICC: 0.25 to 0.74) within and between visits. There were no significant differences in baseline diameter or minimum diameter between body positions, visits, or trials (p&gt;0.05). %FMD and peak diameter following cuff deflation demonstrated no significant difference between body positions (p&gt;0.05).

CONCLUSION
Popliteal artery FMD demonstrates good reliability in the seated position, supporting the development of a standardized measurement protocol.
NEUROCOGNITIVE MOBILE APPLICATION PERCEPTION OF USABILITY IN ADULTS WITH PARKINSON’S
Authors: Sharma Charvi , Ludolph Chonnor , Huynh Thinh , Yabut Christian , Burman Justin , Miranda Jose , Mar Dave del , Clark C. Brendan , VanRavenhorst-Bell Heidi 
Published: February 2025

https://youtu.be/ltLSCUESeR0

INTRODUCTION
Mobile technology and applications are now commonly used for neurocognitive testing. Adequate motor control is necessary to perform such assessments. This study assessed the perceived usability of three neurocognitive mobile applications among healthy individuals and those with Parkinson’s Disease (PD).

METHODS
25 adults (10 females, 15 males), aged 57 to 81 years, divided into two groups: (1) without PD (n= 11; m= 70.36 ± sd= 6.87yrs) and (2) with PD (n= 14; m= 72.64 ± sd= 4.55yrs). Participants completed three trials (initial, wk2, wk4) on three neurocognitive mobile applications (NMA) (app1-smartphone, app2-tablet, app3-touchscreen monitor). Following each trial, perceived level of difficulty (PLD) per NMA was recorded, and NMA preference ranked. Two separate 3x3x2 repeated measures ANOVAs were administered. First, PLD of NMA across trials between groups, and the second to determine preference of NMA.

RESULTS
Greenhouse-Geisser on PLD reported a significant main effect for NMA, F(1.501, 16) = 6.354, p= 0.01, ηp² = 0.28, power = 0.79. No other interactions or main effects for PLD of NMA across trials between groups were found to be significant (p&lt; 0.05). Post-hoc PLD tests revealed both the app1-smartphone (p= 0.01) and app2-tablet (p= 0.02) were significantly easier to use than app3-touchscreen monitor for non-PD. Greenhouse-Geisser also determined preference rankings of the three NMA across trials between groups showing a significant main effect of the NMA, F(1.966, 16) = 14.884, p &lt; 0.001, ηp² = 0.48, power = 0.99. All other analyses showed no significant interactions or main effects (p&lt; 0.05). Post-hoc tests revealed app1-smartphone was the most preferred NMA irrespective of PD status followed by app2-table, and app3-touchscreen being the least preferred.

CONCLUSIONS
Findings suggest, smartphones and tablets were generally perceived as easier to use than touchscreen monitors for neurocognitive assessments, regardless of PD status. Furthermore, participants consistently favored the smaller smartphone and app followed by the tablet-driven app, with the larger touchscreen monitor and app being least preferred. These findings highlight the importance of considering motor control challenges, especially for individuals with PD, when selecting devices for neurocognitive testing.
MOTRPAC CPET CORE LAB - QUALITY CONTROL AND THRESHOLD DETERMINATIONS
Authors: Coyne Brian J. , Carnero Elvis Alvarez , Christle Jeffrey , Brubaker Peter , Kraus William E. , Goodpaster Bret , Stowe Cynthia L. , Rejeski W. Jack , Montalvo Samuel , Fleg Jerome L. 
Published: February 2025

https://youtu.be/KAfCLUuf1XY

INTRODUCTION
The Molecular Transducers of Physical Activity Consortium (MoTrPAC) protocol includes collection of cardiopulmonary exercise testing (CPET) data as a key clinical outcome. Due to the large volume of data and institutions involved in MoTrPAC, a CPET Core Lab was created to manage a CPET data repository, evaluate data quality, and analyze metabolic events in the continuous data like ventilatory thresholds (VT).

METHODS
All clinical centers involved in MoTrPAC conducted CPETs on cycle ergometers following individualized ramp protocols. The CPET Core Lab determines the VTs in all past and current CPETS: VT1 (ventilatory threshold 1) and VT2 (ventilatory threshold 2 or Respiratory Compensation Point) as data permits. VT1 is the point where VE and VCO2 increase at a greater rate than VO2. VT2 occurs when VE increases curvilinearly compensating for excess CO2 production. Two independent adjudicators will review each test and independently determine VT1 and VT2. To ensure quality control between adjudicators, repeated VT readings were performed 2 times on 20 blinded tests by 3 adjudicators. This quality control (QC) evaluation process was performed to establish between- and within-adjudicator concordance and agreement by concordance coefficient correlation (ρc) and Bland and Altman analysis, respectively. Adjudicators analyzed all CPETs without doing any additional confirmatory QC.

RESULTS
The metrics calculated on these data showed a high within-adjudicator concordance (ρc range 0.965 to 0.744) and agreement without significant proportional or systematic bias. Within-adjudicator coefficient of variation was below 8% (range 4.12% to 7.88%) for all adjudicators for both VT1 and VT2. The overall coefficient of variation for all adjudicators was 9.9% for VT1 and 10.7% for VT2 between adjudicators, and below 150 ml/min as empirically suggested.

CONCLUSIONS
VT1 and VT2 reading between-adjudicator had a good concordance and agreement. Additional QC procedures between adjudicators are planned to achieve higher levels of reliability and agreement.
INTER-RATER AGREEMENT ON ECG INTERPRETATION AMONG A CARDIOLOGIST, AN EXPERT READER
Authors: Cosio-Lima Ludmila , Crawley Amy , Lee Lincheng , Lee Youngil , Adlof Lauren 
Published: February 2025

https://youtu.be/ccg0hX-FKqM

INTRODUCTION
The use of electrocardiograms (ECGs) in preparticipation evaluations (PPE) for athletes remains a topic of debate in the United States. Over the years, athlete-specific ECG criteria have evolved, leading to greater specificity and reduced false positive rates. Recent comparisons have been made between local physicians and those from specialized centers in their consistency of ECG interpretation using the 2017 International Criteria. However, there has been limited research on whether novice ECG interpreters, such as undergraduate students, can be trained to accurately interpret athletes’ ECGs using the 2017 International Criteria and further, be able to identify the abnormal condition seen on the ECG. This study aims to evaluate the overall and individual inter-rater reliability of novice ECG interpreters and exercise physiologist when compared to a cardiologist.

METHODS
Three novice ECG interpreters (undergraduate exercise science students) received training in interpreting athlete ECGs using the 2017 International Criteria over the course of one semester under the guidance of an expert reader. During an annual high school sports screening event, 1,350 ECGs were collected and assigned unique identification numbers. After the screening event, three novice interpreters (students), a cardiologist, and an Exercise Physiologist (exercise science professor) independently classified the ECGs as either "normal" or "abnormal" and identified the findings on abnormal ECGs based on the International Criteria. All participants were blinded to cardiologist classifications made during the screening event. Information on the athlete’s age, gender, race/ethnicity, and sport was included with the ECGs. Overall agreement between the cardiologist, exercise physiologist, and three students was assessed using a Fleiss’ kappa analysis and individual pair agreement was calculated using Crosstabs.

RESULTS
1,350 athlete ECGs (males = 879; females = 471, age (mean + SD) 15.09 + 1.3y) were reviewed and 51 (3.8%) abnormal cases were identified and further diagnosed. The overall inter-rater agreement between a cardiologist, an exercise physiologist, and three student readers in classifying an ECG as normal or abnormal was rated as good (k = 0.711, p &lt; .001). Individual agreement between which ECGs were classified as normal ranged from moderate, (k = .585) to very good (k = .845). Abnormal readings were further analyzed, and overall abnormal diagnosis agreement was rated as moderate (k = .432, p = 0.00) with individual agreement on abnormal diagnosis ranging from poor (k = .196) to very good (k = .851).

CONCLUSION
This study demonstrated that novice ECG readers could correctly classify ECGs based on the International Criteria as “normal and abnormal” but may need further training in accurately identifying ECG abnormalities in athletes.
CHANGES IN MUSCLE OXYGENATION & MOTOR UNIT ACTIVATION IN RESISTANCE EXERCISE IN OBESE WOMEN
Authors: Kavouras P. , Tsakyridis L. , Sikovaris S. , Zafeiridis Professor A. , Douda Professor H. , Smilios Professor I. 
Published: February 2025

https://youtu.be/-g6-C7YD-cg

BACKGROUND
The study of motor unit activation during exercise provides information on the function of the neuromuscular system and changes in muscle oxygenation for metabolic functions during exercise. The aim of this study was to examine the changes in muscle oxygenation and motor unit activation during resistance exercise and the correlation between these changes in normoweight and obese women.

METHODS/ DESIGN
A total of 25 women participated who were divided, based on body fat percentage (BF), into normoweight (BF: 25.4±3.41, age: 20.7±0.89 years, n=13) and obese (BF: 40.47±6.07, age: 20.5±0.97 years, n=12) and performed in the single leg extension exercise 3 sets of 10 repetitions at 60% of 1RM with a 3′ rest between sets. During the performance of the exercise, electromyographic (EMG) activity of the vastus lateralis muscle was recorded and through decomposition of the EMG signal, the amplitude of the motor unit action potential (MUAP), the firing rate (FR) was determined. Also, the change in oxygenation of the vastus lateralis muscle was recorded by near-infrared spectroscopy (NIRS) and the slope of the change in oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin during the performance of the sets was calculated.

RESULTS
There was a significant increase (p&lt;0.05) in EMGrms activity and FR of the motor units during the performance of the sets with no difference (p&lt;0.05) in the change between the two groups. The slope of increase in HHb and decrease in O2Hb was higher (p&lt;0.05) in normoweight women. There was no significant correlation between the rate of change of the EMGrms signal (r = 0.08-0.30) and FR (r = 0.04-0.28) with the rate of change of O2Hb and HHb in each set either in the whole sample or in each group separately.

COΝCLUSIONS
In conclusion, normoweight and obese women show similar changes in neuromuscular activation during resistance exercise but different metabolic function with greater deoxygenation in normoweight women. The lack of correlation between the change in neuromuscular activation and muscle oxygenation is likely due to the increased use of anaerobic energy production mechanisms during the performance of this exercise program.
ASSESSING VO2 PEAK PREDICTION ACCURACY IN OLDER ADULTS IN CARDIOPULMONARY REHAB
Authors: Kropatsch Katy 
Published: February 2025

https://youtu.be/OC7ttYm1LLU

BACKGROUND
Peak oxygen uptake (VO2 peak) is an important measure in cardiopulmonary rehabilitation (CR), reflecting cardiovascular health and guiding treatment. Clinical exercise tests predict VO2 using the ACSM model, which may overestimate VO2 peak for older adults in CR. Age-related changes and handrail support during exercise are not considered in most equations. Foster developed a prediction equation for older adults with handrail support, but it hasn’t been tested on CR patients. This study aims to evaluate the accuracy of VO2 peak prediction equations, including the ACSM equation and Foster equations (with and without handrail support), in older adults undergoing CR.

METHODS
CR patients (n=11, age: 69.5 ± 10.4 yrs) underwent a treadmill test measuring VO2 peak via gas exchange analysis. Predicted VO2 peak was calculated using the ACSM equation (modified Bruce protocol) and the Foster equation (Pepper protocol, with and without handrail support). Paired t-tests compared actual and predicted VO2 peak, and effect sizes were calculated.

RESULTS
The Foster model with handrail support provided the most accurate estimate of VO2 peak, but still overestimated it (Foster handrail: 18.06 ± 5.38 ml/kg/min vs. actual: 15.8 ± 6.4 ml/kg/min, p = 0.047). The ACSM model had the greatest discrepancy (ACSM: 21.27 ± 7.75 ml/kg/min vs. actual: 15.8 ± 6.4 ml/kg/min, p = 0.001), with a large effect size (Cohen’s d = -1.37).

CONCLUSION
The ACSM model significantly overestimated VO2 peak in CR patients, while the Foster handrail model provided the most accurate estimates, though still with some overestimation. These results emphasize the need for improved VO2 prediction models for clinical stress testing.