bluuebunny/crossref_metadata_2025_split huggingface dataset:
No frugal innovation without frugal evaluation: the Global IDEAL Sub-Framework
Authors: Bolton William S , Aruparayil Noel K , Cundill Bonnie , McCulloch Peter , Gnanaraj Jesudian , Bundu Ibrahim , Culmer Peter R , Brown Julia M , Scott Julian , Jayne David G 
Published: June 2024

ObjectiveThe Global IDEAL Sub-Framework Study aimed to combine the intended effects of the 2009/2019 IDEAL (Idea, Development, Exploration, Assessment, Long-term study) Framework recommendations on evaluating surgical innovation with the vision outlined by the 2015 Lancet Commission on Global Surgery to provide recommendations for evaluating surgical innovation in low-resource environments.DesignA mixture of methods including an online global survey and semistructured interviews (SSIs). Quantitative data were summarized with descriptive statistics and qualitative data were analyzed using the Framework Method.ParticipantsSurgeons and surgical researchers from any country.Main outcome measuresFindings were used to suggest the nature of adaptations to the IDEAL Framework to address the particular problems of evaluation in low-resource settings.ResultsThe online survey yielded 66 responses representing experience from 40 countries, and nine individual SSIs were conducted. Most respondents (n=49; 74.2%) had experience evaluating surgical technologies across a range of life cycle stages. Innovation was most frequently adopted based on colleague recommendation or clinical evaluation in other countries. Four themes emerged, centered around: frugal innovation in technological development; evaluating the same technology/innovation in different contexts; additional methodologies important in evaluation of surgical innovation in low/middle-income countries; and support for low-income country researchers along the evaluation pathway.ConclusionsThe Global IDEAL Sub-Framework provides suggestions for modified IDEAL recommendations aimed at dealing with the special problems found in this setting. These will require validation in a stakeholder consensus forum, and qualitative assessment in pilot studies. From assisting researchers with identification of the correct evaluation stage, to providing context-specific recommendations relevant to the whole evaluation pathway, this process will aim to develop a comprehensive and applicable set of guidance that will benefit surgical innovation and patients globally.
A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon
Authors: Yalınkaya Ahmet , Oğlak Süleyman Cemil 
Published: June 2024

Background: This study is aimed at evaluating the conservative surgical treatment of patients with placenta accreta spectrum (PAS) disorder and at presenting the experience of a single surgeon.Materials and Methods: This retrospective study included 245 patients with placenta previa accompanied by PAS disorders operated at a university hospital between June 2013 and December 2023. The diagnosis of PAS was made by a single perinatologist using a combination of transvaginal and transabdominal ultrasonography. All patients were operated with conservative surgical technique by the same surgeon. The demographic and clinical characteristics of the patients, the anesthesia and incision types used, and the details of the surgical technique were evaluated.Results: Of the patients, 165 were operated on at the scheduled time, 80 were operated on under emergency conditions, and 232 (94.69%) of them were operated on under spinal anesthesia. All patients were operated on with a Pfannenstiel incision followed by a transverse incision to the upper border of the placenta to enter into the uterus. An average of 0.52 units of red blood cells per patient was transfused to all patients. Spontaneous intra‐abdominal bleeding developed in five patients, and surgical complications occurred in eight patients. No cesarean hysterectomy was performed, and no maternal mortality was detected in any of the cases. The mean time duration of surgery was 54.44 ± 11.37 (30–90) min, and the mean length of hospital stay was 1.71 ± 1.30 (1–9) days.Conclusions: We recommend this procedure as a novel technique and a robust and safe alternative to peripartum hysterectomy and other conservative surgical management procedures for cases with complete PP accompanied with PAS. This technique preserves the uterus as well as reduces blood loss, and transfusion requirement, and thus maternal morbidity and mortality in PAS cases.
Perception-action Dissociations as a Window into Consciousness
Authors: Carrasco Marisa , Spering Miriam 
Published: June 2024

Abstract
Understanding the neural correlates of unconscious perception stands as a primary goal of experimental research in cognitive psychology and neuroscience. In this Perspectives paper, we explain why experimental protocols probing qualitative dissociations between perception and action provide valuable insights into conscious and unconscious processing, along with their corresponding neural correlates. We present research that utilizes human eye movements as a sensitive indicator of unconscious visual processing. Given the increasing reliance on oculomotor and pupillary responses in consciousness research, these dissociations also provide a cautionary tale about inferring conscious perception solely based on no-report protocols.
Dialogue and Conservative Religious Thought
Authors: Ni Buxiao 
Published: June 2024

Abstract
This paper explores the dynamic interplay between Christianity and the Roman Empire as articulated by Tertullian, a prominent figure in early Christian theology. Tertullian delves into the complex relationship between the burgeoning Christian faith and the established structures of the Roman Empire, highlighting the inherent tension between the two. Central to his analysis is the concept of dialogue, wherein Tertullian examines how Christians engage with the broader Roman society while maintaining their distinct religious identity. Furthermore, he discusses the conservative nature of Christian thought, emphasizing the preservation of core beliefs amidst external pressures. This paper provides insights into Tertullian’s perspective on the delicate balance between dialogue and the preservation of Christian values within the context of the Roman Empire.
Evaluation of IMERG and MSG-CPP Precipitation Estimates over Europe Using EURADCLIM: A Gauge-Adjusted European Composite Radar Dataset
Authors: van der Plas Emiel , Overeem Aart , Meirink Jan Fokke , Leijnse Hidde , Bogerd Linda 
Published: June 2024

Abstract
A new pan-European climatological dataset was recently released that has a much higher spatiotemporal resolution than existing pan-European interpolated rain gauge datasets. This radar dataset of hourly precipitation accumulations, European Radar Climatology (EURADCLIM) (Overeem et al.), covers most of continental Europe with a resolution of 2 km × 2 km and is adjusted employing data from potentially thousands of government rain gauges. This study aims to use this dataset to evaluate two important satellite-derived precipitation products over the period 2013–19 at a much higher spatiotemporal resolution than was previously possible at the European scale: the IMERG late run and the Meteosat Second Generation (MSG) cloud physical property product from the SEVIRI instrument. The latter is only available during daytime, so the analyses are restricted to daytime conditions. A direct gridcell comparison of hourly precipitation reveals an apparently low coefficient of correlation. However, looking into slightly more detail at statistics pertaining to longer time scales or specific areas, the datasets show good correspondence. All datasets are shown to have their specific biases, which can be transient or more systematic, depending on the timing or location. The MSG precipitation seems to have an overall positive bias, and the IMERG dataset suffers from some transient overestimation of certain events.
Impact of Rigid Polyurethane Post Consumer Waste on the Texaco Gasification Process
Authors: Hicks D.A. , Soderberg D.J. , Winter J.D. , Cantero H. 
Published: June 2024

Gasification is a leading feedstock recycling process for managing large volumes of post-consumer plastics waste. ICI Polyurethanes, Texaco and Gent University have conducted an experimental evaluation of adding polyurethanes from Dutch refrigerator waste to a mixed plastics gasifier feed. Results show that polyurethanes are an acceptable feedstock for gasification. Nitrogen in the polyurethanes is shown to be beneficial to the process, reducing the impact of chlorine content and giving a “gate fee” equivalent to mixed plastics waste. Details of the experimental work, process economics and commercial possibilities are given. Gasification is shown to be applicable to a wide range of polyurethanes waste streams.
Effects of radial extracorporeal shock wave therapy on flexor spasticity of the upper limb in post-stroke patients: A randomized controlled trial
Authors: Fan Tao , Chen Rong , Wei Mingyang , Zhou Xiangying , Zheng Peng , Zhou Jing , He Peichen , Zhan Xiaojia , Xie Jingyu , Li Rongdong , Li Rihui , Cao Peihua , Huang Guozhi 
Published: June 2024

Objective This study aimed to assess the efficacy of radial extracorporeal shock wave therapy in treating upper limb spasticity after a stroke. Design Randomized controlled trial. Setting Zhujiang Hospital of Southern Medical University. Subjects This study included 95 people with stroke. Intervention The active ( n = 47) and sham-placebo ( n = 48) radial extracorporeal shockwave therapy groups received three treatment sessions (every third day). Main measures The Modified Ashworth Scale, Hmax/Mmax ratio, root mean square, co-contraction ratio, mechanical parameters of the muscle and temperature were measured at baseline and days 2, 5 and 8. Results Among the 135 potential participants screened, 100 were enrolled and allocated randomly, with 95 participants ultimately being included in the intent-to-treat analysis dataset. The active group showed significantly better improvements in upper limb spasticity and muscle function than did the sham-placebo group. Greater improvements in the Modified Ashworth Scale were observed in the active group than in the sham-placebo group (difference, −0.45; 95% CI, −0.69 to −0.22; P < 0.001). Moreover, significant differences in root mean square, co-contraction ratio and Hmax/Mmax ratio were observed between the two groups (all P < 0.001). The mechanical parameters of the biceps muscle were significantly better in the active group than in the sham-placebo group ( P < 0.001). The active group had a higher temperature than the sham-placebo group, although the difference was not significant ( P = 0.070). Conclusions This study revealed that the treatment with extracorporeal shockwave therapy can relieve upper limb spasticity in people with stroke.
Effect of Bright Light Therapy on Perinatal Depression: A Systematic Review and Meta-Analysis: Effet de la luminothérapie sur la dépression périnatale: une revue systématique et une méta-analyse
Authors: Chen Yujia , Zhao Jing , Wang Jiarun , Peng Li , Cai Zhongxiang , Zou Zhijie , Chen Xiaoli 
Published: June 2024

Objective This study represents the inaugural attempt to systematically review and analyse the efficacy of bright light therapy on depression among women experiencing major depressive disorder or depressive symptoms during the perinatal period, encompassing its efficacy on depression scores, remission rates, and response rates. Methods We searched 10 databases for randomized controlled trials examining bright light therapy's efficacy on perinatal depression up to January 2024. Data extraction was performed independently by 2 investigators. The Cochrane Handbook guidelines appraised the study quality, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach assessed evidence certainty. Results We incorporated 6 studies, encompassing 151 participants. When contrasted with dim light therapy, bright light therapy did not significantly alter depression scores (standard mean difference = −0.29, 95% confidence interval [CI], −0.62 to 0.04, P = 0.08, I² = 34%) or response rates (risk ratio [RR] = 1.56, 95% CI, 0.98 to 2.49, P = 0.06, I² = 0%) in women experiencing perinatal depression. Conversely, bright light therapy was associated with a substantial increase in remission rates (RR = 2.63, 95% CI, 1.29 to 5.38, P = 0.008, I² = 2%). Conclusion Bright light therapy did not show efficacy in treating perinatal depression in terms of depression scores and response rates. However, regarding the remission rate, bright light did show efficacy compared to control conditions. Due to the limited sample size in the included studies, type II err or may occur. To obtain more conclusive evidence, future studies must employ larger sample sizes.
Periconceptional Non-medical Maternal Determinants Influence the Tryptophan Metabolism: The Rotterdam Periconceptional Cohort (Predict Study)
Authors: van Zundert Sofie KM , van Rossem Lenie , Mirzaian Mina , Griffioen Pieter H , Willemsen Sten P , van Schaik Ron HN , Steegers-Theunissen Régine PM 
Published: June 2024

Background: The vital role of the maternal tryptophan (TRP) metabolism in maternal health and pregnancy is well established. However, non-medical maternal determinants influencing the TRP metabolism have been poorly investigated. We hypothesise that periconceptional maternal non-medical determinants alter the TRP metabolism, affecting both kynurenine (KP) and serotonin pathway (SP) metabolite concentrations. Therefore, we investigated the influence of non-medical maternal determinants on the TRP metabolism during the periconception period. Methods: About 1916 pregnancies were included from the Rotterdam Periconceptional Cohort between November 2010 and December 2020. Data on periconceptional non-medical maternal determinants were collected through questionnaires. Serum samples were collected at 8.5 (SD = 1.6) weeks of gestation and TRP, kynurenine (KYN), 5-hydroxytryptophan (5-HTP), 5-HT (5-hydroxytryptamine) and 5-hydroxyindole acetic acid (5-HIAA) were determined using validated liquid chromatography (tandem) mass spectrometry. Mixed models were used to determine associations between periconceptional non-medical maternal determinants and these metabolites. Results: In total 11 periconceptional non-medical maternal determinants were identified. Protein intake was positively associated with TRP ( β = .12, 95% CI = 0.07-0.17), while age, energy intake and body mass index (BMI) ( β = −.24, 95% CI = −0.37 to −0.10) were negatively associated with TRP. Age, BMI and total homocysteine were associated with higher KYN, whereas non-western geographical origin was associated with lower KYN ( β = −.09, 95% CI = −0.16 to −0.03). Protein intake and total homocysteine ( β = .07, 95% CI = 0.03-0.11) had a positive association with 5-HTP, while a negative association was found for energy intake. A non-western geographical origin and drug use were associated with higher 5-HT, and BMI with lower 5-HT ( β = −6.32, 95% CI = −10.26 to −2.38). Age was positively associated with 5-HIAA ( β = .92, 95% CI = 0.29-1.56), and BMI negatively. Conclusions: Periconceptional non-medical maternal determinants, including age, geographical origin, drug use, energy and protein intake, BMI and total homocysteine, influence KP and SP metabolite concentrations.
Academic learning challenges and links to vocational outcomes in young autistic adults
Authors: Grosman Hannah E , Aragon-Guevara Diego , McQuaid Goldie A , Wallace Gregory L , Lee Nancy Raitano 
Published: June 2024

Obtaining and maintaining employment can be a challenge for autistic adults and learning challenges may be related to vocational outcomes in this population. The present study sought to evaluate the Learning Needs Screening Tool to identify autistic job seekers who may benefit from additional services to obtain employment. A total of 401 autistic adults participated in this study. Internal consistency of Learning Needs Screening Tool items was evaluated. A principal component analysis was then completed to understand the measure’s factor structure and evaluations of external validity were completed. Evaluation of the screening items of the Learning Needs Screening Tool revealed high internal consistency. Three factors (Orthography, Arithmetic, and Retrospective Learning and Service Receipt) emerged. Overall, 56% of the sample screened positive on the Learning Needs Screening Tool, indicating a history of learning challenges. Analysis of history of special education receipt and vocational outcomes showed strong external validity for the measure. Results support the utility of the Learning Needs Screening Tool as a possible screening tool to evaluate learning challenges in autistic job seekers. As those who screened positive were more likely to have no vocational/educational activities, knowledge of retrospective learning needs may help vocational counselors identify autistic adults who need greater supports when seeking and obtaining jobs. Lay abstract Finding a job can be hard for autistic adults. No studies have been completed that look into whether having difficulties learning and troubles finding a job are related in this population. The current study did so by evaluating the Learning Needs Screening Tool, a measure of learning challenges used in vocational rehabilitation settings, or places meant to help people find work. A total of 401 autistic adults completed this study online. Specifically, the study evaluated (a) the characteristics of the Learning Needs Screening Tool, including the relationships between questions that ask about similar learning challenges, and (b) the ability of the measure to relate to real-world outcomes that are associated with learning difficulties, namely prior special education receipt and difficulties finding a job. Evaluation of the questions asked on the Learning Needs Screening Tool revealed that they were highly related and that learning difficulties fell into different categories. Fifty-six percent of the people in the study showed learning challenges on the measure. People who were identified as having learning difficulties on the Learning Needs Screening Tool had higher rates of receiving special education services in the past and lower rates of current employment. These results suggest that the Learning Needs Screening Tool may help to identify autistic job seekers who have learning difficulties and may have more challenges finding a job.
Knowledge and attitudes of physicians in Chile toward Do-Not-Attempt-Resuscitation orders: A cross-sectional nation-wide study
Authors: Picón-Jaimes Yelson Alejandro , Lozada-Martinez Ivan David , Rahman Sabrina , Cantón Álvarez Maria Belén 
Published: June 2024

Objective: Do-Not-Attempt-Resuscitation orders originated in the early 1960s with the establishment of advanced cardiopulmonary resuscitation. These orders aim to limit therapeutic efforts in cases where it may be futile. The decision not to resuscitate a patient is a process that involves a series of ethical, legal, and clinical considerations. Still, it also requires a process in which priority is given to the patients and their autonomy. The objective of this study was to describe the knowledge and attitudes of physicians working in Chile toward Do-Not-Attempt-Resuscitation orders. Methods: A cross-sectional study was conducted, in which a digital questionnaire was sent to physicians from different regions of Chile. Quantitative variables were analyzed using measures of central tendency and dispersion (e.g., median and interquartile range), while qualitative variables were evaluated using frequencies and percentages. Results: Four hundred and thirty-one physicians completed the survey. 85.4% were familiar with the ethical and legal guidelines for cardiopulmonary resuscitation and the rights and duties of the patient. 39.2% believed that patients should have the final decision Do-Not-Attempt-Resuscitation orders, especially if they themselves requested not to be resuscitated. 87.7% mentioned that the Do-Not-Attempt-Resuscitation orders should be reassessed if the patient’s prognosis improves. In addition, it was found that the decision not to resuscitate was not always discussed with the patient or their family. Conclusions: The study revealed an ethical conflict regarding Do-Not-Attempt-Resuscitation orders and their management by Chilean physicians. Therefore, it is necessary to create recommendations and provide training to guide professionals in this process, which should also involve patients and their families.
Distribution of COVID-19 Home Testing Through Community Health Centers: Results of the COVID CoNOce MÁS Study
Authors: Nodora Jesse N. , Martinez Maria Elena , McDaniels-Davidson Corinne , Shen Jian , Sitapati Amy M. , Torriani Francesca , Mandel Jess , Hill Linda 
Published: June 2024

Objective: To assess acceptability and feasibility of rapid at-home COVID-19 testing and reporting of test results among individuals seeking care at community health centers (CHCs) and their household members. Methods: Participants were recruited from 2 Community Health Centers during a clinic visit or a community event. Over-the-counter COVID-19 tests were distributed to participants for self-testing and to offer testing to household members. Separate surveys were administered to collect baseline information on the study participant and to collect test results on the study participant and household members. We calculated the proportion of individuals who agreed to complete COVID home testing, those who reported test results, and the test positivity. For household members, we calculated the proportion who completed and reported results and the positivity rate. We assessed reasons for undergoing COVID-19 testing and the action taken by participants who reported positive tests. Results: A total of 2189 individuals were approached by CHC staff for participation and 1013 (46.3%) agreed to participate. Among the 959 participants with complete sociodemographic data, 88% were Hispanic and 82.6% were female. The proportion providing test results was 36.2% and the test positivity was 4.2%. Among the 1927 test reports, 35.3% for the index participant and 64.4% were for household members. The largest proportion of test results were for index participants (35.3%) and the second largest was for the participant’s children (32.1%), followed by parents (16.9%), and spouse/partner (13.2%). The 2 most common reasons for testing were symptoms (29%) and attending family gatherings (26%). Among test-positive individuals (n = 80), most (83.3%) noted that they isolated but only 16.3% called their provider and 1.3% visited a clinic. Conclusion: Our results show interest in at-home COVID-19 testing of multiple household members, as we headed into the endemic phase of the pandemic. However, reporting of test results was modest and among test-positive individuals, reporting results to a provider was very low. These results underscore the challenges with reporting and following guidelines among people undergoing home testing for COVID-19, which may have implications for future pandemics.