bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metacontexts and Cross-Contextual Communication: Stabilizing the Content of Documents Across Contexts
Authors: Davies Alex 
Published: July 2023

Abstract
Context-sensitive expressions appear ill suited to the purpose of sharing content across contexts. Yet we regularly use them to that end (in regulations, textbooks, memos, guidelines, laws, minutes, etc.). This paper describes the utility of the concept of a metacontext for understanding cross-contextual content-sharing with context-sensitive expressions. A metacontext is the context of a group of contexts: an infrastructure that can channel non-linguistic incentives on content ascription so as to homogenize the content ascribed to context-sensitive expressions in each context in the group. Documents composed of context-sensitive expressions can share content across contexts when supported by an appropriate metacontext. The bible has its church, the textbook its education system, the form its bureaucracy, and the manifesto its social movement. Some metacontexts support cross-contextual content-sharing. Some don’t. A promising research programme (one with practical importance) would take metacontexts as its unit of analysis.
Construction of a radiation beam scanner and investigation of volume averaging correction factor effects on beam-profile
Authors: Tikkanen Joonas , Morelius Jan , Siiskonen Teemu 
Published: July 2023

Abstract
In radiation beam-profile measurements, an accurate positioning of the detector with high position resolution is essential. For this purpose, we built a scanning device capable of moving a detector in three dimensions (3D) using mainly parts from a commercial 3D-printer. The accuracy and repeatability of movement was tested with caliper, laser displacement sensor and repeated 60Co beam-profile measurements in a water phantom. The results from the caliper and the sensor showed position accuracy for the scanner to be better than $\pm$150 μm. The standard deviation of the error in position from laser sensor measurements was approximately 30 μm, and the beam profile scans showed a maximum deviation from the mean position of 50 μm. The effect of volume averaging correction factors on 60Co beam-profile was investigated with two different sized ionization chambers. The differences in the profiles were reduced significantly after applying the correction factors.
Heavy-ions shielding data for hadrontherapy application with Monte Carlo methods
Authors: Bonforte Francesco , Ferrarini Michele , D’Angola Antonio , Giroletti Elio , Introini Daniele 
Published: July 2023

Abstract
In hadrontherapy centers, ion beams are accelerated by a cyclotron or synchrotron through electric and magnetic fields and, once the treatment energy is reached, ions interact with the patient. The interaction of the beam with magnets, other elements of particle accelerator or with the patient generates secondary radiation and the calculation for the design of the shielding is required. A first assessment of the shielding, generally made by concrete, can be performed by using Monte Carlo simulations, in which neutron yields and the ambient dose equivalent, H*(10), spatial distribution are obtained. The aim of this work is to evaluate, with a Monte Carlo approach, ambient dose equivalent values at various concrete depths generated by the secondary radiation. Simulations are performed considering helium, lithium, carbon, oxygen and iron primary beams. For existing facilities that already accelerates carbon ion, an equivalent carbon ratio is introduced to estimate the ion currents to get, in a given point, the same ambient dose equivalent as a carbon ion. Numerical results have been obtained simulating an ion beam that impinges on a thick iron or international commission on radiation units and measurements (ICRU) tissue, respectively, representing magnets and patient. The secondary radiation is transported through a large concrete shielding where ambient dose equivalent values are calculated as function of concrete thickness.
The association of various physical activities with erectile dysfunction: NHANES 2001-2004
Authors: Zhou Hang , Xu Mingming , Xu Zhunan , Li Muwei , Ren Congzhe , Chen Xiangyu , Liu Xiaoqiang 
Published: July 2023

Abstract

Background
The relationship between erectile dysfunction (ED) and physical activity has been established in several previous studies, but there is little information on the specific forms of activity that affect ED.

Aim
The objective of this study was to evaluate the relationship of 4 exercise categories and 2 activity intensities with ED in US men.

Methods
We used data sets from the National Health and Nutrition Examination Survey, 2001-2004. We used odds ratios (ORs) and multivariate logistic regression models to investigate the relationship between physical activity and ED. We also conducted subgroup analyses by age and controlled for potential confounder variables using propensity score matching analyses.

Outcomes
The primary outcome was ED as assessed through self-reporting.

Results
An overall 4094 adult men were included in the study. Adjusted multivariate regression models indicated that men who participated in monthly muscle-strengthening activities (OR = 0.75, P = .031), leisure activities (OR = 0.76, P = .024), or vigorous activities (OR = 0.64, P = .001) had a lower risk of ED. The subgroup analysis showed that among those ≥40 years old, muscle-strengthening activity (OR = 0.67, P = .005), leisure activity (OR = 0.72, P = .006), and vigorous activity (OR = 0.50, P &lt; .001) were negatively associated with ED. After adjustment of propensity score matching, leisure activity and vigorous activity were also associated with a lower risk of ED, and muscle-strengthening activity was not significantly associated with ED.

Clinical Implications
Our findings could provide guidance to clinicians in helping patients with ED develop exercise programs.

Strengths and Limitations
We explored the relationship of 4 types and 2 intensities of exercise with ED, using a large sample size and sampling weights to produce representative data. However, this is only a cross-sectional study.

Conclusion
Active monthly participation in leisure and vigorous activity is associated with the maintenance of erectile function, while the relevance of muscle-strengthening activities needs further study.
The impact of essential fatty acid ratios and unsaturated to saturated fat ratio on growth performance of grow-finish pigs and estrus detection of gilts
Authors: Becker Spenser L , Greiner Laura L 
Published: July 2023

Abstract
The objective of this study was to investigate the effects of dietary unsaturated and saturated fat ratio (U:S) and the ratio of linoleic and linolenic acid (LA:ALA) on the growth performance of grow-finish pigs and estrus detection of gilts. A total of 240 pigs with initial body weight (BW) 54.4 ± 5.5 kg were randomly assigned to a high (&gt;1.8; HUS) or low (&lt;1.0; LUS) U:S in combination with a high (20:1), moderate (12:1), or low (4:1) LA:ALA in a 3 × 2 factorial arrangement. Dietary ratios were achieved using blends of choice white grease, beef tallow, corn oil, flaxseed oil, or palm kernel oil. Diets were fed across three phases and balanced for energy and LA. Pigs were housed across 60 pens with either four gilts or four barrows per pen. On day 49, 1 gilt per pen was moved to individual housing at approximately 154 d of age for evaluation of reproductive characteristics. Data were analyzed as repeated measures using PROC MIXED (SAS 9.4; SAS Inst., Cary, NC) with pen as the experimental unit and U:S, LA:ALA, sex, and their interactions as fixed effects. Initial BW was fit as a covariate. Within each phase, there were no differences in BW, daily gain (ADG), feed intake (ADFI), or feed efficiency (G:F) for U:S, LA:ALA, or their interaction when averaged across sex (P ≥0.128). Gilt feed efficiency was improved during the second phase compared to barrows; however, feed efficiency was not different between barrows and gilts during the first and third phases; resulting in a similar feed efficiency between sexes for the overall period (P = 0.523). Compared to HUS, gilts receiving LUS had higher ADFI overall (P = 0.018), which translated into improved G:F for HUS gilts (P = 0.011). Overall, gilts receiving the 20:1 diet tended to have improved G:F compared to 12:1 (P = 0.086). ADG was improved in pigs fed diets formulated with unsaturated fat sources to a 20:1 LA:ALA, regardless of sex. Detection of first estrus by 235 d of age in gilts was not impacted by U:S or LA:ALA (P ≥ 0.356). In conclusion, feeding differing dietary U:S and LA:ALA ratios impacts growth of growing pigs, particularly improving feed efficiency of gilts fed diets with unsaturated fat sources or a 20:1 LA:ALA. Further investigation into the physiological mechanisms differentially affecting gilt growth when fed varying dietary LA:ALA is warranted to understand the impact on reproductive outcomes.
The Impact of Single-Dose Debriefing for Meaningful Learning Training on Debriefer Quality, Time, and Outcomes: Early Evidence to Inform Debriefing Training and Frequency
Authors: Bradley Cynthia Sherraden , Johnson Brandon Kyle , Woda Aimee , Hansen Jamie , Loomis Ann , Dreifuerst Kristina Thomas 
Published: July 2023

Abstract

AIM
This study evaluated the impact of a single dose of training in Debriefing for Meaningful Learning (DML) on learner knowledge outcomes and time spent in debriefing.

BACKGROUND
Regulatory bodies recommend that faculty who debrief receive training and competence assessment to ensure positive student learning outcomes, yet there is little literature describing the training needed. There is also little understanding of the impact of a single training on the length of debriefing, debriefer skill, and learner outcomes.

METHOD
Following training, debriefers submitted a recorded debriefing for assessment by experts; their learners completed knowledge assessment tests at three time points.

RESULTS
Longer debriefing time led to higher DML Evaluation Scale scores. Learner knowledge scores improved and later decayed.

CONCLUSION
The results of this study contribute to the evidence about the importance of training to debrief well, the impact of training on the length of debriefing time, and subsequent learner outcomes.
Absolute Monocyte Count as Early and Safe Marker for Antibiotic Cessation in Febrile Neutropenia Without Etiology in Pediatric Oncology Patients
Authors: Alali Muayad , Prather Cassandra , Danziger-Isakov Lara A. , Kussin Michelle L. , Khalifeh Malak , Al Othman Nashwan , Bartlett Allison H. 
Published: July 2023

Background:
There is no practice standard regarding antibiotic duration in children with cancer and unexplained febrile neutropenia (FN). We hypothesized that absolute monocyte count (AMC) and absolute phagocyte count (APC= ANC + AMC + bands) are more sensitive, earlier, and safe markers of antibiotic cessation compared with absolute neutrophil count (ANC).

Methods:
A retrospective review of FN episodes (FNEs) in pediatric oncology patients was conducted between 2009 and 2016. Included patients were afebrile for 24 hours and without an identified infectious source at antibiotic cessation. Primary endpoints, including recurrent fever, readmission, bloodstream infection, microbiologically documented infection, and adverse outcomes, were assessed 10 days after antibiotic cessation and compared among different bone marrow recovery parameters (ANC, AMC, APC). Secondary endpoints included length of FN stay, antibiotic-free days, and cost.

Results:
Three hundred ninety-one FNEs in 235 patients were included. Three groups were compared based on ANC (cells/μL) at the time of antibiotic cessation: < 200 in 102 (26%), 200 to 500 in 111 (28%), and >500 in 178 (46%). No statistically significant differences in primary endpoints were identified among the 3 ANC groups; however, a trend toward unfavorable outcomes in the ANC ≤200 cells/μL group compared with the ANC >200 cells/μL was observed. Primary endpoints based on AMC >100 cells/μL at the time of antibiotic cessation showed statistically significant favorable outcomes compared AMC ≤100 cells/μL (80%, 88%, 90%, 89%, and 93% risk reduction in recurrent fever, readmission, new bloodstream infection, new microbiologically documented infection, and adverse events, respectively). Similar favorable results were seen when APC >300 cells/μL was used as a threshold for antibiotic cessation. The median length of stay for FN if discharged when AMC >100 cells/μL was 3 days shorter and associated with fewer unfavorable outcomes, thus resulting in fewer hospital days, fewer antibiotic days, and decreased cost.

Conclusion:
Our results suggest that AMC >100 cells/μL (regardless of ANC) or APC >300 cells/μL may be safe thresholds for empiric antibiotic cessation and result in reduced unfavorable clinical outcomes within 10 days postdischarge, reduced antibiotic days of therapy and reduced health care costs. Further prospective studies are needed to validate AMC as an accurate surrogate marker for antibiotic cessation in FNEs in children with cancer.
Prognostic Factors and Treatment Outcome of Relapsing and Refractory Pediatric Mature B-cell Non-Hodgkin Lymphoma, Children’s Cancer Hospital Egypt Experience
Authors: Semary Samah F. , Abdel Rahman Hany , Elkinaai Naglaa , Zaky Iman , Nagy Nouran , Salem Sherine , Hamoda Asmaa 
Published: July 2023

Background:
Relapsed non-Hodgkin lymphoma treated by chemotherapy and hematopoietic stem cell transplantation (HSCT) has a dismal prognosis.

Patients:
It is a retrospective study, including pediatric patients diagnosed as mature B-cell non-Hodgkin lymphoma who were primarily refractory or relapsed over 8 years at CCHE. The aim of the study was to analyze the prognostic factors and outcomes of this group of patients. Our result is, 53 of 750 (7%) patients were included. Thirty-four (64.2%) patients had Burkitt lymphoma. Forty-eight (90.6%) patients received LMB 96 protocol initially. The median delay of duration between chemotherapy cycles in first-line treatment was 37 days. Thirty-five (66%) patients relapsed, 23 (65.7%) of them relapsed early, whereas 18 (34%) had tumor progression. Thirty-one (58.5%) patients presented with stage IV at the time of relapse. rituximab, ifosfamide, carboplatin, etoposide was the second line of treatment in 42 (79.24%) patients, and complete second remission was achieved only in 13 (24.3%) patients. Allogeneic HSCT was done for 4 (7.5%) patients, and auto HSCT was done for 3 (5.7%) patients. Three years of overall survival for relapsed and progressed patients were 35.3% and 11.1%, respectively, with a P-value of 0.009. Three years overall survival for patients who underwent HSCT was 85.7% compared with 18.1% for no HSCT with a P-value of 0.007.

Conclusions:
The relapse rate is higher than literatures because of the delay of duration between chemotherapy cycles in first-line treatment and more advanced stage at time of relapse. Progression of the disease had a worse outcome than relapse. HSCT in patients with the second remission markedly improved the outcome.
Rapid Response System Components and In-Hospital Cardiac Arrests Rates 21 Years After Introduction Into an Australian Teaching Hospital
Authors: Jones Daryl , Pearsell James , Wadeson Emma , See Emily , Bellomo Rinaldo ,   on behalf of The Austin Health DPC investigators
Published: July 2023

ObjectivesThe aims of the study are: (1) to evaluate the epidemiology of in-hospital cardiac arrests (IHCAs) 21 years after implementing a rapid response teams (RRTs); and (2) to summarize policies, procedures, and guidelines related to a national standard pertaining to recognition of and response to clinical deterioration in hospital.MethodsThe study used a prospective audit of IHCA (commencement of external cardiac compressions) in ward areas between February 1, 2021, and January 31, 2022. Collation, summary, and presentation of material related to 8 “essential elements” of the Australian Commission for Safety and Quality in Health Care consensus statement on clinical deterioration.ResultsThere were 3739 RRT calls and 244 respond blue calls. There were 20 IHCAs in clinical areas, with only 10 occurring in general wards (0.36/1000 admissions). The median (interquartile range) age was 69.5 years (60–77 y), 90% were male, and comorbidities were relatively uncommon. Only 5 patients had a shockable rhythm. Survival was 65% overall, and 80% and 50% in patients on the cardiac and general wards, respectively. Only 4 patients had RRT criteria in the 24 hours before IHCA. A detailed summary is provided on policies and guidelines pertaining to measurement and documentation of vital signs, escalation of care, staffing and oversight of RRTs, communication for safety, education and training, as well as evaluation, audit, and feedback, which underpinned such findings.ConclusionsIn our mature RRT, IHCAs are very uncommon, and few are preventable. Many of the published barriers encountered in successful RRT use have been addressed by our policies and guidelines.
Deciphering the potential of plasma cell-free metagenomic next-generation sequencing using the Karius test
Authors: Bell Drew T. 
Published: July 2023

Purpose of review
Plasma cell-free metagenomic next-generation sequencing (cf-mNGS) is increasingly employed for the diagnosis of infection, but a consensus for optimal use has not been established. This minireview focuses on the commercially available Karius Test and is aimed at local leaders seeking to understand the complexities of cf-mNGS to make informed test utilization policies and better interpret results.

Recent findings
Recent retrospective studies have reported how the Karius Test was applied at their institutions and identified areas of potential patient benefit. In addition, substantive studies have reported how this test performs in specific indications, particularly invasive fungal disease, endovascular infection and lower respiratory infection.

Summary
Successfully integrating plasma cf-mNGS requires careful assessment of performance in the specific applications and patient populations in which it is used. Individual institutions must independently evaluate implementation strategies and determine where diagnostic yields outweigh the potential pitfalls.
Clinical Utility of Diffusion-Weighted Imaging in Gynecological Imaging
Authors: Fujii Shinya , Gonda Takuro , Yunaga Hiroto 
Published: July 2023

Abstract
Diffusion-weighted imaging (DWI) is an increasingly valuable sequence in daily clinical practice, providing both functional and morphological information. The use of DWI can help quantify diffusion using the apparent diffusion coefficient, which reflects the physiological features of the tissue and tumor microcirculation. This knowledge is crucial for understanding and interpreting gynecological imaging. This article reviews the clinical utility of DWI for gynecological imaging, highlighting its ability to aid in the detection of endometrial and cervical cancers, as well as tumor extension and metastasis. In addition, DWI can easily detect the solid components of ovarian cancer (including dissemination), assist in the diagnosis of adnexal torsion, and potentially show bone marrow status. Apparent diffusion coefficient measurement is useful for differentiating between endometrial lesions, uterine leiomyomas, and sarcomas, and may provide important information for predicting the prognosis of gynecological cancers.
MRI of Temporomandibular Joint Disorders: A Comparative Study of 0.55 T and 1.5 T MRI
Authors: Kopp Markus , Wiesmueller Marco , Buchbender Mayte , Kesting Marco , Nagel Armin M. , May Matthias S. , Uder Michael , Roemer Frank W. , Heiss Rafael 
Published: July 2023

Abstract

Objectives
Temporomandibular disorders (TMDs) are common and may cause persistent functional limitations and pain. Magnetic resonance imaging (MRI) at 1.5 and 3 T is commonly applied for the evaluation of the temporomandibular joint (TMJ). No evidence is available regarding the feasibility of modern low-field MRI for the assessment of TMDs. The objective of this prospective study was to evaluate the image quality (IQ) of 0.55 T MRI in direct comparison with 1.5 T MRI.

Materials and Methods
Seventeen patients (34 TMJs) with suspected intraarticular TMDs were enrolled, and both 0.55 and 1.5 T MRI were performed on the same day. Two senior readers independently evaluated the IQ focusing on the conspicuity of disc morphology (DM), disc position (DP), and osseous joint morphology (OJM) for each joint. We analyzed the IQ and degree of artifacts using a 4-point Likert scale (LS) at both field strengths. A fully sufficient IQ was defined as an LS score of ≥3. Nonparametric Wilcoxon test for related samples was used for statistical comparison.

Results
The median IQ for the DM and OJM at 0.55 T was inferior to that at 1.5 T (DM: 3 [interquartile range {IQR}, 3–4] vs 4 [IQR, 4–4]; OJM: 3 [IQR, 3–4] vs 4 [IQR 4–4]; each P < 0.001). For DP, the IQ was comparable (4 [IQR 3–4] vs 4 [IQR 4–4]; P > 0.05). A sufficient diagnostic IQ was maintained for the DM, DP, and OJM in 92% of the cases at 0.55 T and 100% at 1.5 T. Minor image artifacts (LS score of ≥3) were more prevalent at 0.55 T (29%) than at 1.5 T (12%).

Conclusions
Magnetic resonance imaging of the TMJ at 0.55 T yields a lower IQ than does MRI at 1.5 T but maintains sufficient diagnostic confidence in the majority of patients. Further improvements are needed for reliable clinical application.
Low-Cost Task Trainer for In Utero Fetal Stent Placement
Authors: Codsi Elisabeth , Brost Brian C. , Nitsche Joshua F. 
Published: July 2023

Introduction
Some fetal procedures such as intrauterine fetal stent placement remain rare, and simulation is needed to help learners and specialists in attaining and maintaining technical competence. We sought to design and assess a low-cost, easily assembled yet clinically relevant task trainer for fetal stent placement.

Method
The simulator was constructed using 2 quart-sized freezer bags filled with ultrasound gel and sealed with clear packing tape. The bags were stacked vertically in a transparent plastic container with ultrasound gel applied between the bags when ultrasound was used. This task trainer was used to deploy in utero stents with or without the use of ultrasound. It has been used at the annual meeting of the Society for Maternal-Fetal Medicine since 2015, the annual meeting of the International Society of Ultrasound in Obstetrics and Gynecology in 2015 and 2016, and at regional Maternal-Fetal Medicine Fellow simulation workshops since 2016. Participants were asked to complete a 5-point Likert scale survey regarding the model's realism and usefulness in training.

Results
One hundred thirty-three course participants evaluated the task trainer. The median rating for realism of the ultrasound images, haptic feel of stent deployment, and usefulness in training was 5 (interquartile range, 4–5). Seven physicians participated in the timed assessment of model assembly, stent deployment, and model reassembly. The average times required for the freezer bag task trainer were 2.3 minutes (2.20–2.35), 1.0 minutes (0.70–1.93), and 0.1 minutes (0.08–0.10), respectively. For the porcine tissue-based model tested in parallel, the average times were 6.0 minutes (5.00–7.06), 3.7 minutes (3.63–3.75), and 3.3 minutes (3.00–3.70), respectively.

Conclusions
This low-cost simulator was rated highly when used to practice in utero stent deployment and allows for numerous repetitions in each training session. It could be a valuable tool in training novice providers and allow more experienced providers to maintain competence in this low-volume procedure.