bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple perspectives and dialogue in understanding experiences of living with eating disorders: Two narratives—four unpackings
Authors: Brinchmann Berit Støre , Lyngmo Siri , Herholdt-Lomholdt Sine Maria , Blix Bodil H. 
Published: February 2022

AbstractBackgroundThis is a response to Conti et al.’s article, “Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa” (published in JED, 2016), and its call for relational metaphors and a relational approach to supplement the traditional medical/psychological diagnostic language used to describe the life experiences and complex emotions of people affected by an eating disorder.MethodsFour authors with different backgrounds unpack two narratives, ‘The Prima Donna with the Green Dress’ and ‘Breaking down the Wall’, both narrated during fieldwork in multifamily therapy. The narratives are unpacked from the perspective of a therapist within multifamily therapy, a researcher who conducted the fieldwork, a researcher based in phenomenology and a researcher based in narrative inquiry. The authors enter into dialogue with the narratives, and with each other.ResultsThe four authors focus on different elements within the narratives and understand them differently. One, focuses on strength and pride, and art expression as a different form of language for people living with an eating disorder. Another, on the experience of isolation, boundaries, and balancing openness and closedness. A third, sees the narratives as expressing a wish to see and be seen, and the fourth focuses on the absence of, and longing for, a shared space to explore.ConclusionThe aim is not to reach a correct or shared interpretation of the narratives but to explore how different perspectives may contribute to different insights, not only about one family in particular but about, more generally, the experiences of people living with an eating disorder. Our work shows the significance of engaging with multiple perspectives and dialogue as supplements to the traditional medical/psychiatric diagnostic language in both clinical practice and research.
Experimental study on capillary water absorption of sandstones from different grotto heritage sites in China
Authors: Zhang Yue , Zhang Yunmeng , Huang Jizhong 
Published: February 2022

Abstract
Sandstone grottoes, with their elaborate carvings and decorations, hold high historic, artistic and scientific values and therefore constitute an important part of China’s stone cultural heritage. Although capillary water accounts for severe pathologies at the grottoes, so far there have been limited comprehensive investigations concerned with the capillary water absorption behavior of sandstones. Aiming at three significant and famous sites in China, i.e., Yungang Grottoes (YG), Dazu Rock Carvings (DZ) and Leshan Grand Buddha (LS), capillary water absorption tests were performed on samples from local sandstones. During the test, evolution of cumulative inflow was measured and variation in the height of capillary rise over time was also monitored by combining visual observation and infrared thermography. Scanning electron microscope and mercury intrusion porosimetry were adopted to characterize the pore structure. The results indicate that all the tested sandstones had a medium capacity of water uptake. Kinetics for capillary water absorption was the highest for LS sandstone and the lowest for DZ sandstone. Differences in macroscopic properties were contributed to microstructural features such as average pore diameter and pore size distribution. An irregular shaped water front was only observed in LS sandstone due to its heterogeneity. Infrared thermography provides an efficient and nondestructive way to detect the transition zone between wet and dry portions of the sample, which was not visible to the naked eyes. A proper understanding of the interaction of the sandstones with capillary water is essential for revealing the deterioration of grottoes and the underlying mechanisms.
Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty
Authors: Unterfrauner Ines , Loretz Ruben , Kühne Nathalie , Grubhofer Florian , Fucentese Sandro F. 
Published: February 2022

Abstract
Purpose
Patella baja after total knee arthroplasty (TKA) is a common problem that is usually treated via proximal transfer of the tibial tubercle. As the long-term outcomes of this procedure are unclarified, this study aimed to investigate the changes in clinical function and radiographic patellar height during five years of follow-up.

Methods
Sixty patients with patella baja after TKA who underwent proximalisation of the tibial tubercle were followed up for a mean of 71 months (range 21–153 months). The pre- and postoperative range of motion (ROM) and clinical scores (Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were compared. The radiographic patellar height was measured with the Caton-Deschamps index (CDI), Blackburne-Peel ratio (BP), and modified Insall-Salvati index (MIS).

Results
Proximalisation of the tibial tubercle resulted in a significant improvement in the ROM from 80° to 88°. The KSS and WOMAC did not improve or even worsened after the intervention. The radiographic patellar height immediately after tibial tubercle transfer was not better than prior to the intervention (CDI 0.72 vs. 0.63, p = 0.72; BP 0.66 vs. 0.61, p = 0.72; MIS 1.59 vs. 1.55, p = 1.00) and further decreased significantly so that the mean final values were worse than the values in the native joint (CDI 0.59 vs. 0.78, p = 0.001; BP 0.58 vs. 0.74, p = 0.001; MIS 1.39 vs. 1.81, p < 0.001).

Conclusion
Proximalisation of the tibial tubercle in patients with patella baja after TKA does neither lead to significant improvements in the clinical outcome nor in the radiographic patellar height during long-term follow-up.

Level of evidence
III
Correlation between short-term blood pressure variability parameters with mobil-O-graph pulse wave velocity
Authors: Silva Marco Antonio Vieira , Resende Luiz Antonio Pertilli Rodrigues , Vieira Mateus Marchiori , Jajah Camila Blanco Ferreira , Berzotti Lucas Alves , Rambourg Nicole Cristine , de Souza Pierson Ian Dias , Achkar João Lucas Carvalho , Vieira Livia Marchiori , Moreira Guilherme Marchiori , Borges Geisa Ribeiro , Correia Dalmo 
Published: February 2022

Abstract
Background
Blood pressure variability (BPV) and arterial stiffness show an association with increased cardiovascular events. Evidences demonstrated an association between higher short-term systolic BPV and stiffer arteries. There is no previous study assessed the correlation between BPV and arterial stiffness measured by a Mobil-O-Graph device. We issued to evaluate the correlation between short-term BPV parameters and Mobil-O-Graph pulse wave velocity (PWV) among suspected hypertensive individuals under treatment.

Methods
Mobil-O-Graph device estimated arterial stiffness (oscillometric PWV [oPWV]) in 649 individuals, and they recorded 24-h ambulatory BP; 428 had suspected hypertension and 221 under treatment. We analyzed the correlation between oPWV and measures of BPV: SD of 24 h BP (24-h SD), SD of daytime BP (daytime-SD), and SD of nighttime BP (nighttime-SD), weighted SD of 24-h BP (wSD), coefficient of variation of 24-h BP (CV 24-h) and average real variability (ARV).

Results
Oscillometric PWV showed a positive correlation with all systolic BPV measures, in both groups. Among suspected hypertensives: 24-h SD, r = 0.30; SD daytime-SD, r = 0.34; nighttime-SD, r = 0.16; wSD, r = 0.30; CV 24-h, r = 0.24; ARV, r = 0.22. In the treated individuals: 24-h SD, r = 0.46; daytime-SD, r = 0.47; nighttime-SD, r = 0.35; wSD, r = 0.50; CV 24-h, r = 0.43; ARV, r = 0.37, all P < 0.001. Diastolic BPV demonstrated association with some measures of BPV. In suspected hypertensive group: nighttime-SD, r = 0.13; wSD, r = 0.10, both P < 0.001. And in treated individuals: daytime-SD, r = 0.23; wSD, r = 0.22; CV 24-h, r = 0.19 (all P < 0.001), ARV, r = 0.15 (P < 0.05). Systolic daytime-SD in suspected and diastolic CV 24-h in treated group independently predicted oPWV.

Conclusion
We observed a positive and independent correlation between Mobil-O-Graph pulse wave velocity and BPV measures, strong to systolic BPV and weak to diastolic BP.
Impact of charge patches on tumor disposition and biodistribution of therapeutic antibodies
Authors: Stüber Jakob C. , Rechberger Karin F. , Miladinović Saša M. , Pöschinger Thomas , Zimmermann Tamara , Villenave Remi , Eigenmann Miro J. , Kraft Thomas E. , Shah Dhaval K. , Kettenberger Hubert , Richter Wolfgang F. 
Published: February 2022

AbstractThis study explores the impact of antibody surface charge on tissue distribution into various tissues including tumor. Tumor-bearing mice were dosed intravenously with a mixture comprising three antibodies engineered to carry negative charge patches, a balanced charge distribution, or positive patches, respectively (cassette dosing). Tissue levels were analyzed with a specific LC-MS/MS method. In addition, the antibody mix was administered to non-tumor bearing mice. Muscle and skin interstitial fluid were obtained by centrifugation and analyzed by LC-MS/MS. An in vitro endothelium model was explored for its feasibility to mimic the observed distribution differences.A balanced charge distribution was optimal in terms of total tumor exposure, while in other tissues, negatively charged and balanced charged antibodies gave similar results. In contrast, positive charge patches generally resulted in increased serum clearance but markedly enhanced tumor and organ uptake, leading to higher tissue-to-serum ratios. The uptake and availability in the interstitial space were confirmed by specific assessment of antibody levels in the interstitial fluid of the muscle and skin, with similar charge impact as in total tissue. The in vitro model was able to differentiate the transport propensity of this series of antibody variants. In summary, our results show the differential effects of charge patches on an antibody surface on biodistribution and tumor uptake. These insights may help in the design of molecules with biodistribution properties tailored to their purpose, and an optimized safety profile.
Integrated Palliative Outcome Scale for People with Dementia: easy language adaption and translation
Authors: Spichiger Frank , Keller Senn Anita , Volken Thomas , Larkin Philip , Koppitz Andrea 
Published: February 2022

Abstract
Background
In this article, we report the cultural adaption and translation of the Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) into a Swiss-German easy language version for proxy assessment of people with dementia living in Swiss nursing homes. The Swiss-German easy language version of the IPOS-Dem was developed and culturally adapted in a six-phase process from the German IPOS-Dem using recommended guidelines. With nursing home staff and laypeople, the conceptual definition and relevance of IPOS-Dem items were established during phase I. Phase II encompassed the completion of forward translations. Independent native speakers blind to the original scale translated and back-translated the Swiss-German easy language version. The resulting IPOS-Dem version was then blindly back-translated in phase III. Experts reviewed all resulting translations in phase IV to produce a pre-final IPOS-Dem version. Finally, the phase V cognitive debriefing involved two focus groups assessing the pre-final IPOS-Dem version. Phase V included cognitive interviews with laypeople (n = 2), family members of those with dementia (n = 4) and staff from different care contexts (n = 12).

Results
Using easy language specialists yielded a clinically relevant, comprehensive and understandable translation. In addition, face and content validity for the easy language version were established in the cognitive interviews.

Conclusions
With an easy language IPOS-Dem, all frontline staff and family members can be empowered to communicate their observations after caring interactions. Enhanced clinical communication with easy language tools shows the potential for research and clinical applications. In addition, attentive use in scales of easy language communication may foster increased engagement with untrained laypeople in clinical and care research.
Knee joint line related to bony landmarks of the knee: a radiologic study in a Thai population
Authors: Tantavisut S. , Amarase C. , Ngarmukos S. , Tanavalee C. , Tanavalee A. 
Published: February 2022

Abstract
Background
During revision total knee arthroplasty (TKA), knee joint line restoration may be difficult due to bone loss or structural changes. Although bony landmarks are consistent and can be used as references, there are limited data in Asian patients. We studied the knee joint line related to bony landmarks of the knee in a Thai population.

Materials and methods
Magnetic resonance imaging (MRI) of 140 healthy knees of Thai patients (70 males, 70 females) were investigated. In all knees, a perpendicular line from knee joint line to the medial epicondyle (distance A) and the lateral epicondyle (distance B) in the coronal plane were measured. In the sagittal plane, a perpendicular line from the knee joint line to the fibular head (distance C), the tibial tubercle (distance D), and the inferior patellar pole (distance E) were measured. The femoral transepicondylar width (FW) was measured along the transepicondylar axis. The ratios of distances A, B, C, D, and E related to FW were evaluated (epicondylar ratio).

Results
The mean and standard deviation (SD) of distances A, B, C, D, E, and FW were 27.1 ± 2.7 mm, 21.7 ± 2.5 mm, 12.6 ± 3 mm, 21.3 ± 3.6 mm, 7.6 ± 4.8 mm, and 76.7 ± 3.99, respectively. There was wide variation of measured values, with statistically significant differences between genders in distances A, B, C, and FW. The mean and SD of epicondylar ratios A/FW, B/FW, C/FW, D/FW, and E/FW were 0.35 ± 0.02, 0.29 ± 0.02, 0.16 ± 0.05, 0.28 ± 0.04, and 0.09 ± 0.04, respectively. All epicondylar ratios demonstrated less variation than all measured distances, with statistical differences between genders in the A/FW and D/FW ratios. However, the B/FW ratio had the highest consistent mean value. In addition, it had narrower SD than the rest (0.29 ± 0.02; range, 0.22–0.33).

Conclusions
In Thai knees, the measured distances from bony landmarks to the knee joint line had higher variation than the epicondylar ratio. Among all studied epicondylar ratios, the ratio between lateral epicondyle to joint line distance (distance B)/FW demonstrated the narrowest range of mean and SD values; therefore, this could be the most reliable landmark for intraoperative knee joint line verification by multiplying the FW of the patient by 0.29 to get distance B in that patient.
Can MRI chemical shift imaging replace thymic biopsy in myasthenia gravis patients?
Authors: Taymour Takeya Ahmed , Soliman Enas Samy , Al-Sayyad Enas Hamed , Tadros Sally Fouad 
Published: February 2022

Abstract
Background
Myasthenia gravis is a neuromuscular junction autoimmune condition characterized by muscle weakness. Many people with myasthenia gravis have thymic abnormalities, such as thymic lymphoid hyperplasia and thymic tumors, therefore, the thymus plays a significant role in the disease. The imaging properties of thymic hyperplasia and thymoma on CT and conventional MRI are very similar, yet, MRI has recently revealed promising capability by adding novel sequences. Chemical shift MRI was demonstrated to consistently distinguish thymic hyperplasia from thymus gland tumors. The aim of this study was to determine the value of chemical shift MRI imaging in characterizing thymic lesions in patients diagnosed with myasthenia gravis and its ability to differentiate thymic hyperplasia from thymoma.

Results
MRI showed that thymic lymphoid hyperplasia was more common to be convex in shape while thymoma was more likely to be round or irregular (P = 0.004). Paired comparison between histopathology and chemical shift MRI showed that MRI had 90% sensitivity and 100% specificity in detecting thymoma with overall diagnostic accuracy 93.3% (P = 0.5). MRI chemical shift ratio showed 100% sensitivity by using > 0.85 as a cut off value for diagnosis of thymoma, with specificity 83.3% (P = 0.0001). There was statistically significant difference in chemical shift ratio between thymic lymphoid hyperplasia and thymoma groups, as thymoma group had a higher chemical shift ratio of 1.06 ± 0.06 compared to 0.48 ± 0.13 in thymic hyperplasia group (P = 0.0001).

Conclusion
MRI chemical shift imaging with chemical shift ratio offers a highly sensitive and specific tool in assessment of thymus lesions in myasthenia gravis patients and it can differentiate between thymic hyperplasia and thymoma using cutoff value of > 0.85, hence, unwarranted invasive procedures as thymic biopsy or thymectomy can be avoided and proper management could be planned.
Replaced right hepatic artery passing anterior to pancreas: a rare and challenging anatomical variant during pancreaticoduodenectomy
Authors: Raghavendra D. , Balachandar T. G. , Prabhakaran R. , Swain Sudeepta Kumar , Nirmal J. , Sunil N. , Shekhar Himanshu 
Published: February 2022

Abstract
Background
During pancreaticoduodenectomy proper dissection of local vessels is required. Normal coeliac and hepatic arterial anatomy can be found in only 50–70% of individuals. Good knowledge about aberrant vascular anatomies is necessary to avoid unnecessary complications.

Case presentation
An elderly gentleman presented to us with history of jaundice. Periampullary carcinoma with abnormal right and left hepatic artery morphology was discovered after a contrast enhanced computerized tomography scan.

Conclusion
Despite the anomalous origin and anterior course of replaced right hepatic artery, Classical pancreatoduodenectomy with preservation of replaced right hepatic artery and regional lymphadenectomy with no major intra and post-operative problems was conducted by superior mesenteric artery first approach. Prior to major hepato-pancreatobiliary surgery, a thorough examination of a contrast enhanced computerized tomography scan is required to understand vascular anatomy, recognize anomalous vessels, and understand their significance. Nevertheless, if the abnormal vessel anatomy like replaced right hepatic artery are identified during surgery, a careful dissection of the anomalous vessel is essential to identify all vascular relationships and avoid irreversible injury.
Role of ultrasonography in screening of spinal dysraphism in infants at risk
Authors: Hussein Nada Ahmed , Ahmed Khaled A. , Osman Noha Mohamed , Yacoub George Ezzat Elkess 
Published: February 2022

Abstract
Background
Spinal dysraphism (SD) encompasses congenital spinal defects that result from inappropriate fusion of the different midline osseous, mesenchymal, and neural elements. The primary tools for diagnosis of SD are both spinal ultrasonography (USG) and magnetic resonance imaging (MRI). Spinal USG is growingly being used as an initial screening modality with sensitivities and accuracies equivalent to those of MRI. Anorectal malformations (ARM) have ultimate association with many other congenital abnormalities, of which spinal dysraphism is one of the most common. The main aim of study was to assess the diagnostic accuracy of spinal USG as a screening modality in comparison with MRI in infants with closed spinal dysraphism. We also endeavored to highlight the associated spinal dysraphism radiological findings in patients with either ARM or back cutaneous stigmata.

Results
Our prospective diagnostic comparative study included 33 patients, all of whom underwent both MRI and USG. Both MRI and USG showed appreciable agreement in the assessment of spinal dysraphism. In comparison with the gold standard MRI, spinal USG revealed comparable diagnostic metrics: specificity (98.6–100%), sensitivity (66.6–91.6%), PPV (90–100%) and NPV (94.1–98.7%) in diagnosis of different types of spinal dysraphism. The main clinical presentation of nineteen patients was anorectal malformation (ARM), 11 of whom (57.9%) had evidence of associated spinal dysraphism. The most common types of ARM were cloacal malformation, recto-urethral fistula, and rectal atresia with no fistula. On the other hand, sixteen patients were mainly presented with back cutaneous stigmata, 11 of whom (68.8%) had associated spinal dysraphism. The most common presenting cutaneous stigmata were low back swelling and atypical dimples.

Conclusion
The front-line screening modality for infants with closed SD should be spinal USG, however, its main limitation is the restrained time window in the first 6 months of life. Infants with ARM should be screened for spinal anomalies, especially those with high and complex types. Infants with high-risk back cutaneous stigmata should be similarly screened, as well.
Facilitators and barriers to implementing provider-initiated HIV counselling and testing at the clinic-level in Ekurhuleni District, South Africa
Authors: Mshweshwe-Pakela Nolundi , Mabuto Tonderai , Ntombela Nasiphi , Hlongwane Mpho , Kubeka Griffiths , Kerrigan Deanna L. , Hoffmann Christopher J. 
Published: February 2022

Abstract
Background
HIV testing is the entry point into the HIV care continuum and critical for HIV epidemic control. Facility-based HIV testing services (HTS) reach individuals who are already seeking clinical care and engaging with the medical care system. For this reason, individuals diagnosed with HIV during facility-based HIV testing are more likely to continue into HIV care. To increase the number of PLHIV who are diagnosed and initiated on ART, in 2015, the South African Department of Health instituted Provider-Initiated Counselling and Testing (PICT) policy—encouraging healthcare providers to recommend HIV testing, but this strategy remains under-utilized. We aimed to identify key constraints to the normalization of PICT implementation in 10 Ekurhuleni District healthcare facilities in South Africa.

Methods
In-depth interviews were conducted with 40 healthcare workers (28 clinicians and 12 lay counsellors). Health care workers were purposefully selected to participate in the interviews, stratified by health facility and work category. Interviews were audio-recorded, transcribed, and translated for analysis. Thematic analysis was guided by the normalization process theory (NPT). NPT theory explains how practices are routinely embedded within organizational contexts. We used NVivo 10 software for qualitative data management.

Results
Both clinicians and lay counsellors exhibited a clear understanding of the PICT policy— acknowledging its purpose and value. The identified barrier to normalization of PICT among clinicians was offering HIV testing based on suspicion of HIV despite understanding that PICT involves offering testing to all clients. Additionally, clinicians perceived PICT as incongruent with their clinical roles and perceived it to be lay counsellors’ responsibility. The main facilitator was the participation of all healthcare workers, specifically the presence of lay counsellors, although they also faced barriers such as a lack of workspace and under-appreciation.

Conclusions
Use of NPT helped identify barriers that prevent the normalization of PITC and its integration into routine patient care. These barriers can be modified by low-cost interventions that promote congruence of PICT to the roles of clinicians and integrate the role of lay counsellors within the patient flow in the facility.