bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a task-sharing psychological intervention to treat mild to moderate symptoms of perinatal depression and anxiety in South Africa: a mixed-method formative study
Authors: Boisits Sonet , Abrahams Zulfa , Schneider Marguerite , Honikman Simone , Kaminer Debra , Lund Crick 
Published: March 2021

Abstract
Background
Symptoms of depression and anxiety are highly prevalent amongst perinatal women in low-resource settings of South Africa, but there is no access to standardised counselling support for these conditions in public health facilities. The aim of this study is to develop a task-sharing psychological counselling intervention for routine treatment of mild to moderate symptoms of perinatal depression and anxiety in South Africa, as part of the Health Systems Strengthening in sub-Saharan Africa (ASSET) study.

Methods
We conducted a review of manuals from seven counselling interventions for depression and anxiety in low- and middle-income countries and two local health system training programmes to gather information on delivery format and common counselling components used across task-sharing interventions. Semi-structured interviews were conducted with 20 health workers and 37 pregnant women from four Midwife Obstetric Units in Cape Town to explore perceptions and needs relating to mental health. Stakeholder engagements further informed the intervention design and appropriate service provider. A four-day pilot training with community-based health workers refined the counselling content and training material.

Results
The manual review identified problem-solving, psychoeducation, basic counselling skills and behavioural activation as common counselling components across interventions using a variety of delivery formats. The interviews found that participants mostly identified symptoms of depression and anxiety in behavioural terms, and lay health workers and pregnant women demonstrated their understanding through a range of local idioms. Perceived causes of symptoms related to interpersonal conflict and challenging social circumstances. Stakeholder engagements identified a three-session counselling model as most feasible for delivery as part of existing health care practices and community health workers in ward-based outreach teams as the best placed delivery agents. Pilot training of a three-session intervention with community-based health workers resulted in minor adaptations of the counselling assessment method.

Conclusion
Input from health workers and pregnant women is a critical component of adapting existing maternal mental health protocols to the context of routine care in South Africa, providing valuable data to align therapeutic content with contextual needs. Multisector stakeholder engagements is vital to align the intervention design to health system requirements and guidelines.
Molecular features of untreated breast cancer and initial metastatic event inform clinical decision-making and predict outcome: long-term results of ESOPE, a single-arm prospective multicenter study
Authors: Callens Céline , Driouch Keltouma , Boulai Anaïs , Tariq Zakia , Comte Aurélie , Berger Frédérique , Belin Lisa , Bièche Ivan , Servois Vincent , Legoix Patricia , Bernard Virginie , Baulande Sylvain , Chemlali Walid , Bidard François-Clément , Fourchotte Virginie , Salomon Anne Vincent- , Brain Etienne , Lidereau Rosette , Bachelot Thomas , Saghatchian Mahasti , Campone Mario , Giacchetti Sylvie , Zafrani Brigitte Sigal , Cottu Paul 
Published: March 2021

Abstract
Background
Prognosis evaluation of advanced breast cancer and therapeutic strategy are mostly based on clinical features of advanced disease and molecular profiling of the primary tumor. Very few studies have evaluated the impact of metastatic subtyping during the initial metastatic event in a prospective study. The genomic landscape of metastatic breast cancer has mostly been described in very advanced, pretreated disease, limiting the findings transferability to clinical use.

Methods
We developed a multicenter, single-arm, prospective clinical trial in order to address these issues. Between November 2010 and September 2013, 123 eligible patients were included. Patients at the first, untreated metastatic event were eligible. All matched primary tumors and metastatic samples were centrally reviewed for pathological typing. Targeted and whole-exome sequencing was applied to matched pairs of frozen tissue. A multivariate overall survival analysis was performed (median follow-up 64 months).

Results
Per central review in 84 patients (out of 130), we show that luminal A breast tumors are more prone to subtype switching. By combining targeted sequencing of a 91 gene panel (n = 67) and whole-exome sequencing (n = 30), a slight excess of mutations is observed in the metastases. Luminal A breast cancer has the most heterogeneous mutational profile and the highest number of mutational signatures, when comparing primary tumor and the matched metastatic tissue. Tumors with a subtype change have more mutations that are private. The metastasis-specific mutation load is significantly higher in late than in de novo metastases. The most frequently mutated genes were TP53 and PIK3CA. The most frequent metastasis-specific druggable genes were PIK3CA, PTEN, KDR, ALK, CDKN2A, NOTCH4, POLE, SETD2, SF3B1, and TSC2. Long-term outcome is driven by a combination of tumor load and metastasis biology.

Conclusions
Profiling of the first, untreated, metastatic event of breast cancer reveals a profound heterogeneity mostly in luminal A tumors and in late metastases. Based on this profiling, we can derive information relevant to prognosis and therapeutic intervention, which support current guidelines recommending a biopsy at the first metastatic relapse.

Trial registration
The trial was registered at ClinicalTrials.gov (NCT01956552).
Giant Darier–Ferrand dermatofibrosarcoma protuberans of the abdomen and pelvis: a case report
Authors: Triki A. , Aloui M. , Ghalleb M. , Jbir I. , Naceur Ben , Hassouna J. Ben , Chargui R. , Rahal K. 
Published: March 2021

Abstract
Background
Darier–Ferrand dermatofibrosarcoma (DFS) is a rare malignant cutaneous neoplasm characterized by local aggressiveness, high risk of recurrence, and low metastatic potential.

Case presentation
A 60-year-old Tunisian man with recurrent abdominopelvic DFS for which he had undergone multiple excisions presented with an extensive DFS that invaded the external genitals. He underwent a large excision with emasculation and thin cutaneous graft of the abdominal wall and local skin flap in the pelvis.

Conclusion
DFS is a rare yet recurrent skin tumor. Wide excision with free margins remains the cornerstone of treatment. We report a case of a giant DFS treated with wide excision and reconstructive surgery to cover the defect.
Therapeutic effects of peripherally administrated neural crest stem cells on pain and spinal cord changes after sciatic nerve transection
Authors: Zhang Yang , Xu Xiang , Tong Yuxin , Zhou Xijie , Du Jian , Choi In Young , Yue Shouwei , Lee Gabsang , Johnson Blake N. , Jia Xiaofeng 
Published: March 2021

Abstract
Background
Severe peripheral nerve injury significantly affects patients’ quality of life and induces neuropathic pain. Neural crest stem cells (NCSCs) exhibit several attractive characteristics for cell-based therapies following peripheral nerve injury. Here, we investigate the therapeutic effect of NCSC therapy and associated changes in the spinal cord in a sciatic nerve transection (SNT) model.

Methods
Complex sciatic nerve gap injuries in rats were repaired with cell-free and cell-laden nerve scaffolds for 12 weeks (scaffold and NCSC groups, respectively). Catwalk gait analysis was used to assess the motor function recovery. The mechanical withdrawal threshold and thermal withdrawal latency were used to assess the development of neuropathic pain. Activation of glial cells was examined by immunofluorescence analyses. Spinal levels of extracellular signal-regulated kinase (ERK), NF-κB P65, brain-derived neurotrophic factor (BDNF), growth-associated protein (GAP)-43, calcitonin gene-related peptide (CGRP), and inflammation factors were calculated by western blot analysis.

Results
Catwalk gait analysis showed that animals in the NCSC group exhibited a higher stand index and Max intensity At (%) relative to those that received the cell-free scaffold (scaffold group) (p < 0.05). The mechanical and thermal allodynia in the medial-plantar surface of the ipsilateral hind paw were significantly relieved in the NCSC group. Sunitinib (SNT)-induced upregulation of glial fibrillary acidic protein (GFAP) (astrocyte) and ionized calcium-binding adaptor molecule 1 (Iba-1) (microglia) in the ipsilateral L4–5 dorsal and ventral horn relative to the contralateral side. Immunofluorescence analyses revealed decreased astrocyte and microglia activation. Activation of ERK and NF-κB signals and expression of transient receptor potential vanilloid 1 (TRPV1) expression were downregulated.

Conclusion
NCSC-laden nerve scaffolds mitigated SNT-induced neuropathic pain and improved motor function recovery after sciatic nerve repair. NCSCs also protected the spinal cord from SNT-induced glial activation and central sensitization.
Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide
Authors: Barnea Royi , Niv-Yagoda Adi , Weiss Yossi 
Published: March 2021

Abstract
Background
The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures.

Methods
Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics.

Results
Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%.
Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%.

Conclusions and policy implications
In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals.
Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.
In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study
Authors: Postl Lukas , Mücke Thomas , Hunger Stefan , Bissinger Oliver , Malek Michael , Holberg Svenia , Burgkart Rainer , Krennmair Stefan 
Published: March 2021

AbstractBackgroundThe accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies.MethodsPatients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group.ResultsThe deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies.ConclusionsSurgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.
Splenectomy is associated with altered leukocyte kinetics after severe trauma
Authors: Teuben Michel Paul Johan , Hollman Arne , Blokhuis Taco , Pfeifer Roman , Spijkerman Roy , Teuber Henrik , Pape Hans-Christoph , Leenen Luke Petrus Hendrikus 
Published: March 2021

Abstract
Background
Inadequate activation of the innate immune system after trauma can lead to severe complications such as Acute Respiratory Distress Syndrome and Multiple Organ Dysfunction Syndrome. The spleen is thought to modulate the cellular immune system. Furthermore, splenectomy is associated with improved outcome in severely injured trauma patients. We hypothesized that a splenectomy alters the cellular immune response in polytrauma.

Methods
All adult patients with an ISS ≥ 16 and suffering from splenic or hepatic injuries were selected from our prospective trauma database. Absolute leukocyte numbers in peripheral blood were measured. White blood cell kinetics during the first 14 days were compared between splenectomized patients, patients treated surgically for liver trauma and nonoperatively treated individuals.

Results
A total of 129 patients with a mean ISS of 29 were included. Admission characteristics and leukocyte numbers were similar in all groups, except for slightly impaired hemodynamic status in patients with operatively treated liver injuries. On admission, leukocytosis occurred in all groups. During the first 24 h, leukopenia developed gradually, although significantly faster in the operatively treated patients. Thereafter, leukocyte levels normalized in all nonoperatively treated cases whereas leukocytosis persisted in operatively treated patients. This effect was significantly more prominent in splenectomized patients than all other conditions.

Conclusions
This study demonstrates that surgery for intra-abdominal injuries is associated with an early drop in leucocyte numbers in peripheral blood. Moreover, splenectomy in severely injured patients is associated with an altered cellular immune response reflected by a persistent state of prominent leukocytosis after trauma.
Tumor mutation burden estimated by a 69-gene-panel is associated with overall survival in patients with diffuse large B-cell lymphoma
Authors: Chen Cunte , Liu Sichu , Jiang Xinmiao , Huang Ling , Chen Feili , Wei Xiaojun , Guo Hanguo , Shao Yang , Li Yangqiu , Li Wenyu 
Published: March 2021

Abstract
Background
Tumor mutation burden (TMB) as estimated by cancer gene panels (CGPs) has been confirmed to be associated with prognosis and is effective in predicting clinical benefit from immune checkpoint blockade (ICB) in solid tumors. However, whether the TMB calculated by CGPs is associated with overall survival (OS) for patients with diffuse large B-cell lymphoma (DLBCL) is worth exploring.

Methods
The prognostic value of panel-TMB, calculated by a panel of 69 genes (GP69), for 87 DLBCL patients in our clinical center (GDPH dataset) was explored. The results were further validated using 37 DLBCL patients from the Cancer Genome Atlas (TCGA) database (TCGA dataset).

Results
Spearman correlation analysis suggested that panel-TMB is positively correlated with the TMB calculated by whole-exome sequencing (wTMB) in the TCGA dataset (R = 0.76, P < 0.0001). Both GDPH and TCGA results demonstrated that higher panel-TMB is significantly associated with a poor OS for DLBCL patients (P < 0.05) where a panel of 13 genes was associated with poor OS, and another panel of 26 genes was correlated with a favorable OS for DLBCL patients. Further subgroup analysis indicated that higher panel-TMB had shorter OS in DLBCL patients with younger than 60 years, elevated LDH, greater than one extranodal involvement, stage III/IV, an IPI score of 3–5, or HBsAg, anti-HBc, or HBV-DNA negativity (P < 0.05). Interestingly, the nomogram model constructed by panel-TMB, stage, and IPI could individually and visually predict the 1-, 2- and 3-year OS rates of DLBCL patients.

Conclusions
We established GP69 for the evaluation of OS for Chinese DLBCL patients. panel-TMB might be a potential predictor for prognostic stratification of DLBCL patients.
Does access to credit reduce SMEs’ tax avoidance? Evidence from a regression discontinuity design
Authors: Kong Xiaowei , Si Deng-Kui , Li Haiyang , Kong Dongmin 
Published: March 2021

AbstractThis study investigates the effect of targeted reserve requirement ratio cuts (TRRRCs) on tax avoidance among small and micro enterprises (SMEs) with operating revenues below specific cutoffs in China. Using a regression discontinuity design, we causally show that, by increasing loan availability, TRRRCs significantly alleviate the financial constraints and cash dependence of SMEs and consequently reduce tax avoidance. This is especially the case among firms with lower market power and higher entertainment and travel costs. Our findings provide evidence for the real effect of TRRRCs on corporate tax avoidance and show the inclusive effect of TRRRCs on SMEs. In doing so, we indirectly reveal a rent-seeking channel underlying bank lending, thus offering clear policy implications for regulators.
Clinical Course of Euthyroid Subjects With Positive TSH Receptor Antibody: How Often Does Graves’ Disease Develop?
Authors: Suzuki Nami , Kawaguchi Akiko , Yoshimura Noh Jaeduk , Yoshimura Ran , Mikura Kentaro , Kinoshita Aya , Suzuki Ai , Mitsumatsu Takako , Hoshiyama Ayako , Fukushita Miho , Matsumoto Masako , Yoshihara Ai , Watanabe Natsuko , Sugino Kiminori , Ito Koichi 
Published: March 2021

Abstract

Background
Thyroid stimulating hormone receptor antibody (TRAb) is detected in the serum of patients with Graves’ disease (GD). This study aims to investigate the prevalence of euthyroid individuals showing positive results for TRAb and to clarify the clinical course of thyroid function and TRAb levels in these subjects.

Objective
Subjects were female patients who newly visited our hospital for a screening test prior to fertility treatment and showed normal thyroid function and volume without nodules between 2014 and 2017. After excluding subjects with a history of thyroid disease, 5,622 subjects were analyzed.

Results
Forty-seven of the 5,622 subjects showed positive results for TRAb (reference range, &lt;2.0 IU/L) at the initial visit. Median initial TRAb was 2.9 IU/L (range, 2.0-14.7 IU/L) and median follow-up was 18.3 months (range, 0-66.5 months). Six of the 47 subjects (12.8%) developed GD and median duration until development was 6.6 months (range, 1.2-13.2 months). Median TRAb values initially and at diagnosis of GD for those 6 patients were 3.7 IU/L (range, 2.7-5.1 IU/L) and 7.2 IU/L (range 3.6-21.4 IU/L), respectively. TRAb results turned negative for 20 of the 47 subjects but remained positive despite normal thyroid function in 13 of the 47 subjects.

Conclusion
GD developed over time in 12.8% of euthyroid young female patients showing positive TRAb within a median of 6.6 months. A positive result for TRAb itself did not mean development of GD, so other factors must be essential for the pathogenesis of GD.
Postoperative Hematocrit and Adverse Outcomes in Pediatric Cardiac Surgery Patients: A Cross-Sectional Study From the Society of Thoracic Surgeons and Congenital Cardiac Anesthesia Society Database Collaboration
Authors: Long Justin B. , Engorn Branden M. , Hill Kevin D. , Feng Liqi , Chiswell Karen , Jacobs Marshall L. , Jacobs Jeffrey P. , Goswami Dheeraj 
Published: March 2021

BACKGROUND:
We sought to examine potential associations between pediatric postcardiac surgical hematocrit values and postoperative complications or mortality.

METHODS:
A retrospective, cross-sectional study from the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and Congenital Cardiac Anesthesia Society Database Module (2014–2019) was completed. Multivariable logistic regression models, adjusting for covariates in the STS-CHSD mortality risk model, were used to assess the relationship between postoperative hematocrit and the primary outcomes of operative mortality or any major complication. Hematocrit was assessed as a continuous variable using linear splines to account for nonlinear relationships with outcomes. Operations after which the oxygen saturation is typically observed to be <92% were classified as cyanotic and ≥92% as acyanotic.

RESULTS:
In total, 27,462 index operations were included, with 4909 (17.9%) being cyanotic and 22,553 (82.1%) acyanotic. For cyanotic patients, each 5% incremental increase in hematocrit over 42% was associated with a 1.31-fold (95% confidence interval [CI], 1.10-1.55; P = .003) increase in the odds of operative mortality and a 1.22-fold (95% CI, 1.10-1.36; P < .001) increase in the odds of a major complication. For acyanotic patients, each 5% incremental increase in hematocrit >38% was associated with a 1.45-fold (95% CI, 1.28-1.65; P < .001) increase in the odds of operative mortality and a 1.21-fold (95% CI, 1.14-1.29; P < .001) increase in the odds of a major complication.

CONCLUSIONS:
High hematocrit on arrival to the intensive care unit (ICU) is associated with increased operative mortality and major complications in pediatric patients following cardiac surgery.
Lalla Essaydi’s Bullets and Bullets Revisited
Authors: Hachad Naïma 
Published: March 2021

Abstract
In Bullets and Bullets Revisited (2009–14) the Moroccan-born artist Lalla Essaydi invites the onlooker to reflect on the power dynamics of image production and consumption in a globalizing visual culture. As in the artist’s previous series, the photographs present Moroccan women in interior spaces and poses made familiar to an international audience by nineteenth-century European paintings. However, Essaydi trades Orientalism’s apparent realism and colorful decors for a monochromatic gold color scheme that originates from thousands of bullet casings she has meticulously sewn together to fabricate ceilings, walls, floors, furniture, jewelry, and clothes for her models. This article underscores how Essaydi’s use of a readable symbol of violence allows her to take part in and act on representational traditions that have shaped the perception of Arab Muslim women and the Middle East. Her violent aesthetics further account for curatorial and marketing practices that neutralize the subversive content of art by women originating in North Africa and the Middle East. Often shown in exhibitions featuring similar images and associating women with the veil, weapons, and scenes of destruction, Essaydi’s photographs are uncritically linked to events and situations as varied as the Arab uprisings, violence in the Palestinian territories, and the wars in Syria, Yemen, and Iraq. Instead of illuminating complex sociopolitical issues and reshaping dominant discourses, they become part of a homogenizing visual archive that sustains ways of seeing and producing the Middle East—as inherently violent and culturally backward—that are rooted in imperial imaginaries and political ideologies.