bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of Schwannomas in the Forearms, Hands, and Digits: A Retrospective Study
Authors: Suzuki Ayumi , Kanda Toshihiro , Yoshimizu Takaki , Mukoda Masashi , Inoue Yoshiya 
Published: December 2020

Background: Previous reports on schwannomas of the upper extremities have mainly focused on proximal involvement. This study aimed to evaluate pre- and peri-operative findings in schwannomas of the distal upper extremities and assess the accuracy of diagnosis and surgical outcome. Methods: We identified 24 patients with isolated tumors. Seven patients had schwannomas located in the forearm, eleven in the hand, and six in the digits. We collected the following data: preoperative clinical and magnetic resonance imaging findings, provisional diagnosis, surgical findings and procedures, tumor volume, and postoperative clinical findings. Data were compared between tumors of different locations. Results: The mean age of our cohort at the time of surgery was 48.0 years and the mean follow-up period was 10.6 months. All patients with forearm schwannomas were diagnosed preoperatively by the presence of the Tinel-like sign and suggestive magnetic resonance imaging findings. In contrast, schwannomas in the hands and digits often lacked these diagnostic features; only five patients with hand schwannomas and one with digit schwannoma were correctly diagnosed. Microsurgical enucleation was the most common treatment. Ten patients reported newly acquired paresthesia after operation, which resolved within the follow-up period in nine patients. Three of the four patients with preoperative paresthesia and one patient who underwent enucleation with surgical loupes still had paresthesia at the final follow-up. Conclusions: In schwannomas of the distal upper extremities, a more distal location is associated with a lower occurrence of the Tinel-like sign and fewer suggestive magnetic resonance imaging findings, resulting in lower diagnostic accuracy. However, intra-operative diagnosis is usually straightforward and microsurgical enucleation does not cause iatrogenic nerve deficit. When treating soft tissue tumors in the hand and digits that present without specific or suggestive findings, the possibility of schwannoma should be considered.
An Unusual Presentation of Gout Involving the Ankle Ligaments
Authors: Cheung Tommy Tsang , Chan Helen Ka Yan , Lee Gavin Ka Wing 
Published: December 2020

Gout is the most common inflammatory arthritis due to deposition of monosodium urate (MSU) crystals in joints and connective tissues. In contrast to joint disease, the majority of extra-articular involvement remains asymptomatic in patients with gout. Achilles tendon is the most common site of involvement and the inflammation elicited by MSU crystals can be falsely attributed to injury or overuse. In addition, tendon or ligament damage secondary to MSU crystal deposition can lead to ligament tear or tendon rupture.However, the diagnosis of gout in patients with extra-articular involvement is often delayed or even missed because tissue sampling is not feasible in routine clinical practice. Advanced imaging techniques using ultrasound and dual-energy computer tomography (DECT) can detect MSU crystal deposition in a non-invasive manner and confirm the diagnosis of gout in patients with extra-articular involvement.The following case demonstrates an atypical presentation of gout causing multiple ligament tears in the ankle and highlights the role of DECT in the diagnosis of gout with extra-articular involvement.
Histopathologic Parameters at Diagnosis as Early Predictors of Histologic Remission along the Course of Ulcerative Colitis
Authors: Yamamoto-Furusho Jesús K. , Martínez-Benítez Braulio , Sánchez-Morales Germán E. 
Published: December 2020

Background. Currently, the treatment goal in ulcerative colitis (UC) is to achieve clinical and endoscopic remission; nevertheless, histologic remission is a potential new treatment goal since it is associated with favorable long-term clinical outcome lower rates of hospitalization, complications, and colectomies. Aim. Evaluate clinical and histopathologic characteristics at diagnosis as potential predictors of histologic remission in patients with ulcerative colitis. Methods. This is a retrospective cohort study from 2007 to 2014, including 260 patients. Clinical and demographic information and Mayo endoscopic and Riley histologic grade were obtained accordingly with the follow-up. Histological evaluation was made for all 260 patients; fifty-six patients with histologic remission at the follow-up underwent separate evaluation of mucosal biopsy at the moment of diagnosis. Univariate and multivariate analyses were applied to data from these 56 patients to identify histologic features at diagnosis associated with histologic remission during follow-up. The odds ratio (OR) was determined as a measure for the strength of association. A

P

value of less than 0.05 was taken as a level of significance. Results. The frequency of histologic remission according to the Riley index in our study group was 21.5%. Factors associated with histologic remission were treatment with steroids (

P
=
0.01

,

OR
=
0.38

,

CI

95
%
=
0.16
‐
0.90

), reduced mucin production (

P
=
0.02

,

OR
=
0.23

,

CI

95
%
=
0.06
–
0.86

), and less than 10 eosinophils per high power field (

P
=
0.001

,

OR
=
6.66

,

CI

95
%
=
2.03
–
21.84

). Conclusion. Factors that impair histologic remission in patients with ulcerative colitis were treatment with steroids and reduced mucin production; meanwhile, less than 10 eosinophils per high power showed a predictive value for histologic remission.
Cerebral Blood Flow and Cognitive Performance in Postural Tachycardia Syndrome: Insights from Sustained Cognitive Stress Test
Authors: Wells Rachel , Malik Varun , Brooks Anthony G. , Linz Dominik , Elliott Adrian D. , Sanders Prashanthan , Page Amanda , Baumert Mathias , Lau Dennis H. 
Published: December 2020

Background
The physiology underlying "brain fog" in the absence of orthostatic stress in postural tachycardia syndrome (POTS) remains poorly understood.

Methods and Results

We evaluated cognitive and hemodynamic responses (cardiovascular and cerebral: heart rate, blood pressure, end‐tidal carbon dioxide, and cerebral blood flow velocity (CBFv) in the middle cerebral artery at baseline, after initial cognitive testing, and after (30‐minutes duration) prolonged cognitive stress test (PCST) whilst seated; as well as after 5‐minute standing in consecutively enrolled participants with POTS (n=22) and healthy controls (n=18). Symptom severity was quantified with orthostatic hypotensive questionnaire at baseline and end of study. Subjects in POTS and control groups were frequency age‐ and sex‐matched (29±11 versus 28±13 years; 86 versus 72% women, respectively; both
P
≥0.4). The CBFv decreased in both groups (condition,
P
=0.04) following PCST, but a greater reduction in CBFv was observed in the POTS versus control group (−7.8% versus −1.8%; interaction,
P
=0.038). Notably, the reduced CBFv following PCST in the POTS group was similar to that seen during orthostatic stress (60.0±14.9 versus 60.4±14.8 cm/s). Further, PCST resulted in greater slowing in psychomotor speed (6.1% versus 1.4%, interaction,
P
=0.027) and a greater increase in symptom scores at study completion (interaction,
P
<0.001) in the patients with POTS, including increased difficulty with concentration. All other physiologic responses (blood pressure and end‐tidal carbon dioxide) did not differ between groups after PCST (all
P
>0.05).

Conclusions
Reduced CBFv and cognitive dysfunction were evident in patients with POTS following prolonged cognitive stress even in the absence of orthostatic stress.
Coronary Computed Tomography Angiography Compared With Single Photon Emission Computed Tomography Myocardial Perfusion Imaging as a Guide to Optimal Medical Therapy in Patients Presenting With Stable Angina: The RESCUE Trial
Authors: Stillman Arthur E. , Gatsonis Constantine , Lima Joao A.C. , Liu Tao , Snyder Bradley S. , Cormack Jean , Malholtra Vinay , Schnall Mitchell D. , Udelson James E. , Hoffmann Udo , Woodard Pamela K. , Kim M‐S , Hegde V , Kenny  , Afaq M , Clouse M , Malhotra V , Cole  , Al‐Khori F , Scherer M , Rothenberg F , Kirsch J , Shah A , Quyyumi A , Engberding N , Becker C , Li D , Pantelic M , Duerinckx A , Martin  , Schrank J , Zachariah  , Jacob R , Borges A , Roberge E , Truong Q , Edelman R , Akers S , Marsh K , Kemp  , Reingold J , Chilakapati V , Osborne J , Lui K , Gomes A , Bajpai A , del Rio J.R. , Singh  , Thompson B , Rivard A , Jha S , Mavromatis K , Woodard P , Sinusas A 
Published: December 2020

Background
The RESCUE (Randomized Evaluation of Patients with Stable Angina Comparing Utilization of Noninvasive Examinations) trial was a randomized, controlled, multicenter, comparative efficacy outcomes trial designed to assess whether initial testing with coronary computed tomographic angiography (CCTA) is noninferior to single photon emission computed tomography (SPECT) myocardial perfusion imaging in directing patients with stable angina to optimal medical therapy alone or optimal medical therapy with revascularization.

Methods and Results

The end point was first major adverse cardiovascular event (MACE) (cardiac death or myocardial infarction), or revascularization. Noninferiority margin for CCTA was set a priori as a hazard ratio (HR) of 1.3 (95% CI=0, 1.605). One thousand fifty participants from 44 sites were randomized to CCTA (n=518) or SPECT (n=532). Mean follow‐up time was 16.2 (SD 7.9) months. There were no cardiac‐related deaths. In patients with a negative CCTA there was 1 acute myocardial infarction; in patients with a negative SPECT examination there were 2 acute myocardial infarctions; and for positive CCTA and SPECT, 1 acute myocardial infarction each. Participants in the CCTA arm had a similar rate of MACE or revascularization compared with those in the SPECT myocardial perfusion imaging arm, (HR, 1.03; 95% CI=0.61‐1.75) (
P
=0.19). CCTA segment involvement by a stenosis of ≥50% diameter was a better predictor of MACE and revascularization at 1 year (
P
=0.02) than the percent reversible defect size by SPECT myocardial perfusion imaging. Four (1.2%) patients with negative CCTA compared with 14 (3.2%) with negative SPECT had MACE or revascularization (
P
=0.03).

Conclusions
There was no difference in outcomes of patients who had stable angina and who underwent CCTA in comparison to SPECT as the first imaging test directing them to optimal medical therapy alone or with revascularization. CCTA was a better predictor of MACE and revascularization.

Registration Information

URL:
https://www.clinicaltrials.gov/
. Identifier: NCT01262625.
Exercise Reduces Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Saco‐Ledo Gonzalo , Valenzuela Pedro L. , Ruiz‐Hurtado Gema , Ruilope Luis M. , Lucia Alejandro 
Published: December 2020

Background
Although exercise training reduces office blood pressure (BP), scarcer evidence is available on whether these benefits also apply to ambulatory blood pressure (ABP), which is a stronger predictor of cardiovascular disease and mortality. The present study aims to assess the effects of exercise training on ABP in patients with hypertension based on evidence from randomized controlled trials.

Methods and Results

A systematic search of randomized controlled trials on the aforementioned topic was conducted in PubMed and Scopus (since inception to April 1, 2020). The mean difference between interventions (along with 95% CI) for systolic BP and diastolic BP was assessed using a random‐effects model. Sub‐analyses were performed attending to (1) whether participants were taking antihypertensive drugs and (2) exercise modalities. Fifteen studies (including 910 participants with hypertension) met the inclusion criteria. Interventions lasted 8 to 24 weeks (3–5 sessions/week). Exercise significantly reduced 24‐hour (systolic BP, −5.4 mm Hg; [95% CI, −9.2 to −1.6]; diastolic BP, −3.0 mm Hg [−5.4 to −0.6]), daytime (systolic BP, −4.5 mm Hg [−6.6 to −2.3]; diastolic BP, −3.2 mm Hg [−4.8 to −1.5]), and nighttime ABP (systolic BP, −4.7 mm Hg [−8.4 to −1.0]; diastolic BP, −3.1 mm Hg [−5.3 to −0.9]). In separate analyses, exercise benefits on all ABP measures were significant for patients taking medication (all
P
<0.05) but not for untreated patients (although differences between medicated and non‐medicated patients were not significant), and only aerobic exercise provided significant benefits (
P
<0.05).

Conclusions
Aerobic exercise is an effective coadjuvant treatment for reducing ABP in medicated patients with hypertension.
Representation of a Foreign Woman in Contemporary Japan
Authors: Forero-Montoya Betsy 
Published: December 2020

Abstract
Under the conceptual framework of foreign Otherness in Japan, the article explores the media representation of a Latin American woman, Anita Alvarado. It proposes that she became a well-known character who was instrumental in the othering processes of foreign identities in Japan. Originally from Chile, Alvarado moved to Japan and became involved in a scandalous fraud committed by her husband. Since then, Japanese media have produced content that continue reminding audiences of the incident, while simultaneously creating an atmosphere of suspicion around her. Based on a content analysis and a textual analysis of written news, the article argues that media references to Alvarado nourish the Japanese structure of othering.
Understanding the Power Interactions between Villages and the State
Authors: Huang Qidong , Xu Jiajun 
Published: December 2020

Abstract
Chinese villages have been historically regarded as autonomous areas without officials from the state. Since the founding of modern China in 1949, the two forces of state and villages that once co-existed and had no influence on each other have produced ever closer relations or even conflicts. The state power has accelerated the process of infiltration into villages in the last decade. Through the observation and research of sand mining in Beicun village, we find that the villagers do not simply resist or obey the state power, but gradually seek the balance between the traditional ritual order and the modern political system. Moreover, with the entry of state power into the village, power dissimilation, such as political favouritism and politicisation of local magnates, are affecting village governance. The key point of reconstructing modern rural political ecology lies in reserving sufficient room for the development of rural conventions under the national political system and in finding balance in the power interactions the state and villages.
Citizenship through Fiction
Authors: Syed Ghazal Kazim 
Published: December 2020

Abstract
This study explores students’ responses to identifying two themes of citizenship, identity, and discrimination in literary texts taught to them at undergraduate level as part of their curriculum at a department of English at a government university in Sindh, Pakistan. The current study takes responses of the students who have read five novels as part of their curriculum, through questionnaires, to find out if they identify the two themes in those novels. Further to the questionnaire data, interviews are conducted under the framework of reader-response theory to investigate the factors that have led to students’ choice of certain texts over others. The study finds that students relate to and identify citizenship themes in the texts that are closer to their socio-geographic cultures. The students, however, do not identify themes in those novels that are difficult in structure as understanding the narrative technique takes up most of the effort of the readers. Based on the findings of this study, citizenship educators and teachers of English can recommend more appropriate texts to teach identity and discrimination through literature wherever explicit statutory teaching of citizenship may not be possible.
Constructing Authenticity in Discourse(s)
Authors: Thadathil Hashim 
Published: December 2020

Abstract
Claiming and representing “True” Islam has been a major preoccupation among the Muslim groups in Kerala in recent times. In a way, this has augmented the Muslim public sphere in which active debates happen, and also breaks with the general understanding of Islam as monolithic in its ideology and practice. This paper attempts to bring precisely this dynamics of Muslim public sphere in Malabar where prominent groups like the Sunni, Jamaat-e-Islami, and Kerala Nadvathul Mujahideen debate constantly over the representation and following of what is called “True Islam.” The claim towards a true Islam is done by each of the groups by claiming authenticity over what they preach and practice. This paper highlights these debates in the context of the academic debates over “True” and “Authenticated” Islam.
Determinants of Multicultural Identity for Well-Being and Performance
Authors: Balakrishnan Kavitha , Harji Madhubala Bava , Angusamy Ajitha 
Published: December 2020

Abstract
Cultural diversity, which poses both challenges and opportunities in a multicultural education setting, necessitates recognising factors that promote multicultural identities of educators to maximise multicultural attitudes for their wellbeing and performance. This study employs structural equation modelling to examine the determinants of multicultural identities from the perspective of the cognitive-developmental model of social identity integration (CDMII) framework. Categorisation, compartmentalisation, and integration were hypothesised to explain multicultural identity and its effect on well-being and performance. Purposive sampling via survey method involved 288 educators from Malaysian Universities. The findings confirmed that multicultural identity constructs have direct and significant relationship with well-being and well-being has direct and positive relationship with the performance of multicultural team.
Concepts of Happiness and Well-Being
Authors: Charan Iftikhar Ahmed , Xin Shen , Wang Zezhuang , Yao Dewei 
Published: December 2020

Abstract
Culture always plays an important role in creating and affecting happiness in human beings. This study examined the predictive power of cultural factors of differences in happiness and well-being. It explored how different dimensions of cultural and psychological indices differ in their effects on happiness. Growing evidence suggests that happiness is associated with success in multiple domains, such as work, education, culture, and social relationships. We used both qualitative and quantitative methods to examine the relationship between the various factors of well-being and happiness. This study investigates the relationship between happiness and well-being in cultural and psychological resources through the concept of psychological capital, education, workplace well-being, and perceived happiness. This study compares the personal and group level cultural, social, and economic aspects of the Pakistani community that resides in cities in mainland China. Moreover, the main pillars of workplace happiness were determined to be understanding goals, finding meaning in work, and establishing social relationships at both the personal and group levels. We found that happiness and well-being are strongly associated with the behaviour of the people and leadership.
Thatched Cottage in a Fallen City
Authors: Yang Zhiyi 
Published: December 2020

Abstract
This article examines the construction of lyric identities by Li Xuanti, a classical-style poet, cultural celebrity and prominent civil servant in collaborationist regimes based in Nanjing during the Second Sino-Japanese War. It argues that Li used his poetry to explore the confusion, ambivalence and sense of cultural pride while living with the occupiers. Despite his collaboration, a frequent identity that appears in Li’s poetry is that of a yimin (loyalist), who has retreated to the inner world of reclusion. With the progress of the war, however, another identity eventually emerged in Li’s poetry, namely that of a patriot. Historical allusions in Li’s poems thus acquire double-entendre, expressing his ambivalent loyalty. Li was also at the social centre of a group of like-minded collaborators and accommodators in Nanjing, bound by their common practice of classical-style poetry and arts. Their community thus becomes a special case of study for the sociology of survival under the Japanese occupation.
Preleukemic and leukemic evolution at the stem cell level
Authors: Stauber Jacob , Greally John M. , Steidl Ulrich 
Published: December 2020

Abstract
Hematological malignancies are an aggregate of diverse populations of cells that arise following a complex process of clonal evolution and selection. Recent approaches have facilitated the study of clonal populations and their evolution over time across multiple phenotypic cell populations. In this review, we present current concepts on the role of clonal evolution in leukemic initiation, disease progression, and relapse. We highlight recent advances and unanswered questions about the contribution of the hematopoietic stem cell population to these processes.
Prolonged rituximab maintenance in follicular lymphoma patients: long-term results of the SAKK 35/03 randomized trial
Authors: Moccia Alden A. , Taverna Christian , Schär Sämi , Vanazzi Anna , Rondeau Stéphanie , Hitz Felicitas , Mingrone Walter , Pabst Thomas , Cevreska Lidija , del Giglio Auro , Raats Johann , Rauch Daniel , Vorobiof Daniel A. , Lohri Andreas , Ruegsegger Céline , Biaggi Rudolf Christine , Rusterholz Corinne , Hayoz Stefanie , Ghielmini Michele , Zucca Emanuele 
Published: December 2020

Abstract
The Swiss Group for Clinical Cancer Research (SAKK) conducted the SAKK 35/03 randomized trial (NCT00227695) to investigate different rituximab monotherapy schedules in patients with follicular lymphoma (FL). Here, we report their long-term treatment outcome. Two-hundred and seventy FL patients were treated with 4 weekly doses of rituximab monotherapy (375 mg/m2); 165 of them, achieving at least a partial response, were randomly assigned to maintenance rituximab (375 mg/m2 every 2 months) on a short-term (4 administrations; n = 82) or a long-term (up to a maximum of 5 years; n = 83) schedule. The primary end point was event-free survival (EFS). At a median follow-up period of 10 years, median EFS was 3.4 years (95% confidence interval [CI], 2.1-5.5) in the short-term arm and 5.3 years (95% CI, 3.5-7.5) in the long-term arm. Using the prespecified log-rank test, this difference is not statistically significant (P = .39). There also was not a statistically significant difference in progression-free survival or overall survival (OS). Median OS was 11.0 years (95% CI, 11.0-NA) in the short-term arm and was not reached in the long-term arm (P = .80). The incidence of second cancers was similar in the 2 arms (9 patients after short-term maintenance and 10 patients after long-term maintenance). No major late toxicities emerged. No significant benefit of prolonged maintenance became evident with longer follow-up. Notably, in symptomatic patients in need of immediate treatment, the 10-year OS rate was 83% (95% CI, 73-89%). These findings indicate that single-agent rituximab may be a valid first-line option for symptomatic patients with advanced FL.