The Role of Information and Communication Technology in the Acculturation of Vietnamese Refugees

One of the most significant refugee populations in the United States is the Vietnamese. This group initially fled their native country to escape political oppression at the conclusion of the Vietnam War in 1975 and continued to flee in a series of separate waves that continued for more than three decades. As a relatively new immigrant group in the U.S., the Vietnamese still face a variety of challenges as they try to reestablish their lives and adapt in a new cultural environment. Acculturation is a complex process that is influenced by a number of factors. Throughout history, U.S. immigration policy has significantly affected the admission and adaptation of refugees. As shifts in the ideological frameworks, economic demands, and attitudes towards the rest of the world occurred in the twentieth century, which eventually brought the liberalization of immigration policy, this influence slowly decreased. This allowed for factors in the domestic political, economic, and social environments to become more powerful in affecting how refugees adapt in the U.S. Information and communication technologies (ICTs) have become integral aspects in both assisting and complicating the acculturation process for refugees. These technologies are helping Vietnamese refugees culturally adjust in American communities as well as maintain ties with their native culture; thus, illustrating the multifaceted nature of acculturation. However, the impact of ICTs is not uniform across all of the different waves of refugees who fled from Vietnam. This study demonstrates that interaction and communication are key aspects in cross-cultural adaptation and the importance of media in contemporary everyday life

Northeast Ohio GRIDs Monitor

Groups of Regional Industry Drivers (GRIDs) were identified in Northeast Ohio (NEO). GRIDs are wealth-creating industries that have a strong regional specialization, growing output, rising productivity, and local competitive advantage. Overall, the three identified GRIDs—Professional Services, Growing Legacy Manufacturing, and Oil and Gas—contributed nearly 40% ($90.4 billion) to NEO’s total output and employed 20% (369,054 people) of NEO workforce in 2018. This research provides an update on the performance of GRIDs economy focusing on 2017-18 changes and projections for 2019. Calculations in this monitor are based on the data from Moody\u27s Analytics Economy.com

Relapsed refractory multiple myeloma with CNS involvement successfully treated with Elranatamab: First reported case

Central nervous system (CNS) involvement in multiple myeloma (MM) is a rare and challenging complication associated with poor prognosis and limited treatment options. Emerging T-cell directing therapies, such as bispecific antibodies (bsAbs) and chimeric antigen receptor T cells (CAR-T), have shown remarkable success in treating MM, but their efficacy in CNS involvement remains unclear. Elranatamab, a humanized bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3-expressing T cells, has demonstrated promising results in relapsed refractory MM. However, its efficacy in treating CNS-MM has not been reported. We present a case of a 37-year-old male MM patient with CNS involvement who has been successfully treated with Elranatamab

Investigation of the presence of encephalitozoon intestinalis and enterocytozoon bieneusi in bone marrow transplant patients by IFA-MAbs method

Mikrosporidian patojenler her yerde bulunabilen, omurgalı ve omurgasız konaklarda enfeksiyona neden olabilen, 144 cins altında 1200'den fazla türü tanımlanmış zorunlu hücre içi ökaryotik parazitlerdir. İnsanlarda patojen olarak tanımlanan 14 microsporidia türü arasında en sık saptananlar Enterocytozoon bieneusi ve Encephalitozoon intestinalis olup gastrointestinal sistemde enfeksiyona yol açmaktadırlar. Bu etkenler, özellikle immün sistemi baskılanmış hastalarda kronik ishallerin yanı sıra, yaygın enfeksiyonlara neden olarak hayatı tehdit eden ağır klinik tablolar oluşturmaktadır. Microsporidia sporları çok küçük olduklarından, rutin dışkı incelemelerinde genellikle gözden kaçmaktadır. Bu nedenle tanıda moleküler yöntemler ve mümkünse transmisyon elektron mikroskopi altın standart olarak kullanılmaktadır. Bu yöntemlerin uygulanamadığı laboratuvarlarda ise, monoklonal antikorların kullanıldığı immünofl oresan antikor (IFA-MAbs) yöntemi, konvansiyonel yöntemlere üstünlüğü nedeniyle tercih edilebilir. Bu çalışmada, kemik iliği transplant (KİT) hastalarında E.intestinalis ve E.bieneusi varlığının IFA-MAbs yöntemi ile araştırılması amaçlanmıştır. Çalışmaya, 147'sinde ishal şikayeti olan 200 KİT hastası (134'ü erkek, 66'sı kadın; yaş ortalaması: 43.2 ± 15.01 yıl) ile kontrol olarak 80 sağlıklı birey (43'ü erkek, 37'si kadın; yaş ortalaması: 31.9 ± 11.76 yıl) dahil edilmiştir. Tüm olguların dışkı örnekleri, konvansiyonel yöntemlerin (nativ-lugol ve modifi ye aside dirençli boyama) yanı sıra, ticari bir IFA-MAbs (Bordier Affi nity Products, İsviçre) yöntemiyle de değerlendirilmiştir. Hastaların %25.5 (51/200)'inde E.intestinalis, %4 (8/200)'ünde E.bieneusi ve %9.5 (19/200)'inde her ikisi birden olmak üzere, toplam %39 (78/200)'unda pozitifl ik saptanmıştır. Bu oranlar kontrol grubu için sırasıyla, %5 (4/80), %2.5 (2/80), %3.8 (3/80) ve %11.3 (9/80) olarak tespit edilmiştir. Hasta ve kontrol gruplarında saptanan pozitifl ik oranları arasındaki fark istatistiksel olarak anlamlı bulunmuştur (%39'a karşı %11.3, p< 0.05). Hasta grubunda pozitif bulunan 78 hastanın 67 (%85.9)'sinin ishalli olduğu izlenmiş; ishal varlığı ile parazit pozitifl iği arasında istatistiksel olarak anlamlı bir ilişkinin olduğu görülmüştür (p< 0.05). Sonuç olarak, KİT hastalarının yaşam kalitesini yükseltmek ve tedavi sürecindeki olumsuzlukları azaltmak için, bu hastaların, özellikle de gastrointestinal yakınması olanların düzenli aralıklarla E.intestinalis ve E.bieneusi açısından değerlendirilmesi gerektiği düşünülmüştürMicrosporidian pathogens are obligatory intracellular eukaryotic parasites which can be found worldwide. They have been represented in 144 genera and more than 1200 species that may cause infections in both vertebrate and invertebrate hosts. Enterocytozoon bieneusi and Encephalitozoon intestinalis are the most common species among 14 species of microsporidia identifi ed as human pathogens and they cause infections in the gastrointestinal tract. These species may also cause chronic diarrhea particularly in immunocompromised patients, as well as disseminated infections with severe clinical conditions which can be life-threatening. Since the spores of microsporidia are quite small-sized structures, they frequently may be overlooked in routine stool examinations. Therefore, molecular methods and transmission electron microscopy, if possible, are used as the gold standard methods in laboratory diagnosis. In laboratories in which those methods could not be applied, immunofl uorescence assay using monoclonal antibodies (IFA-MAbs) may be advantageous compared to conventional methods. The aim of this study was to investigate the presence of E.intestinalis and E.bieneusi in bone marrow transplant (BMT) patients by using IFA-MAbs method. A total of 200 BMT patients (134 male, 66 female; mean age: 43.2 &plusmn; 15.01 years), of them 147 with diarrhea and 80 healthy subjects (43 male, 37 female; mean age: 31.9 &plusmn; 11.76 years) as control group were included in the study. All of the stool samples were examined by a commercial IFA-MAbs (Bordier Affi nity Products, Switzerland) method as well as conventional (native-lugol and modifi ed acid-fast staining) methods. Of the patients 25.5% (51/200) were positive for E.intestinalis, 4% (8/200) for E.bieneusi and 9.5% (19/200) for both of them, giving a total positivity rate of 39% (78/200). Those rates were 5% (4/80), 2.5% (2/80), 3.8% (3/80) and 11.3% (9/80), respectively for control group. The difference between the patient and control groups in terms of positivity was found statistically signifi cant (39% vs 11.3%, p&lt; 0.05). Among 78 positive BMT patients, 67 (85.9%) were suffering from diarrhea. The correlation between the presence of diarrhea and the presence of microsporidia was statistically signifi cant (p&lt; 0.05). It was concluded that, BMT patients particularly those with gastrointestinal complaints, have to be evaluated for microsporidian pathogens regularly to improve quality of life and to decrease the problems during the treatment perio

Comparison of efficacy and safety of generic plerixafor vs original plerixafor in the mobilization of myeloma patients

Introduction The commonest indication for an Autologous Stem Cell Transplantation (ASCT) is still Multiple Myeloma. A successful mobilization of hematopoietic stem cells (HSC) is a sine qua non of ASCT. The introduction of Plerixafor, which is a partial agonist of the alfa-chemokine receptor CXCR4 has added an important value and impact on mobilization. Plerixafor is successfully integrated into both growth factor-only and cyclophosphamide and growth factor mobilization strategies with significantly reducing the mobilization failure rate in myeloma patients. In addition, plerixafor + G-CSF has also been shown to successfully mobilize the majority of patients who previously failed to mobilize with either growth factor alone or in combination with chemotherapy. Even a Just-in-Time algorithm which induces plerixafor in patients who lacks a certain threshold of CD34 positive HSCs on the day of mobilization led to a cost-effective and successful mobilization with highly restricted rates of mobilization failure. In this study we tried to demonstrate the efficacy and safety of a novel generic Plerixafor (Pleksor - Gen Ilac) and to compare it with original one (Mozobil - Sanofi) in a retrospective manner. Method Patients who were transplanted in two centers who adopted the same mobilization standard operating procedures (SOP) were included in the study. An age and sex matched cohort of patients who received Mozobil (from 2020-2022 - Group A) were compared with the ones who received Pleksor (2021-2022 Group B) as a Just-in-Time conjunct to GCSF alone or chemo mobilization. Poor mobilization was defined as a final yield of 2 million CD34 positive HSCs per kg. Our aim was to collect enough stem cells for at least two ASCTs, thus our current SOP's indicated a minimum CD34 positive HSC threshold of at least 4 million per kg and an ideal HSC threshold of 6 million per kg. Results A total of 28 patients were included and they were equally distributed among Group A (n=14) and B (n=14). Median age of the patients at the time of mobilization were as follows, 60 (35-72) in Group A and 61 (38-70) in Group B. 14 patients who received Pleksor achieved a median yield of 8.40 million CD34 positive HSCs per kg (4.8-21) and the patients who received Mozobil have ended with a yield of 6.7 million CD34 positive HSCs per kg (4.5-13) (p=0.210). None of the patients in both groups were named to be a poor mobilizer according to the threshold of 2 million CD34 positive HSCs per kg but 3 of the patients in Group A and 2 of the patients in Group B ended with a yield of 6 million CD34 positive cells which was below to the ideal threshold for two transplants. Regarding lenalidomide exposure before mobilization, history of radiotherapy, line of the therapies received before mobilization, number of leukapheresis and the mobilization policy (chemo vs gcsf alone) there were no statistically significant difference between two groups (p=0.120, 0.702, 0.842, 0.769 and 0.420 respectively). The median neutrophil engraftment time in days were as follows for Group A and B, 11(10-14) vs 11 (10-16), p=0.541 and the median platelet engraftment time in days were 17 (10-30) in Group A and 16 (10-28) in Group B with a p value of 0.571. In none of the cases any specific side effects were noted which could be attributable to Pleksor or Mozobil. Conclusion Our study demonstrated a comparable efficacy of a generic form of Plerixafor when compared with the originator. This would lead to a decrease in the cost of total process of mobilization with a similar efficacy and toxicity profile. We are now planning to initiate a prospective trial to validate these results in a larger patient population. Up to our knowledge this is the first study comparing the efficacy of a generic Plerixafor in a sole myeloma patient cohort

Cytomegalovirus (CMV) and Hepatitis B (HBV) reactivation during autologous stem cell transplantation: A single-center experience

Amaç: Sitomegalovirüs (CMV) reaktivasyonu allojenik hematopoetik kök hücre transplantasyo- nu sırasında sık görülür. Hepatit B reaktivasyonu (HBV), akut hepatit ve fulminan karaciğer yet- mezliği veya sadece HBV DNA düzeyinde artma şeklinde ortaya çıkabilir. Allojenik hematopoetik kök hücre nakli bağımsız bir risk faktörüyken, otolog hematopoetik kök hücre (HKH) alıcıları için risk ve nakil sürecine etkileri net bilinmemektedir. Çalışmamızda, geriye dönük olarak analiz etti- ğimiz otolog HKH alıcılarında CMV enfeksiyonu-engraftman ve hepatit B reaktivasyonu ilişkisini ortaya koymayı amaçladık. Hastalar ve Yöntem: Temmuz 2014-Aralık 2019 tarihleri arasında takip edilmiş olan toplamda 174 otolog KHN alıcı olan hasta değerlendirildi. CMV enfeksiyonuna bağlı organ tutulumları doku tanısı, görüntüleme ve klinik bulgularla doğrulandı. CMV enfeksiyonun tipi hastanın klinik izlemi, radyolojik raporları, hastanın tedavi alıp almamasına göre kopya sayısı seyri, virüsün herhangi bir dokunun patolojik incelemesinde tespit edilip edilmemesine göre değerlendirildi. Bulgular: Çalışmaya toplam 174 otolog KHN alıcı dahil edildi. CMV reaktivasyon oranı 18 has- tayla %10.3’tü. CMV reaktivasyonu olan olguların total Anti-HBc pozitif olma oranı, CMV negatif grubuna göre istatistiksel olarak anlamlı seviyede yüksek saptandı. CMV reaktivasyonu grubun- daki olguların HBV reaktivasyon oranı, CMV reaktivasyonu olmayan hasta grubundan istatistiksel olarak anlamlı seviyede yüksek saptandı. Sonuç: Otolog kök hücre nakli de viral reaktivasyonlar açısından dikkatli olunması gereken önemli bir tedavi tipini oluşturmaktadır.Objective: Cytomegalovirus (CMV) reactivation is a frequently encountered clinical condition during allogeneic hematopoietic stem cell transplantation. Hepatitis B reactivation (HBV) can occur asymptomatically only with re-emergence or increase in blood HBV-DNA levels, as well as in different clinical manifestations, including acute hepatitis and fulminant liver failure. While allogeneic hematopoietic stem cell transplantation is an independent risk factor, the risk for autologous hematopoietic stem cell (HSC) recipients and its effects on the transplantation process are not clear. In our study, we aimed to reveal the relationship between CMV reactivation and engraftment process and HBV reactivation in autologous HSC recipients. Patients and Methods: A total of 174 autologous HSC recipients who were followed-up between July 2014 and December 2019 were included in our study. Organ involvement due to CMV infection was confirmed by tissue pathology, imaging methods and clinical find- ings. The type of CMV infection was evaluated according to the patient’s clinical follow-up, radiological reports, the course of the copy number according to whether the patient received treatment, and whether the virus was detected in the pathological examination of any tissue. Results: The CMV reactivation rate was 10.3% with 18 patients. The rate of total Anti-HBc positivity in cases with CMV reactivation was found to be statistically significantly higher than in the CMV negative subgroup. The HBV reactivation rate of the patients in the CMV reactivation subgroup was found to be statistically significantly higher than the patient group without CMV reactivation. Conclusion: Autologous stem cell transplantation also constitutes an important type of treatment to be careful in terms of viral reacti- vation

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: A real-world data from Turkey

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m2 on day 1, and bendamustine 90 mg/m2 on days 1–2 of each cycle. Median age at Pola-BR initiation was 55 (19–84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3–4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile

Encephalitozoon intestinalis: A Rare Cause of Diarrhea in an Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) Recipient Complicated by Albendazole-Related Hepatotoxicity

Abstract: A 50-year-old male patient previously diagnosed with acute myelomonocytic (M4) leukemia in July 2009 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). During the pre-transplant period complete blood count (CBC), liver and renal function tests, coagulation tests, and other parameters were normal. On the first day of transplantation teicoplanin (400 mg d -1 for the first 3 d, and then 400 mg d -1 ) and caspofungin (first dose was 1×70 mg d -1 , followed by 1×50 mg d -1 ) were started intravenously due to white plaques and oropharyngeal candidiasis in the patient&apos;s mouth and perianal erythema. On the 14 th d of transplantation watery diarrhea occurred, along with abdominal discomfort, nausea, and fatigue

“The Lolelaplap (Marshall Islands) in Us: Sailing West to East (Ralik→Ratak) to These Our Atolls (Aelon Kein Ad) Ad Jolet Jen Anij (Our Blessed Inheritance from God)”

This paper discusses the expansion of Oceania through a Marshallese indigenous lens as a focal point. It explains that decolonizing methodologies allows reclaiming of space for mental liberation and reassurement of constitutional rights. It highlights similar occurrences of decolonization practices meeting resistance in the 21st century all while strengthening the human right argument that no human deserves any less than their fellow human brothers and sisters. It argues that an indigenous imagery can only be viewed through an indigenous lens where the researches’ level of purity is retained and unfiltered. It nevertheless argues that Marshallese ethnolinguistics reveal the same cultural practices in America, Judeo-Christianity, and Oceania thus dictating the reality that “we are the same not withstanding one stays here and one there (Bedbedjin Bedbedjen, Bedbedjinma wot Kwe)”. It further explains the importance in these similarities and how Marshallese spirituality predates introduced American Judeo-Christianity despite the latter attempting to marginalize the former. It concludes by stating that Marshallese contributions on the global stage are rooted in that culture of love (IaKwe) which is echoed by the custom(s) revealing the significance of Marshallese validation academically, spiritually, economically, & socially to prevent institutionalized discrimination. This paper ends stating that the agency to know one’s self and how one should fit in the world, is a human right in itself and Marshallese are entitled to this sense of self worth through knowing thy self by thy self where real thinking takes place in one’s own mind as we all live our own lives