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A 53-year-old male presented with pancytopenia for 13 months. He had a past history of follicular lymphoma and hypopharyngeal cancer, which was treated via chemotherapy and radiotherapy. Bone marrow aspiration biopsy of the patient revealed a hypocellular marrow with 32% of hypergranular blasts without Auer bodies. There were also erythroid and megakaryocytic dysplasia in the bone marrow. Although the PML/RARA transcript was detected by fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction (RT-PCR), the G-banding karyotype analysis showed a complex karyotype without t (15;17). The PML/RARA fusion signal was identified on chromosome 15 by metaphase FISH. The patient was diagnosed of therapy-related acute promyelocytic leukemia (t-APL) with cryptic PML/RARA. He successfully attained molecular complete remission with all-trans retinoic acid (ATRA) and two courses of arsenic trioxide (ATO). He was subsequently administered nivolumab without ATRA maintenance therapy because of a progressing metastasis of a hypopharyngeal cancer to the lung. The patient had a relapse of t-APL following nine courses of nivolumab, 8 months after ending consolidation therapy with ATO. Reinduction therapy with ATRA was not effective for the relapsed t-APL that was accompanied by del (5q) and monosomy 7. Little has been previously reported on t-APL with cryptic PML/RARA. Therefore, the clinical course of this patient may provide useful insights about the characteristics of t-APL with cryptic PML/RARA.
Assuntos
Leucemia Promielocítica Aguda , Cromossomos Humanos Par 15/genética , Humanos , Hibridização in Situ Fluorescente , Cariótipo , Leucemia Promielocítica Aguda/tratamento farmacológico , Leucemia Promielocítica Aguda/genética , Masculino , Metáfase , Pessoa de Meia-Idade , Proteínas de Fusão Oncogênica/genética , TretinoínaRESUMO
A 56-year-old man diagnosed with multiple myeloma was treated with CBD (cyclophosphamide, bortezomib, and dexamethasone; DEX), which was discontinued because of bortezomib-associated adverse events. Thereafter, he was treated with Ld (lenalidomide; LEN+DEX) followed by high-dose chemotherapy with autologous stem cell rescue, resulting in a complete response. Ld as maintenance therapy was discontinued because of immune thrombocytopenia, resulting in disease progression. Although treatment was switched to Pd (pomalidomide+DEX), DLd (daratumumab+LEN+DEX), and IRd (ixazomib+LEN+DEX); the patient's M protein level continued to increase and the extramedullary disease expanded despite radiotherapy. He was treated with E-Ld (elotuzumab+LEN+DEX) after 3 cycles of short VAD (vincristine, doxorubicin, and DEX). The extramedullary disease disappeared after 8 cycles of E-Ld. To the best of our knowledge, this is the first report showing the effectiveness of E-Ld treatment for extramedullary disease of a heavily treated patient for multiple myeloma. We believe that the clinical course of this patient provides useful insights about the antimyeloma mechanism of elotuzumab.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Mieloma Múltiplo , Anticorpos Monoclonais Humanizados , Dexametasona , Humanos , Lenalidomida , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/tratamento farmacológicoRESUMO
The maximization principle-that people aspire to the highest possible level of something good if all practical constraints are removed-is a common yet untested assumption about human nature. We predict that in holistic cultures-where contradiction, change, and context are emphasized-ideal states of being for the self will be more moderate than in other cultures. In two studies ( Ns = 2,392 and 6,239), we asked this question: If participants could choose their ideal level of happiness, pleasure, freedom, health, self-esteem, longevity, and intelligence, what level would they choose? Consistent with predictions, results showed that maximization was less pronounced in holistic cultures; members of holistic cultures aspired to less happiness, pleasure, freedom, health, self-esteem, longevity, and IQ than did members of other cultures. In contrast, no differences emerged on ideals for society. The studies show that the maximization principle is not a universal aspect of human nature and that there are predictable cultural differences in people's notions of perfection.
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Comparação Transcultural , Liberdade , Felicidade , Autoimagem , Adulto , Feminino , Saúde , Humanos , Inteligência , Longevidade , Masculino , Pessoa de Meia-Idade , PrazerRESUMO
Terror management theory outlines how humans seek self-esteem and worldview validation to manage death-related anxiety. Accumulating evidence reveals that close relationships serve a similar role. However, to date, there has been no synthesis of the literature that delineates when close relationships buffer mortality concerns, under what conditions, on which specific outcomes, and for whom. This systematic review presents over two decades of research to address these questions. Findings from 73 reviewed studies revealed that close relationships serve an important role in buffering death-related anxiety. A range of dispositional and situational moderating factors influence either the activation or inhibition of relational strivings to manage heightened death awareness, the most influential being attachment, gender, and relationship-contingent self-esteem. These findings were integrated into an overarching model that highlights some of the conditions under which mortality salience (MS) influences relational outcomes. We conclude by highlighting a range of theoretical and methodological concerns to be addressed by future research.
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Ansiedade/psicologia , Atitude Frente a Morte , Morte , Relações Interpessoais , Apego ao Objeto , Autoimagem , Humanos , Teoria Psicológica , Pesquisa , Fatores SexuaisRESUMO
Despite concerns about animal welfare, and health and environmental issues associated with eating meat, meat consumption has continued to increase worldwide, including in Australia. One exception to this is Germany, with 2021 meat consumption levels being the lowest in the last 30 years. This pre-registered study investigated socio-cultural variables associated with meat consumption in Germany (n = 399) and Australia (n = 399) in a cross-sectional online survey. Participants reported levels of current and intended meat consumption, and they completed measures of speciesism, motivations to eat meat, empathy, animal farming perceptions, perceived behavioural control (PBC) over meat eating, and avoidance and dissociation regarding the animal origins of meat. In both Australia and Germany, enjoying the taste of meat positively predicted consumption and empathy towards farmed animals negatively predicted consumption. PBC was a strong positive predictor of intentions to reduce meat consumption in both countries. Empathy and liking the taste of meat were among the best predictors of red meat and poultry consumption, suggesting that interventions to reduce meat consumption may work best by targeting these factors while also increasing people's sense of control over their food choices.
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Although applauding Pickering & Garrod's (P&G's) attempt to ground language use in the ideomotor perception-action link, which provides an "infrastructure" of embodied social interaction, we suggest that it needs to be complemented by an additional control mechanism that modulates its operation in the service of the language users' communicative intentions. Implications for intergroup relationships and intercultural communication are discussed.
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Compreensão/fisiologia , Modelos Teóricos , Percepção da Fala/fisiologia , Fala/fisiologia , HumanosRESUMO
Death is an important reminder that our lives are finite. Although some studies have shown that thinking about one's own death increases temporal discounting (i.e., the devaluing of future rewards), the underlying neural mechanisms are still unknown. In a functional magnetic resonance imaging experiment, we compared the neural and behavioral processes of temporal discounting across four conditions involving distinct types of future thinking (death related, negative, neutral, and positive). Replicating prior research, the behavioral evidence showed that temporal discounting increased when thinking about one's own future death. Multivoxel pattern analysis showed that death-related future thinking was decoded in default mode regions, including the inferior parietal lobule, precuneus, and medial prefrontal cortex (MPFC). When future thinking was death related (vs. negative), increased temporal discounting was associated with a higher decoding accuracy in the precuneus and MPFC. The present findings suggest that death-related neural representations are distributed across default mode regions, and neural populations in the cortical midline structures play a crucial role in the integration of one's own death into economic decision-making.
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Acute myeloid leukemia (AML) with BCR-ABL1, also termed Philadelphia chromosome-positive AML (Ph+ AML), is a rare leukemia subtype classified by the World Health Organization in 2016. The characteristics of Ph+ AML have not been fully identified yet. We herein report a patient with Ph+ AML who phenotypically exhibited megakaryoblastic characteristics, FAB:M7 and harbored a subclone expressing BCR-ABL1 gene fusion products. This case suggests that BCR-ABL1 was acquired as a subclone due to a secondary event that might have occurred late during leukemia evolution. Our findings may aid in deciphering the mechanism underlying Ph+ AML development in future studies.
Assuntos
Leucemia Megacarioblástica Aguda , Leucemia Mielogênica Crônica BCR-ABL Positiva , Proteínas de Fusão bcr-abl/genética , Humanos , Leucemia Megacarioblástica Aguda/genéticaRESUMO
Antifungal prophylaxis is crucial for successful hematopoietic stem cell transplantation (HSCT). Maintenance therapy with fluconazole (FLCZ) is generally prescribed as secondary prophylaxis in patients with human immunodeficiency virus infection and non-immunocompromised hosts. However, previous reports have revealed that FLCZ is insufficient as a secondary prophylaxis for cryptococcal infection in HSCT cases. There is no well-established evidence of effective secondary prophylaxis against cryptococcal infection in conditions of severe immunosuppression, such as in HSCT. Herein, we report a case of atypical chronic myeloid leukemia (aCML) presenting with cryptococcal meningitis. A 58-year-old man with progressive leukocytosis and headache was referred to our hospital. Bone marrow biopsy revealed aCML. Because the estimated overall survival was limited, HSCT was indicated. Furthermore, enhanced magnetic resonance imaging and lumbar puncture aided in diagnosing cryptococcal meningitis, which was treated with a combination therapy comprising liposomal amphotericin B and 5-fluorocystine for 28 days. Given the high recurrence rate of cryptococcal meningitis, voriconazole (VRCZ) dose was calculated using the trough concentration of VRCZ in the cerebrospinal fluid. Eventually, HSCT was successfully performed at an appropriate therapeutic range of VRCZ. To the best of our knowledge, there is no case report on HSCT with secondary prophylaxis against cryptococcal meningitis. Our report thus emphasizes the efficacy of VRCZ maintenance therapy as secondary prophylaxis for cryptococcal infection.
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An experiment examined the potency of nostalgia-a sentimental longing for one's past-to facilitate detection of death-related stimuli, using functional magnetic resonance imaging (fMRI) and behavioral techniques (i.e., judgmental accuracy, reaction times). We hypothesized and found that, at the neural level, nostalgic (relative to control) participants evinced more intense activation in right amygdala in response to death-related (vs. neutral) words. We also hypothesized and found that, at the behavioral level, nostalgic (relative to control) participants manifested greater accuracy in judging whether two death-related (vs. neutral) words belonged in the same category. Exploratory analyses indicated that nostalgic (relative to control) participants did not show faster reaction times to death-related (vs. neutral) words. In all, nostalgia appeared to aid in death threat detection. We consider implications for the relevant literatures.
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Emoções/fisiologia , Adolescente , Adulto , Tonsila do Cerebelo/fisiologia , Comportamento/fisiologia , Neurociência Cognitiva/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
Growing efforts have been made to pool coronavirus data and control measures from countries and regions to compare the effectiveness of government policies. We examine whether these strategies can explain East Asia's effective control of the COVID-19 pandemic based on time-series data with cross-correlations between the Stringency Index and number of confirmed cases during the early period of outbreaks. We suggest that multidisciplinary empirical research in healthcare and social sciences, personality, and social psychology is needed for a clear understanding of how cultural values, social norms, and individual predispositions interact with policy to affect life-saving behavioural changes in different societies.
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We examine the access that culturally diverse migrant groups in Australia have to different sources of social support and how this access, or lack thereof, is associated with psychological flourishing and distress. A national online survey was conducted with 1334 migrants in Australia, examining 11 different sources of social support, including family, friends, relationship partner, acquaintances, work colleagues, health professionals, government agencies, community organisations, religious groups, social groups and online groups. We also examined migrants from different cultural groups. All sources of support were significantly associated with mental health, but somewhat differently for the dimensions of distress and flourishing. Flourishing was linked to higher support from all 11 sources, though not for all cultural groups. High psychological distress was linked to lower support only from family, friends, a partner, acquaintances, work colleagues and social groups, and only for some cultural groups. In particular, for distress, there was no link between migrants from Southern Asia and family support, as well as Confucian Asia groups and friend support. Understanding where migrants from different cultural origins draw their support from could help policymakers and support workers improve health and well-being in migrant populations, especially by focusing on sources of support that are linked to lower distress and greater flourishing, as indicated in this study.
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Aculturação , Emigrantes e Imigrantes/psicologia , Nível de Saúde , Autoimagem , Apoio Social , Estresse Psicológico/prevenção & controle , Adulto , Austrália , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Adulto JovemRESUMO
Mortality salience (MS) has been shown to lead to derogation of others with dissimilar worldviews, yet recent research has shown that Asian-Americans who presumably adopt an interdependent self-construal (SC) tend to reveal greater tolerance after MS induction. In the present study, we demonstrated that Japanese individuals who are high on interdependent SC indeed show greater tolerance toward worldview-threatening other in the MS (vs control) condition, thus replicating the prior research. Extending this research, we also found that interdependent people's tolerance toward worldview-threatening other was mediated by increased activity in the right ventrolateral prefrontal cortex in the MS condition. These data suggested that when exposed to death-related stimuli, highly interdependent individuals may spontaneously activate their neural self-control system which may serve to increase tolerance toward others.
Assuntos
Atitude Frente a Morte/etnologia , Autocontrole , Meio Social , Povo Asiático , Mapeamento Encefálico , Feminino , Hemoglobinas/análise , Hemoglobinas/metabolismo , Humanos , Japão , Masculino , Oxigênio/sangue , Córtex Pré-Frontal/fisiologia , Autoimagem , Espectroscopia de Luz Próxima ao Infravermelho , Adulto JovemRESUMO
Reminders of death often elicit defensive responses in individuals, especially among those with low self-esteem. Although empirical evidence indicates that self-esteem serves as a buffer against mortality threats, the precise neural mechanism underlying this effect remains unknown. We used functional magnetic resonance imaging (fMRI) to test the hypothesis that self-esteem modulates neural responses to death-related stimuli, especially functional connectivity within the limbic-frontal circuitry, thereby affecting subsequent defensive reactions. As predicted, individuals with high self-esteem subjected to a mortality threat exhibited increased amygdala-ventrolateral prefrontal cortex (VLPFC) connectivity during the processing of death-related stimuli compared with individuals who have low self-esteem. Further analysis revealed that stronger functional connectivity between the amygdala and the VLPFC predicted a subsequent decline in responding defensively to those who threaten one's beliefs. These results suggest that the amygdala-VLPFC interaction, which is modulated by self-esteem, can reduce the defensiveness caused by death-related stimuli, thereby providing a neural explanation for why individuals with high self-esteem exhibit less defensive reactions to mortality threats.
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Tonsila do Cerebelo/fisiologia , Atitude Frente a Morte , Medo/fisiologia , Córtex Pré-Frontal/fisiologia , Autoimagem , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Adulto JovemRESUMO
Life satisfaction of migrants to Australia from 17 countries, assessed at 4-5 months, 16-17 months and 3½ years after arrival, was analyzed with a longitudinal, multilevel analysis. The results indicated that migrants were more satisfied, if the national average life satisfaction was higher in their country of origin, after adjustment for individual-level income, age, and sex and a linear temporal trend. Simultaneously, the migrants were also happier if people in their country of origin had a higher frequency of 5-HTT long allele, a genotype known to be associated with resilience under life stresses. These two relationships were independent, suggesting that both culture and gene matter in international transitions.
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Cultura , Emigrantes e Imigrantes/psicologia , Satisfação Pessoal , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adulto , Fatores Etários , Alelos , Austrália , Feminino , Frequência do Gene , Genótipo , Humanos , Renda , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Valor Preditivo dos Testes , Resiliência Psicológica , Fatores Sexuais , Estresse Psicológico/genética , Estresse Psicológico/psicologiaRESUMO
In this article, the authors report an investigation of the relationship between terror management and social identity processes by testing for the effects of social identity salience on worldview validation. Two studies, with distinct populations, were conducted to test the hypothesis that mortality salience would lead to worldview validation of values related to a salient social identity. In Study 1, reasonable support for this hypothesis was found with bicultural Aboriginal Australian participants (N = 97). It was found that thoughts of death led participants to validate ingroup and reject outgroup values depending on the social identity that had been made salient. In Study 2, when their student and Australian identities were primed, respectively, Anglo-Australian students (N = 119) validated values related to those identities, exclusively. The implications of the findings for identity-based worldview validation are discussed.
Assuntos
Morte , Medo , Identificação Social , Valores Sociais , Adolescente , Adulto , Austrália/etnologia , Características Culturais , Feminino , Humanos , Masculino , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologiaRESUMO
Although differences in self-conception across cultures have been well researched, regional differences within a culture have escaped attention. The present study examined individual, relational, and collective selves, which capture people's conceptions of themselves in relation to their goals, significant others, and in groups, comparing Australians and Japanese participants living in regional cities and metropolitan areas. Culture, gender, and urbanism were found to be related to individual, relational, and collective selves, respectively. Australians emphasized individual self more than Japanese, women stressed relational self more than men, and residents in regional cities regarded collective self as more important than their counterparts in metropolitan areas. These findings provide support for the tripartite division of the self and suggest a need to construct a culture theory that links self and societal processes.
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Características Culturais , Autoimagem , Condições Sociais , Adulto , Austrália/etnologia , Feminino , Objetivos , Humanos , Japão/etnologia , Masculino , Fatores Sexuais , População UrbanaRESUMO
Social psychological studies have shown that an experience of threat such as an encounter with death-related stimuli and social exclusion results in tuning toward positive emotional information. Neuroimaging studies have also begun to uncover the neural basis of threat coping, and in this literature, the activity of the right ventrolateral prefrontal cortex (rVLPFC) has been suggested to play a key role in detection and regulation of threats. Using near-infrared spectroscopy (NIRS), we examined the activity of rVLPFC while participants were subliminally primed with the concept of "death" or the control concept "pain". We found greater rVLPFC activities relative to the prior baseline in the death prime condition, and furthermore, these activities negatively correlated with the evaluation of the positive (but not negative) essay. These data provide initial evidence to suggest that lesser neuronal regulation of threat, when it is first encountered, may lead to subsequent regulation by affect tuning.
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Adaptação Psicológica/fisiologia , Medo/fisiologia , Córtex Pré-Frontal/fisiologia , Estimulação Subliminar , Adulto , Mapeamento Encefálico , Morte , Feminino , Humanos , Masculino , Dor/psicologiaRESUMO
With data from 33 nations, we illustrate the differences between cultures that are tight (have many strong norms and a low tolerance of deviant behavior) versus loose (have weak social norms and a high tolerance of deviant behavior). Tightness-looseness is part of a complex, loosely integrated multilevel system that comprises distal ecological and historical threats (e.g., high population density, resource scarcity, a history of territorial conflict, and disease and environmental threats), broad versus narrow socialization in societal institutions (e.g., autocracy, media regulations), the strength of everyday recurring situations, and micro-level psychological affordances (e.g., prevention self-guides, high regulatory strength, need for structure). This research advances knowledge that can foster cross-cultural understanding in a world of increasing global interdependence and has implications for modeling cultural change.