US Academic Research Articles

Co-producing knowledge and care in team-based fieldwork in the Covid-19 era

In this article, we examine how the pandemic has led us to a dispersed and technologically mediated form of team-based fieldwork framed by an ethics of care. Covid-19 has changed the proximity of research teams and, thus, affected how teams are present for one another during challenging times, such as when researchers witness extreme suffering or death during a study. The four authors present reflections on collaborating on a caregiving study in a Zambian paediatric hospital during Covid-19. We describe a collaboration founded on a feminist ethics of care, co-production of knowledge, and attention to power dynamics between African academics and US academics, research assistants and established scholars. We do so through foregrounding the views and experiences of the research assistants, offering a glimpse into the experiential aspects of dispersed team-based research in a pandemic. The article offers insights into distanced, collaborative research across continents, including regular check-ins and radical listening; generous feedback, modelling and co-mentoring; and co-imagining our presence and futures. These serve as interventions into virtual collaborative work and also into collaboration in anthropology in general.

P-201: Triple-class refractory disease as a modern therapeutic benchmark for clinical trials testing new agents for relapsed refractory Multiple Myeloma

P-201: Triple-class refractory disease as a modern therapeutic benchmark for clinical trials testing new agents for relapsed refractory Multiple Myeloma

Representation of Women and Underrepresented Groups in US Academic Medicine by Specialty

Representation of Women and Underrepresented Groups in US Academic Medicine by Specialty

Laboratory analysis of symptomatic and asymptomatic pregnant patients with SARS-CoV-2 infection

BACKGROUNDInflammatory biomarkers have been used to portend disease severity in nonpregnant individuals with SARS-CoV-2 infection. However, currently, limited data are available, and with mixed results, to elucidate which inflammatory biomarkers may be most associated with clinical phenotype in pregnant patients.OBJECTIVEWe aimed to compare laboratory findings among pregnant patients with SARS-CoV-2 infection by symptom status and disease severity.STUDY DESIGNWe retrospectively evaluated pregnant patients with positive SARS-CoV-2 infection, confirmed through polymerase chain reaction testing, at an urban academic US hospital between March 2020 and October 2020, performed for reported symptoms or universal screening on admission. In our hospital, all patients with SARS-CoV-2 infection were recommended to have baseline laboratory testing, including leukocyte, neutrophil, and lymphocyte counts; aspartate aminotransferase and alanine aminotransferase; high-sensitivity C-reactive protein; procalcitonin; lactate dehydrogenase; D-dimer; and ferritin. We performed multivariable logistic regression to evaluate peak laboratory abnormalities significantly associated with symptomatic SARS-CoV-2 infection and disease severity with gestational age at diagnosis, maternal age, and obesity as covariates. The sensitivity and specificity of laboratory abnormalities were calculated to identify symptomatic vs asymptomatic infection and severe to critical disease vs mild to moderate disease.RESULTSWe identified 175 pregnant patients with SARS-CoV-2 infection, of whom 100 (57%) were symptomatic; 17 (17%) of those who were symptomatic had a severe to critical disease. Laboratory data were available for 128 patients, of whom 67 (52%) were symptomatic. Compared with asymptomatic individuals, symptomatic individuals were more likely to exhibit elevated high-sensitivity C-reactive protein levels after adjusting for gestational age (adjusted odds ratio, 5.67; 95% confidence interval, 1.42–22.52; sensitivity, 81%; specificity, 43%). In symptomatic individuals, transaminitis (adjusted odds ratio, 5.67; 95% confidence interval, 1.27–25.43), elevated procalcitonin levels (adjusted odds ratio, 16.60; 95% confidence interval, 2.61–105.46), and elevated lactate dehydrogenase levels (adjusted odds ratio, 17.55; 95% confidence interval, 2.51–122.78) were independently associated with severe to critical disease rather than mild to moderate disease after adjusting for maternal age and obesity. For differentiating disease severity, sensitivity rates for transaminitis, procalcitonin elevation, and lactate dehydrogenase elevation were 47%, 87%, and 53%, respectively, whereas the specificity rates were 89%, 63%, and 90%, respectively.CONCLUSIONInflammatory biomarkers in pregnant patients with SARS-CoV-2 infection exhibited vast heterogeneity, poor discriminative ability, and thereby limited clinical utility. Larger registry studies should evaluate which inflammatory biomarkers may be most useful for risk stratification and prognostication of pregnant patients with SARS-CoV-2 infection, taking into account the physiology of pregnancy.

Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic

Prior studies on COVID-19 and pregnancy have reported higher rates of cesarean delivery and preterm birth and increased morbidity and mortality. Additional data encompassing a longer time period are needed. To examine characteristics and outcomes of a large US cohort of women who underwent childbirth with vs without COVID-19. This cohort study compared characteristics and outcomes of women (age ≥18 years) who underwent childbirth with vs without COVID-19 between March 1, 2020, and February 28, 2021, at 499 US academic medical centers or community affiliates. Follow-up was limited to in-hospital course and discharge destination. Childbirth was defined by clinical classification software procedural codes of 134-137. A diagnosis of COVID-19 was identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis of U07.1. Data were analyzed from April 1 to April 30, 2021. The presence of a COVID-19 diagnosis using ICD-10. Analyses compared demographic characteristics, gestational age, and comorbidities. The primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay, intensive care unit (ICU) admission, mechanical ventilation, and discharge status. Continuous variables were analyzed using t test, and categorical variables were analyzed using χ2. Among 869 079 women, 18 715 (2.2%) had COVID-19, and 850 364 (97.8%) did not. Most women were aged 18 to 30 years (11 550 women with COVID-19 [61.7%]; 447 534 women without COVID-19 [52.6%]) and were White (8060 White women [43.1%] in the COVID-19 cohort; 499 501 White women (58.7%) in the non-COVID-19 cohort). There was no significant increase in cesarean delivery among women with COVID-19 (6088 women [32.5%] vs 273 810 women [32.3%]; P = .57). Women with COVID-19 were more likely to have preterm birth (3072 women [16.4%] vs 97 967 women [11.5%]; P < .001). Women giving birth with COVID-19, compared with women without COVID-19, had significantly higher rates of ICU admission (977 women [5.2%] vs 7943 women [0.9%]; odds ratio [OR], 5.84 [95% CI, 5.46-6.25]; P < .001), respiratory intubation and mechanical ventilation (275 women [1.5%] vs 884 women [0.1%]; OR, 14.33 [95% CI, 12.50-16.42]; P < .001), and in-hospital mortality (24 women [0.1%] vs 71 [<0.01%]; OR, 15.38 [95% CI, 9.68-24.43]; P < .001). This retrospective cohort study found that women with COVID-19 giving birth had higher rates of mortality, intubation, ICU admission, and preterm birth than women without COVID-19.

Anti-Racism and Anti-Colonialism Praxis in Global Health-Reflection and Action for Practitioners in US Academic Medical Centers.

ABSTRACT.The movement to decolonize global health and address power inequities among its actors is not new. Founded on the work of colonized and marginalized people themselves, initiatives at universities, schools of public health, and international development organizations have emerged to call for anti-racism and anti-colonialism within the field. US Academic Medical Centers (AMCs) have been less vocal in this wider discussion, despite their large engagement in the field through clinical, research, and medical education activities. As global health practitioners currently based at an AMC, we believe that it is important to critically evaluate our practices. We therefore propose three starting questions for our colleagues and students to consider and act upon as they adopt and navigate a praxis in anti-racism and anti-colonialism as foundational principles in global health. These questions call on us to closely examine the legacies of racism and colonialism in global health, the value placed on different ways of knowing in this field, and our motivations for engaging in this work. They are presented as a tool to reexamine global health, challenging the constructed binary of the “global South” and “global North,” and the perceived ideas of poverty and resource scarcity as the natural immutable reality of the global South.

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center.

There is growing interest from multiple specialties, including internal medicine, to incorporate diagnostic point of care ultrasound (POCUS) into standard clinical care. However, few internists currently use POCUS. The objective of this study was to understand the current determinants of POCUS adoption at both the health system and clinician level at a U.S. academic medical center from the perspective of multi-level stakeholders. We performed semi-structured interviews of multi-level stakeholders including hospitalists, subspecialists, and hospital leaders at an academic medical center in the U.S. Questions regarding the determinants of POCUS adoption were asked of study participants. Using the framework method, team-based analysis of interview transcripts were guided by the contextual domains of the Practical Robust Implementation and Sustainability Model (PRISM). Thirty-one stakeholders with diverse roles in POCUS adoption were interviewed. Analysis of interviews revealed three overarching themes that stakeholders considered important to adoption by clinicians and health systems: clinical impact, efficiency and cost. Subthemes included two that were deemed essential to high-fidelity implementation: the development of credentialing policies and robust quality assurance processes. These findings identify potential determinants of system and clinician level adoption that may be leveraged to achieve high-fidelity implementation of POCUS applications that result in improved patient outcomes.

Use of Tokyo Guidelines (TG-18) for Acute Cholangitis Provides Improved Specificity and Accuracy Compared to Fellow Clinical Assessment: A US Academic Center Pilot Study

Acute cholangitis is a serious medical problem unless treated early. Although the diagnostic grading criteria on the 2018 Tokyo Guidelines (TG18) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice (2). Our study aims to apply and compare if the Tokyo 2018 guidelines can improve diagnostic accuracy and assist in earlier detection of acute cholangitis in an academic center in the United States.

Homenagem: Remembering the Life and Work of Abdias Nascimento

This essay provides a brief introduction to this special issue focused on the life and work of Black Brazilian scholar-activist Abdias Nascimento. The contributors include, Vera Lucia Benedito, Ollie Johnson, Zachary Morgan, Elisa Larkin Nascimento, and Cheryl Sterling who all participated in a 2015 conference at Africana Studies at Brown University. This group of scholars aptly illustrate that Nascimento had long contributed to the internationalization of Black Studies as a field in US academe and he was crucial in establishing Brazil as a central component of the Black World. The essays have much to teach us about Nascimento’s views on the relationship between art and politics, the role of military service in shaping his activism, the significance of black politicians in the reconceptualization of Brazilian democracy, and the importance of preserving archives and expanding our understanding of the Black radical tradition.

Discharge Practices for COVID-19 Patients: Rapid Review of Published Guidance and Synthesis of Documents and Practices at 22 US Academic Medical Centers.

BackgroundThere are currently no evidence-based guidelines that provide standardized criteria for the discharge of COVID-19 patients from the hospital.ObjectiveTo address this gap in practice guidance, we reviewed published guidance and collected discharge protocols and procedures to identify and synthesize common practices.DesignRapid review of existing guidance from US and non-US public health organizations and professional societies and qualitative review using content analysis of discharge documents collected from a national sample of US academic medical centers with follow-up survey of hospital leadersSetting and ParticipantsWe reviewed 65 websites for major professional societies and public health organizations and collected documents from 22 Academic Medical Centers (AMCs) in the US participating in the HOspital MEdicine Reengineering Network (HOMERuN).ResultsWe synthesized data regarding common practices around 5 major domains: (1) isolation and transmission mitigation; (2) criteria for discharge to non-home settings including skilled nursing, assisted living, or homeless; (3) clinical criteria for discharge including oxygenation levels, fever, and symptom improvement; (4) social support and ability to perform activities of daily living; (5) post-discharge instructions, monitoring, and follow-up.LimitationsWe used streamlined methods for rapid review of published guidance and collected discharge documents only in a focused sample of US academic medical centers.ConclusionAMCs studied showed strong consensus on discharge practices for COVID-19 patients related to post-discharge isolation and transmission mitigation for home and non-home settings. There was high concordance among AMCs that discharge practices should address COVID-19-specific factors in clinical, functional, and post-discharge monitoring domains although definitions and details varied.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06711-x.

Analysis of COVID-19 Patients With Acute Respiratory Distress Syndrome Managed With Extracorporeal Membrane Oxygenation at US Academic Centers.

Objective:This study analyzed the outcomes of COVID-19 patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers.Summary Background Data:ECMO has been utilized in COVID-19 patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia. Early case series with the use of ECMO in these patients reported high mortality exceeding 90%.Methods:Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April and September 2020, were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay, and direct cost. For comparative purposes, the outcome of a subset of COVID-19 patients aged between 18 and 64 years and managed with versus without ECMO were examined.Results:1,182 patients with COVID-19 and ARDS received ECMO. In-hospital mortality was 45.9%, mean length of stay was 36.8 ± 24.9 days, and mean ICU stay was 29.1 ± 17.3 days. In-hospital mortality according to age group was 25.2% for 1 to 30 years; 42.2% for 31 to 50 years; 53.2% for 51 to 64 years; and 73.7% for ≥65 years. A subset analysis of COVID-19 patients, aged 18 to 64 years with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups (44.6% with ECMO vs 37.9% without ECMO).Conclusions:In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO.

P35.19 The Mutational Landscape in South Asian Patients with Non-Small Cell Lung Cancer at an US Academic Medical Center

Various molecular underpinnings of lung cancer have been noted in Asian populations, especially with targetable mutations such as EGFR and ALK (Doval et al., Ann Oncol 2014). However, the distribution and prevalance of these mutations have been less well characterized in South Asian/Indian patients, especially those who live outside of South Asia. We performed a retrospective review of NSCLC cases from 2005-2019, at Stanford Cancer Center, USA, and identified seventy-two patients who had a South Asian name. Their ethnicity was confirmed with manual review, with inclusion of patients noting origin from India, Pakistan, Bangladesh, or Sri Lanka. Patients were excluded if they did not have a confirmation of their ethnicity in the electronic medical record. Molecular testing data and type of methodology used for testing was also collected. 72 patients were identified from 2005-2019, of which 63 patients had mutational testing (from 2009-2019) performed. Of the 9 patients who had no mutational testing, 7/9 had non metastatic disease. Demographics and testing characteristics are shown in Table 1. 35 of 63 patients had targetable mutations (55.6%), with 21 patients with EGFR activating mutations (exon 19 deletion or exon 21 L858R) (33.3% of 63 patients).. Other mutations included 8 ALK rearrangements (12.7%), 6 KRAS mutations (9.5%), 2 ROS1 fusions (3.1%), and 2 BRAF V600E mutations (3.1%) (Figure 1). In assessing co-mutations, 3 ARID1A and 3 STK11 mutations were noted.Table 1N= 72Female37 (51%)Median age of diagnosis, years (range)64 (38-89)Non-Smoker62 (86%)Country of Origin/EthnicityIndia- 68 (94%) Pakistan- 3 (4%) Bangladesh-1 (1%)PathologyAdenocarcinoma- 63 (88%) Adenocarcinoma with Mixed Features- 4 (6%) Squamous (4%)Stage of DiseaseI or II- 12 (17%) I or II with recurrence- 7 (10%) III- 7 (10%) III with recurrence-1 (1%) IV-45 (63%)Type of TestingFluorescence in situ hybridization (FISH) only – 3 (4%) Next Generation Sequencing (NGS)- 34 (47%) Polymerase Chain Reaction (PCR) (includes ddPCR)- 27 (37.5%) Open table in a new tab South Asian patients, largely of Indian origin, with NSCLC at an US academic center appear to have a high chance of harboring a driver mutation, emphasizing the importance of molecular testing in this population. These findings corroborate rates of mutations reported from South Asia, and suggest similar trends in mutation prevalance despite different geographical locations. We are collaborating with an institution in Northern India to further compare and report on the molecular landscape of this population.

What Is Empathy: Cancer Patients’ Perceptions of an Ill-Defined Construct (F415D)

1.Identify and reflect on behaviors that one conceives in their own practice as conveying empathy.2.Describe key categories of behaviors perceived by patients with cancer to convey empathy.3.Discuss integrating behaviors and actions that can heighten perceived empathy among patients with cancer. Patients, clinicians, and healthcare systems associate empathy with high quality medical care. High patient ratings on survey instruments used to assess empathy are associated with greater patient satisfaction, increased self-efficacy, and reduced emotional distress following consultation. These instruments lacked patient input in their development. Because patients have not, to our knowledge, been directly queried on their definition of physician empathy, we investigated their perspectives on this question. We wanted to examine the range and homogeneity of patients’ views, and to compare with constructs used in research and quality assessment. We elicited up to 10 open-ended descriptions of how an empathic physician would behave from 89 patients receiving ambulatory and inpatient care in an academic US cancer center. Three members of the research team independently coded 363 free-response items using an inductive thematic analysis approach to identify latent themes. Disagreements were adjudicated among the three coders and further disagreements were referred to a fourth coder for final decision. Qualitative analysis elucidated 8 themes—physician competency and accessibility, physician demeanor, communication, attention to what matters to the patient, institutional resources, information sharing, attention to emotion, and interpersonal sensitivity. Responses representing “attention to what matters most to the patient,” e.g. “Asking how things are at home,” were most common. This is the first study to derive insights on empathy from patients. Intensive exposure to the healthcare system by patients with cancer gives them an in-depth perspective into behaviors that result in high-quality, patient-centered care. Some but not all of the thematic categories align with researcher-derived empathy assessment instruments.

Funding Public Health: Achievements and Challenges in Public Health Financing Since the Institute of Medicine's 2012 Report.

The purpose of this study was to review changes in public health finance since the 2012 Institute of Medicine (IOM) report "For the Public's Health: Investing in a Healthier Future." Qualitative study involving key informant interviews. Purposive sample of US public health practitioners, leaders, and academics expected to be knowledgeable about the report recommendations, public health practice, and changes in public health finance since the report. Qualitative feedback about changes to public health finance since the report. Thirty-two interviews were conducted between April and May 2019. The greatest momentum toward the report recommendations has occurred predominantly at the state and local levels, with recommendations requiring federal action making less progress. In addition, much of the progress identified is consensus building and preparation for change rather than clear changes. Overall, progress toward the recommendations has been slow. Many of the achievements reported by respondents were characterized as increased dialogue and individual state or local progress rather than widespread, identifiable policy or practice changes. Participants suggested that public health as a field needs to achieve further consensus and a uniform voice in order to advocate for changes at a federal level. Slow progress in achieving 2012 IOM Finance Report recommendations and lack of a cohesive voice pose threats to the public's health, as can be seen in the context of COVID-19 emergency response activities. The pandemic and the nation's inadequate response have highlighted deficiencies in our current system and emphasize the need for coordinated and sustained core public health infrastructure funding at the federal level.

96 Preterm birth disparities at a single United States academic institution during the COVID pandemic

International reports suggest lower preterm birth (PTB) rates during the COVID pandemic. We sought to describe the PTB rate during COVID pandemic compared to prior years in a single academic US hospital system while stratifying for race and ethnicity.

Oligopoly and the End of US Academic Medicine-Resistance Is Not Futile.

We read the article “Strength in Numbers: National Practice Radiology Versus Academic Radiology” [1] with interest and welcome the invitation to join the discussion and address the important issues raised therein.

Metadata Analysis Reveals Major Worldwide Trends in Industrial and Academic Geophysics

We summarize our metadata analysis of the last 38 well-attended annual conferences, organized by the Society of Exploration Geophysicists. In 2018, Schlumberger and Saudi Aramco had the highest number of publications among service and production companies. In 2019, BGP and PetroChina took the lead. Throughout history, US academics have had the highest number of publications, but in 2019 Chinese academia came close to taking the lead. Analysis of the publication activity of oil-producing and oilfield service companies provides insights into the state of geophysical research. The number of publications from industrial companies in the energy sector reflects their financial standing and aspirations for the near future. Publications from academia in different countries tell us about state and private funding of research in each country, and indirectly reflect the geopolitical situation in the world. The changing number of publications over time reflects the dynamics of the transformation of research in geophysics, and allows us to understand better what is happening and make forecasts.

Assessing Readability of Patient Education Materials on Breast Reconstruction by Major US Academic Hospitals as Compared With Nonacademic Sites.

Women undergoing postmastectomy breast reconstruction face many complex choices. A myriad of online patient education materials exist to assist in decision making. Understanding of these materials, termed health literacy, affects surgical decision making and outcomes. The National Institutes of Health recommends writing patient education materials at a sixth- to seventh-grade reading level. The primary goal of this study was to assess readability of online breast reconstruction materials. Resources were collected from every academic hospital with a plastic surgery residency program, 97 in total. These data were compared with the top nonacademic Web sites ranked by search engine results, 14 in total. Materials were analyzed using 3 validated readability assessment scales: Coleman-Liau Index, SMOG (Simplified Measure of Gobbledygook) Readability Formula, and Flesch-Kincaid Grade Level. Average readability was analyzed, and results were compared using a 1-way analysis of variance to assess for significance between the different tools and a 2-sided t test to assess for significance between academic and nonacademic readability results. The mean readability scores across the academic programs were a Coleman-Liau Index of 13.38 (standard Deviation [SD] 2.81, 13th to 14th grade), Flesch-Kincaid Grade Level of 13.04 (SD = 3.9, 13th grade), and SMOG Readability of 13.64 (SD = 2.99, 13th to 14th grade). For the 14 nonacademic sites, results showed a Coleman-Liau Index of 11.93 (SD = 1.14, 12th grade), Flesch-Kincaid of 11.82 (SD = 2.33, 11th to 12th grade), and SMOG Readability of 10.91 (SD = 1.79, 11th grade). One-way analysis of variance demonstrated no significant differences in mean readability scores across the 3 readability tools used (academic F = 2.7804, P = 0.06; nonacademic F = 1.14, P = 0.33). Two-tailed t test results demonstrated that there was statistical significance between readability of the academic in comparison with nonacademic search engine results (t = 2.04, P = 0.04). Average readability across all Web sites were much higher than the recommended reading level, at a 13th to 14th grade reading level for academic institutions, and an 11th to 12th grade for nonacademic Web sites. Plastic surgeons may contribute to improving patient understanding and perioperative outcomes through revising patient education materials.

The Adoption of non-Chinese Names as Identity Markers of Chinese International Students in Japan: A Case Study at a Japanese Comprehensive Research University

This study explores naming practices among Chinese international students and their relation to personal identity during their sojourn in Japan. Although previous studies have reported that some Chinese international students in English-speaking countries adopt names of Western origin (Cotterill 2020 Cotterill, Simon. 2020. “Call Me Fei: Chinese-Speaking Students’ Decision Whether or Not to Use English Names in Classroom Interaction.” Language, Culture and Curriculum 33, no. 3: 228–214. https://doi.org/10.1080/07908318.2019.1614598.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Diao 2014 Diao, Wenhao. 2014. “Between Ethnic and English Names: Name Choice for Transnational Chinese Students in a US Academic Community.” Journal of International Students 4, no. 3: 205–222. http://search.proquest.com/docview/1776144300?accountid=12528%5Cn http://search.lib.monash.edu/openurl/MUA/MUL_SERVICES_PAGE?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ:education&atitle=Between+Ethnic+and+Englis.[Crossref] , [Google Scholar]; Edwards 2006 Edwards, Rachel. 2006. “What’s in a Name? Chinese Learners and the Practice of Adopting ‘English’ Names.” Language, Culture and Curriculum 19, no. 1: 90–103. https://doi.org/10.1080/07908310608668756.[Taylor & Francis Online] , [Google Scholar]), participants in this study were found to exhibit different naming practices: either adopting names of Japanese or Western origin; or retaining both Western and Japanese names. Drawing on fifteen semi-structured interviews with Mainland Han Chinese students, this investigation examines their motivations for adopting non-Chinese names and determines how personal identities are presented through them. The qualitative analysis reveals that the practice of adopting non-Chinese names is influenced by teacher-student power relations, Chinese conventions for terms of address, pronunciation, and context-sensitivity of personal names. As will be shown in this article, through the respondents’ years of self-exploration, their self-adopted non-Chinese names gradually became internalized personal identity markers that allow the bearers to explore and exhibit personality traits, which might not have been as easily displayed via their Chinese given names.

CNS Prophylaxis during Front-Line Therapy in Aggressive Non-Hodgkin Lymphomas: Real-World Outcomes and Practice Patterns from 19 US Academic Institutions

CNS Prophylaxis during Front-Line Therapy in Aggressive Non-Hodgkin Lymphomas: Real-World Outcomes and Practice Patterns from 19 US Academic Institutions