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Evaluate the real-world costs over two years and costs by site of care for ocrelizumab (OCR), natalizumab (NTZ), and alemtuzumab (ATZ) in patients with multiple sclerosis (MS). This retrospective study used HealthCore Integrated Research Database and included continuously enrolled adults with MS initiating OCR, NTZ, and ATZ between April 2017 and July 2019 (i.e. patient identification period). Annual total cost of care (pharmacy and medical costs) was evaluated for the first- and second-year of follow-up, further stratified by site of care. Costs were measured using health plan allowed amount and adjusted to 2019 US dollars. Sensitivity analyses were conducted in patients who completed yearly dosing schedule according to Food and Drug Administration approved prescribing information. Overall, 1,058, 166, and 46 patients were included in OCR, NTZ, and ATZ cohorts, respectively. Mean (standard deviation [SD]) total cost of care during first- and second-year follow-up were $125,597 ($72,274) and $109,618 ($75,085) for OCR, $117,033 ($57,102) and $106,626 ($54,872) for NTZ, and $179,809 ($97,530) and $108,636 ($77,973) for ATZ. Infusible drug cost was the main driver in all three cohorts accounting for >78% of the total costs. Annual total cost of care increased substantially after patients started/switched to infusible DMTs. Across site of care, hospital outpatient infusion was common (OCR 58%, NTZ 37%, ATZ 49%) and expensive followed by physician office infusion (OCR 28%, NTZ 40%, ATZ 16%); home infusion was the least common (<10%) and least expensive. The results were limited to commercially insured patients (specifically those with Anthem-affiliated health plans). Real-world costs increased after patients started/switched to infusible DMTs. Drug cost is the main driver for the total costs, which varied substantially by site of care. Controlling drug cost markups and using home setting for infusion can reduce costs in the treatment of MS patients. Ocrelizumab (OCR), natalizumab (NTZ), and alemtuzumab (ATZ) are infusible drugs to treat patients with multiple sclerosis (MS). We did a study to understand the costs of these infusible MS drugs in real-world settings by analyzing a patients' pharmacy and medical claims database. A total of 1,058 patients were included. We found that the annual total costs increased substantially after patients started to use these infusible MS drugs. Specifically, the average first- and second-year total costs for patients were $125,597 and $109,618 for OCR, $117,033 and $106,626 for NTZ, and $179,809 and $108,636 for ATZ, respectively. We also found that the cost of the drug itself is the main driver for the overall healthcare spending, accounting for >78% of the total costs. Additionally, we found that the cost varies depending on where patients receive these infusible MS drugs, and generally speaking, infusions received from hospital outpatient settings would be more expensive than received from home settings. In summary, this study showed that the real-world costs of these infusible MS drugs are very high. Shifting patients away from more costly hospital outpatient departments or using MS drugs that do not require infusion resources (e.g. oral/self-injectable) may help reduce the overall healthcare spending on MS. [ABSTRACT FROM AUTHOR]

Foe (1986) is one of the most ambiguous and controversial novels written by J.M. Coetzee, and has been discussed extensively by criticism from a great variety of theoretical positions. This essay purports to contribute another intertextual reading of the novel, trying to elucidate some of its dark points, particularly section IV, which has been so much debated and for whose ambiguity no wholly satisfactory explanation has so far been produced. Our main contention is that, in addition to Borges's narratives "Pierre Menard, Author of the Quixote" (in Fictions, 1944) and "Borges and I" (in The Maker, 1960), Coetzee's novel can benefit from a parallel reading of other Borgesian tales, particularly "Brodie's Report" (1970) and "The Writing of the God" (1949), among others. Borges's gnosticism is clearly followed by Coetzee, who has explicitly acknowledged his interest in the ethical and esthetic motivations that lie in some of Borges's most mysterious stories. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which discusses topics within the issue including issues of sexuality in Egypt; sovereignties of the Syrian civil war; and discourses of nation-building in Burma.

This article discusses how Rojava and its 'Autonomous Administration' simultaneously subvert and reinstate the state(s) they are fighting. Based on Abdullah Öcalan's (b. 1948) conversion to libertarianism after his imprisonment in 1999, the Syrian Kurdish Democratic Union Party (PYD) has been invested in presenting its political experiment as a 'stateless democracy', which has elicited both enthusiasm and suspicion from anarchists worldwide, and from large sections of the Western left. Far from trying to prove or disprove Rojava's own narrative, this article analyses how the construction of Rojava is a complex and often self-contradictory process, both at the rhetorical/propagandist level and in terms of actual military, political and social practices. By engaging many enemies (ISIS, al Nusra, the Free Syrian Army, the Assad regime, Iraqi Kurdistan, Turkey), both discursively and in battle, and trying to obtain support from various potential and mutually conflicting allies (the United States, Russia, Iraqi Kurdistan, the EU, the Western left, the Assad regime) the PYD/YPG-J (People's Protection Units) are entrenched in a fraught space in which subversion and mimicry coexist in uneasy tension. [ABSTRACT FROM AUTHOR]

This essay explores the images emerging from the Syrian conflict through the genre of war documentaries by focusing on the performance of sovereignty. Drawing on Foucault’s notion of governmentality and Butler’s performative theory, the author looks at states as performative agents that stage power in front of the camera as a form of self-legitimisation. War documentaries are part of a documentary war in which image, information and emotional involvement have become weaponised. He assesses a few examples of religious and secular sovereignty performed for journalists who are embedded with various militias. This genre is brought about through cooperation between the embedded reporters (i.e. working inside an army or militia) and the fighters assigned to protect and show them around the territory they control. This results in a symbiotic relationship in which both sides co-produce a heavily mediated image of the war from the inside, one that satisfies the journalist’s desire for ‘exclusive access’ and the fighter’s desire for recognition. Such a representational pact contributes a unique feature to the war documentary genre in which the films show the raw reality of war as much they offer an opportunity to perform the state before the camera. From this perspective, the fighters appear not only as destroyers but as builders of a new order, thus complicating the image of the jihadi as an irrational, nihilistic and violent subject. [ABSTRACT FROM AUTHOR]

Introduction: Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20). Objective: To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population. Method: In total, 225 patients diagnosed with psychotic, affective or personality disorders were included. The HCR-20 was applied at hospital admission and violent behaviours were assessed during psychiatric hospitalization using the Overt Aggression Scale (OAS). Construct validity, predictive validity and internal consistency were determined. Results: Violent behaviour remains more severe in patients classified in the high-risk group during hospitalization. Fifteen items displayed adequate communalities in the original designated domains of the HCR-20 and internal consistency of the instruments was high. Conclusion: The HCR-20 is a suitable instrument for predicting violence risk in Mexican psychiatric inpatients. [ABSTRACT FROM AUTHOR]

This paper presents a restructured set of axioms for categorical logic. In virtue of it, the syllogistic with indefinite terms is deduced and proved, within the categorical logic boundaries. As a result, the number of all the conclusive syllogisms is deduced through a simple and axiomatic methodology. Moreover, the distinction between immediate and mediate inferences disappears, which reinstitutes the unity of Aristotelian logic. [ABSTRACT FROM AUTHOR]

Available data involve neurotrophins and their receptors in carcinomas. Quantitative evaluation of these molecules in these tumors might be useful as prognostic marker and eventual treatments. Our study on 40 mammary tumors tries to correlate expression of these molecules and prognosis. Immunohistochemistry for NGF, BDNF, NT3, TrkA, TrkB, TrkC, and p75 was used. Patient's age, histopathology, Bloom-Richardson grading, estrogen and progesterone receptors, Ki-67 index, HER-2, p53 were evaluated. Statistics found inverse relationship between grading and TrkC expression. We found significantly higher TrkC expression in Grade I than in Grade III tumors. Rise in TrkC expression could indicate good prognosis. [ABSTRACT FROM AUTHOR]