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Background Rituximab is actively used as a rescue therapy for nephrotic syndrome (NS). The development of antidrug antibodies, including antirituximab antibodies (ARA) and human antichimeric antibodies (HACA), is reported with rituximab treatment in various diseases. Here we report two pediatric patients with NS who developed ARA. Case diagnosis and treatment Rituximab was given as a rescue therapy for two patients with steroid-dependent NS. Both patients had been treated orally with glucocorticosteroid, methylprednisolone, and calcineurin inhibitors but experienced frequent relapses. With rituximab treatment, the patients remained in remission for several months. After the B-cell count recovered, the patients received a second course of rituximab administration and experienced a hypersensitivity reaction during drug infusion. CD19 cell counts rose despite treatment with rituximab. ARA titers were monitored before and after rituximab treatment, and the development of ARA after the second course of rituximab administration was confirmed. Conclusions We report the development of HACA in two patients with NS who did not achieve B-cell depletion after repeated administration of rituximab. This report suggests that additional studies are needed to determine the incidence of ARA in patients with NS, and its clinical significance. Keywords Nephrotic syndrome * Rituximab * Human antichimeric antibody, Introduction Rituximab, a chimeric monoclonal antibody against the CD20 antigen on B cells, is used as a steroid-or calcineurin-inhibitor-sparing agent in steroid-dependent nephrotic syndrome (SDNS), often with satisfactory results [1,2]. [...]

Why do some UN targeted sanctions (or "smart" sanctions) cause collateral damage to the general population, while others minimize it? We suggest the scope and the effectiveness of smart sanctions, as well as the political institutions of target countries, are critical determinants of sanctions' adverse effects on human rights. Leaders targeted by sanctions with a broad scope will have a greater incentive to oppress people to ward off potential support for challengers. The degree to which they can carry out successful oppression, however, hinges upon the effectiveness of the implementation of sanctions. Furthermore, we expect that authoritarian systems are more likely to encourage oppression than other ones. We conduct a quantitative analysis of 56 UN-imposed smart sanction episodes. Our study reveals sanctions with a broad scope that are less effective result in deteriorated human rights conditions, especially in authoritarian countries. However, we find when sanctions with a narrow scope work effectively, they do not hurt innocent citizens. [ABSTRACT FROM AUTHOR]

Conflict across African states has often been linked to ethnic-based biases in government, and exclusive policies. However, the domestic politics of developing states, and the elites who contest for power therein, have often been overlooked when explaining the patterns and risk of disorder and violence. We consider how African leaders practice politics in whom to represent, and at what level. These choices have consequences as how regimes accommodate political elites creates different competitive conditions which, in turn, create incentives and opportunities for political violence. Using a dataset on cabinet appointments over twenty years, we find that high levels of elite political inclusion and mal-apportionment in positions is consistently associated with increases in non-state violence. Power distribution levels among those groups included in senior positions account for more political violence than that which stems from exclusive politics. [ABSTRACT FROM AUTHOR]

The prevention of cheating and other security issues concerning online game development are discussed.