Mobilization Failure Research Articles

A Novel Self-Forming Virtual Sub-Nets Based Cross-Layer MAC Protocol for Multihop Tactical Network

A tactical network mainly consists of software-defined radios (SDRs) integrated with programmable and reconfigurable features that provide the addition and customization of different waveforms for different scenarios, e.g., situational awareness, video, or voice transmission. The network, which is mission-critical, congested, and delay-sensitive, operates in infrastructure-less terrains with self-forming and self-healing capabilities. It demands reliability and the need to survive by seamlessly maintaining continuous network connectivity during mobility and link failures. SDR platforms transfer large amounts of data that must be processed with low latency transmissions. The state-of-the-art solutions lack the capability to provide high data throughput and incorporate overhead in route discovery and resource distribution that is not appropriate for resource-constrained mission-critical networks. A cross-layer design exploits existing resources to react to environment changes efficiently, enable reliability, and escalate network throughput. A solution that integrates SDR benefits and cross-layer optimization can perform all the mentioned operations efficiently. In tactical networks, SDR’s maximum usable bandwidth can be utilized by exploiting radios’ autonomous behavior. This paper presents a novel virtual sub-nets based cross-layer medium access control (VSCL-MAC) protocol for self-forming multihop tactical radio networks. It is a MAC-centric design with cross-layer optimization that enables dynamic routing and autonomous time-slot scheduling in a multichannel network environment among SDRs. The cross-layer coupling uses link-layer information from the hybrid of time division multiple access and frequency division multiple access (TDMA/FDMA) MAC to proactively enable distributed intelligent routing at the network layer. The virtual sub-nets based distributed algorithm exploits spectrum resources and provides call setup with persistently available k-hop route information and simultaneous collision-free transmission of voice and data. The experimental results over extensive simulations show significant performance improvements in terms of minimum control overhead, processing time in relay nodes, a substantial increase in network throughput, and lower data latency (up to 76.98%) compared to conventional time-slotted MAC protocols. The design is useful for mission-critical, time-sensitive networks and exploits multihop simultaneous communication in a distributed manner.

Comparison of prediction models for two different peripheral stem cell collection protocols in autologous patients. How to avoid errors in calculating total blood volume to process?

Introduction: Calculating accurate blood volume to process is a critical practice in apheresis planning; therefore, researchers try to develop dedicated prediction models. In this analysis, we have attempted to compare three algorithms for two different apheresis collection protocols. Methods: In a retrospective study, we have analyzed 137 apheresis procedures performed on 100 autologous patients. Apheresis procedures were performed with the Spectra Optia apheresis device with two protocols: mononuclear cell collection (MNC) and continuous mononuclear cell collection (cMNC). Three algorithms: a model based on mean collection efficiency (CE2), a linear regression model, and a power regression model were validated by plotting collected CD34 + cell dose versus predicted CD34 + cell dose. Results: All models showed high predictability for MNC procedure, a high correlation of predicted CD34 + yield and actual CD34 + yield ( R 2 = 0.9547; 0.9487; 0.9474 for CE2-based model, linear and power regression model, respectively). In contrast, alteration between models for the cMNC procedure was greater ( R 2 = 0.8049, 0.7970, and 0.8169) with a higher number of overpredictions. Further analysis revealed that for low CD34 + precounts blood volume to process, calculated with the three models, differ significantly up to fivefold times. Conclusions: Utilizing regression models may lead to calculation errors, which can affect undercollection, repetition of apheresis, or even mobilization failure. Contrary to regression models, the model based on mean CE2 gave the most accurate prediction both for MNC and cMNC procedures. Although new prediction algorithms are created, this simple formula remains a reliable tool that promotes careful planning of apheresis, thus improving patient safety.

First experience of the use of a generic of plerixafor in peripheral blood stem cell mobilization in multiple myeloma and lymphoma patients

Mobilization failure in patients is a major therapeutic concern which makes subsequent ASCT impossible. A new growth factor called Plerixafor (Mozobil®) developed by the pharmaceutical industry (Sanofi-aventis, France), is a chemoreceptor antagonist, CXCR4 type, which disrupts the interaction of SDFI and CXCR4, thereby enhancing the effect of G-CSF mobilization and is especially indicated for mobilization failure. Currently, there is a generic of plerixafor developed by the pharmaceutical industry (Hetero Drugs Ltd, India). The brand name of this medicine is Mozifor®. The objective of this study was to evaluate if generic plerixafor has the same efficacy and safety as originator plerixafor when used with G-CSF in the mobilization of PBSCs for autologous ASCT in multiple myeloma (MM) and lymphoma failure patients. The 32 patients received plerixafor were divided in two groups. The first group concerns the 11 consecutive patients prospectively received generic plerixafor (Mozifor®) in the period between January to July 2020. These were compared with a retrospective control cohort (second group n = 21) who had been treated between 2009 and 2019 with originator plerixafor (Mozobil®). For the Mozifor® group, the mean CD34+ was 4.54x106/kg(1.56-6.79), the median time to achieve an absolute neutrophil count >0.5 G/L was 13 days (range: 8–21). The median time to self-sustained platelet count >20 G/L was 15 days (range: 8–24). For the Mozobil® group, the mean CD34+ was 3.1x106/kg (0.56-8.91) (p=0.86), the median time to achieve an absolute neutrophil count >0.5 G/L was 10 days (range 7–23). The median time to self-sustained platelet count >20 G/L was 13 days (range: 7–29). Our study showed that the generic of plerixafor was practically identical to that of the originator (Mozobil®) with no significant difference (p = 0.52). This study demonstrates the safety and feasibility of mobilization PBSC with generic plerixafor in ASCT in MM and lymphoma. Although these outcomes are encouraging, prospective comparison with other traditional auto-HCT regimens used for patients with MM and lymphoma is warranted.

Low-Dose Cyclophosphamide versus Intermediate-High-Dose Cyclophosphamide versus Granulocyte Colony-Stimulating Factor Alone for Stem Cell Mobilization in Multiple Myeloma in the Era of Novel Agents: A Multicenter Retrospective Study

The optimal stem cell (SC) mobilization strategy for patients with multiple myeloma (MM) remains a matter of debate. Possible approaches include low or high doses of cyclophosphamide (Cy), other chemotherapeutic agents, or granulocyte colony-stimulating factor (G-CSF) alone. The scope of the study was to compare low-dose Cy plus G-CSF versus intermediate-high-dose Cy plus G-CSF versus G-CSF alone for SC mobilization in MM, in terms of efficacy and safety. We retrospectively analyzed 422 MM patients undergoing SC mobilization in 6 Italian centers, including 188 patients who received low-dose Cy (LD-Cy group, defined as 2 g/m2), 163 patients who received intermediate-high-dose Cy (HD-Cy group, defined as ≥ 3 g/m2), and 71 patients who received G-CSF alone (G-CSF group). The median peak of circulating CD34+ cells was 77/µL in the LD-Cy group, 92/µL in the HD-Cy group, and 55/µL in the G-CSF group (P=.0001). The median amount of SCs collected was 9.1×106/kg, 9.7×106/kg, and 5.6×106/kg in the 3 groups, respectively (P=.0001). The rate of mobilization failure (defined as failure to collect ≥2×106/kg) was 3.7% in the LD-Cy group, 3.4% in the HD-Cy group, and 4.3% in the G-CSF group (P=.9). The target SC dose of at least 4×106/kg was reached in 90.4%, 91.1%, and 78.6% of the patients in these 3 groups, respectively (P=.014). The "on demand" use of plerixafor was higher in the G-CSF group (76%) compared with the LD-Cy group (19%) and the HD-Cy group (6%). In multivariate analysis, G-CSF mobilization and previous use of melphalan or radiotherapy were independently associated with failure to collect the target SC dose of ≥4×106/kg. No impacts of age, blood counts, or previous treatment with lenalidomide, bortezomib, or carfilzomib were observed. Our results suggest that LD-Cy may be considered for successful SC mobilization in patients with MM.

Poor mobilization of autologous CD34+ peripheral blood stem cells in haematology patients undergoing autologous stem cell transplantation is associated with the presence of variants in genes implicated in clonal haematopoiesis of indeterminant potential.

Clonal haematopoiesis of indeterminant potential (CHIP) increases in frequency with age. The effect of CHIP on the mobilization of autologous CD34+ peripheral blood stem cells (PBSC) has not been reported. This study uses a DNA-based targeted candidate gene approach to identify the presence of somatic mutations in ASXL1, DNMT3A, JAK2, SF3B1, TET2 and TP53 in CD34+ haematopoietic progenitor cell-apheresis products of 96 patients who undergo PBSC mobilization for autologous stem cell transplantation (ASCT). Variants were identified in a significantly greater proportion of patients who experience poor CD34+ PBSC mobilization. A DNA-based targeted candidate gene array is able to predict poor CD34+ PBSC mobilization and may be deployed pre-emptively to minimize mobilization and graft failures.

A multicenter report on the safety and efficacy of plerixafor based stem cell mobilization in children with malignant disorders.

Pleraxifor for peripheral blood stem cell (PBSC) mobilization in children with malignancies is often given following failure of standard mobilization (SM) rather than as a primary mobilizing agent. In this retrospective multicenter study, we report the safety of plerixafor-based PBSC mobilization in children with malignancies and compare outcomes between patients who received plerixafor upfront with SM (Group A) with those who received plerixafor following failure of SM (Group B). In the latter pleraxifor was given either following a low peripheral blood (PB) CD34 (<20 cells/cu.mm) (Group B1) or as a second collection process due to an unsuccessful yield (CD34 + < 2 × 106 /kg) (Group B2) following failed SM and first apheresis attempts. The study cohort (n = 47) with a median age of 8 (range 0.6-21) year, comprised 19 (40%) Group A and 28 (60%) Group B patients (B1 = 12 and B2 = 16). Pleraxifor mobilization was successful in 87.2% of patients, similar between Groups A and B (84.2% vs 89.2%) and resulted in a median 4-fold increase in PB CD34. Median number of apheresis attempts was 2 in Groups A and B1 but 4 in Group B2. In Group B2, median total CD34+ yield post-plerixafor was 9-fold higher than after SM (P = .0013). Mild to moderate transient adverse events affected 8.5% of patients. Among patients who proceeded to autologous transplant (n = 39), all but one engrafted. Plerixafor-based PBSC collection was safe and effective in our cohort and supports consideration as a primary mobilizing agent in children with malignancies.

Addition of plerixafor to G-CSF in poor mobilizing healthy related donors overcame mobilization failure: An observational case series on behalf of the Grupo Español de Trasplante Hematopoyético (GETH)

Plerixafor (Mozobil, Sanofi) is approved for using in patients with lymphoma and multiple myeloma when steady-state mobilization strategies fail. Although off-label use of plerixafor in healthy related donors (HRD) is known, limited data are available and no recommendations exist to guide its use in this setting. With the aim of collecting data from HRDs who received plerixafor in our country, we designed an observational case series study within the Spanish Group of Hematopoietic Transplant and Cell Therapy (GETH). Plerixafor was administered subcutaneously to 30 HRDs at a median dose of 0.24 mg/Kg (interquartile range (IQR): 0.23−0.25) because mobilization failure after using mobilization with G-CSF (mobilization failure was defined as collection of <4.0 × 106 CD34+ cells/Kg recipient). All HRDs received G-CSF at a median dose of 11 μg/Kg/day (IQR: 10–12) for 4–5 days. Leukocytapheresis after G-CSF mobilization was performed in 23 (77 %) HRDs collecting a median of 1.6 × 106 CD34+ cells/Kg recipient weight (IQR: 0.9–2.5). Addition of plerixafor allowed the collection of a higher median number of CD34 cells (4.98 × 106 CD34+ cells/Kg recipient weight (IQR: 3.5–5.8)) when compared with the collection of CD34+ cells with G-CSF alone (p < 0.01). The final median total number of CD34+ cells collected was 6.1 × 106/Kg recipient weight (IQR: 4.8–7.3). Mild adverse events related with plerixafor administration were reported in 8 (27 %) donors. In conclusion, addition of plerixafor after G-CSF mobilization failure in HRDs allowed collecting higher number of CD34+ cells in comparison with steady-state mobilization.

Percolation thresholds for robust network connectivity

Communication networks, power grids, and transportation networks are all examples of networks whose performance depends on reliable connectivity of their underlying network components even in the presence of usual network dynamics due to mobility, node or edge failures, and varying traffic loads. Percolation theory quantifies the threshold value of a local control parameter such as a node occupation (resp., deletion) probability or an edge activation (resp., removal) probability above (resp., below) which there exists a giant connected component (GCC), a connected component comprising of a number of occupied nodes and active edges whose size is proportional to the size of the network itself. Any pair of occupied nodes in the GCC is connected via at least one path comprised of active edges and occupied nodes. The mere existence of the GCC itself does not guarantee that the long-range connectivity would be robust, e.g. to random link or node failures due to network dynamics. In this paper, we explore new percolation thresholds that guarantee not only spanning network connectivity, but also robustness. We define and analyze four measures of robust network connectivity, explore their interrelationships, and numerically evaluate the respective robust percolation thresholds for the 2D square lattice.

Is absence of CD56 a predictive factor for peripheral blood stem cell mobilization failure in patients with multiple myeloma?

CD56 is believed to play a major role in MM pathogenesis with a 70% to 80% expression rate in malignant plasma cells at the time of diagnosis. Our objective in this study was to investigate the relationship between the characteristics of CD56 expression in bone marrow aspiration material at the time of diagnosis and the success of stem cell mobilization in patients diagnosed with MM. This monocenter study included 94 patients who were diagnosed with MM and had a stem cell mobilization procedure for autologous hematopoietic stem cell transplantation. The primary endpoint of the study was to compare the mobilization success between the groups with and without CD56 expression. The secondary endpoint was to identify other factors affecting mobilization failure outside CD56. At the time of diagnosis, 49 (52.1%) patients had CD56 expression and 45 (47.9%) did not. Mobilization failed in 11 (11.7%) patients. Age, gender, ISS stage and the number of premobilization treatment regimens were not found predictive of mobilization failure. CD56 negativity was 42.2% in the group that had mobilization success and 90.9% in the group that had mobilization failure (P= .001). The fact that CD56 residing on the membrane enables interaction between bone marrow cells and ECM and functions as a signal molecule increases sensitivity to the chemotherapy and G-CSF that are used for mobilization. We found that absence of CD56 can be used as a predictive factor for mobilization failure at the time of diagnosis.

Prediction of Stem Cell Mobilization Failure in Patients with Hodgkin and Non-Hodgkin Lymphoma

Objective:Autologous stem cell transplantation (ASCT) is a significant and potentially curative treatment modality for patients with relapsed/refractory lymphoma. Insufficient mobilization and harvest of peripheral stem cells can be a major obstacle for performing ASCT. The aim of this study was to evaluate the factors that might influence mobilization failure in patients with lymphoma.Materials and Methods:Eighty-seven patients diagnosed with non-Hodgkin and Hodgkin lymphoma who underwent stem cell mobilization afterwards at the Hacettepe University Medical School Bone Marrow Transplantation Center, Turkey, between the years of 2000 and 2018 were evaluated.Results:A total of 87 patients were included in this study. In 66 of 87 patients (75.9%), the first mobilization trial was successful. Adequate (≥2x106/kg) CD34+ cells were collected in the first apheresis for 66 patients (9.5±8.1). For 21 of 87 (24.1%), the first mobilization trial was unsuccessful. Therefore, a second mobilization trial was performed for these patients with plerixafor (5.5±3.3). The number of CD34+ cells was significantly higher in patients who were successful in the first mobilization (p=0.002).Conclusion:The success rate of the first mobilization trial was found to be higher in patients with high platelet counts before mobilization and patients who received chemotherapy-based mobilization protocols. In the patients who had mobilization failure in the first trial, plerixafor was used in a later mobilization, and those patients had an adequate amount of stem cells for ASCT. Parameters predicting mobilization failure would allow for preemptive, more cost-effective use of such agents during the first mobilization attempt; however, risk factors for mobilization failure are still not clear.

IMOC: Optimization Technique for Drone-Assisted VANET (DAV) Based on Moth Flame Optimization

Technology advancement in the field of vehicular ad hoc networks (VANETs) improves smart transportation along with its many other applications. Routing in VANETs is difficult as compared to mobile ad hoc networks (MANETs); topological constraints such as high mobility, node density, and frequent path failure make the VANET routing more challenging. To scale complex routing problems, where static and dynamic routings do not work well, AI-based clustering techniques are introduced. Evolutionary algorithm-based clustering techniques are used to solve such routing problems; moth flame optimization is one of them. In this work, an intelligent moth flame optimization-based clustering (IMOC) for a drone-assisted vehicular network is proposed. This technique is used to provide maximum coverage for the vehicular node with minimum cluster heads (CHs) required for routing. Delivering optimal route by providing end-to-end connectivity with minimum overhead is the core issue addressed in this article. Node density, grid size, and transmission ranges are the performance metrics used for comparative analysis. These parameters were varied during simulations for each algorithm, and the results were recorded. A comparison was done with state-of-the-art clustering algorithms for routing such as Ant Colony Optimization (ACO), Comprehensive Learning Particle Swarm Optimization (CLPSO), and Gray Wolf Optimization (GWO). Experimental outcomes for IMOC consistently outperformed the state-of-the-art techniques for each scenario. A framework is also proposed with the support of a commercial Unmanned Aerial Vehicle (UAV) to improve routing by minimizing path creation overhead in VANETs. UAV support for clustering improved end-to-end connectivity by keeping the routing cost constant for intercluster communication in the same grid.

Outcomes of GCSF and Pre-Emptive Plerixafor Based Peripheral Blood Stem Cell Mobilization Among Patients with Multiple Myeloma-Experience from Newly Established Transplant Unit in Eastern Mediterranean Area

Introduction Granulocyte Colony Stimulating Factor (GCSF) with cyclophosphamide based peripheral blood stem cell (PBSC) mobilization is a widely used strategy among patients with multiple myeloma (MM), however, it is associated with toxicity and morbidity including severe infectious complications needing hospitalization. Plerixafor with GCSF has been widely used for mobilization as a preemptive strategy or during second attempt at collection with encouraging results. Methods We describe our experience from a newly established transplant unit in the Eastern Mediterranean region. A retrospective chart review was done and all consecutive patients of MM who underwent PBSC mobilization by GCSF and plerixafor between 2017 to 2020 were included in the study. Patients received GCSF (filgrastim, 10 µg/kg/day) and if peripheral blood CD34 count was less than 20/µl on day 4, patients received the first dose of plerixafor (240 µg/kg/day) on the evening of Day 4. Daily apheresis started on Day 5 for a maximum of 4 days, or until enough stem cells collected for one or two transplants at physician's discretion. Results A total of seventeen PBSC collections were carried out among patients with myeloma (n=17). There were 10 males and 7 females. The median age was 53 years (range 38-71), and 8/17 were less than 50 years of age. 14/ 17 were of IgG myeloma subtype, 2/17 were light chain myeloma, 1/17 was IgA myeloma type. 6/17 patients had R-ISS stage 3 disease while rest (11/17) had R-ISS stage 2 disease. 15/17 patients were in first remission. Only 1/17 patients had high-risk cytogenetics. 12/17 patients had bortezomib based therapy while 5/17 had lenalidomide based therapy. 13/17 patients had GCSF alone mobilization while 4/17 had GCSF plus pre-emptive plerixafor. 9/17 had a single collection while 8/17 had 2 collections. All patients on plerixafor needed two collections. Median CD34 stem cell dose was 8.6 x10^6 cells/kg (range 3.4-20 x 10^6 cells/kg). No grade 2-4 adverse events were recorded with this strategy post-collection and none required hospitalization for any adverse events. All patients underwent melphalan based conditioning and autologous stem cell transplant, although only 12/17 received a full dose of 200 mg/m2. 13/17 patients had fresh stem cells infused while the rest had cryopreserved stem cells. Median time to neutrophil recovery was 11 days (range 9-27) while median time to platelet recovery was 12 days (range 10-37). Day 100 mortality was zero percent. Conclusions Our study demonstrates successful collection with high stem cell yield enough for two stem cell transplants with GCSF and preemptive plerixafor strategy, in patients with MM, thus saving patients toxic effects of cyclophosphamide including cytopenias, infections which at times are severe causing morbidity and mortality. Over two-thirds of patients collected with GCSF alone. No major adverse events post stem cell collection were noted and all our patients engrafted early thus reducing hospital stay. Although the use of plerixafor increases cost but failure of mobilization, second mobilization, and infections (at times severe), delayed engraftment have their own costs and implications. Our study at our new transplant unit confirms that this pre-emptive strategy is safe, effective and reasonable chemo free first line option with no major adverse events as demonstrated by other studies. Disclosures No relevant conflicts of interest to declare.

Fault-tolerant complete visibility for asynchronous robots with lights under one-axis agreement

We consider the distributed setting of N autonomous mobile robots that operate in Look-Compute-Move (LCM) cycles and communicate with other robots using colored lights following the robots with lights model. We assume obstructed visibility under which a robot cannot see another robot if a third robot is positioned between them on the straight line connecting them. We study the fundamental Complete Visibility problem of repositioning N robots, starting from N distinct points, on a plane so that each robot is visible to all others. We are interested in fault-tolerant algorithms. We study fault-tolerance with respect to failures on the mobility of robots. Therefore, any algorithm for Complete Visibility is required to provide visibility between all non-faulty robots (i.e., no three non-faulty robots are collinear and no faulty robot is between two non-faulty robots on the straight line connecting them), independently of the behavior of the faulty ones. We model mobility failures as crash faults in which each faulty robot may stop its movement at any time and, once it stopped moving, it will remain stationary indefinitely thereafter. There exists an algorithm for this problem that tolerates a single faulty robot in the semi-synchronous setting under both-axis agreement. In that algorithm, the light of the faulty robot does not need to work correctly after the robot experiences fault. In this article, we assume the model in which, even after a robot experiences fault, its light still operates correctly and provide the first algorithm for Complete Visibility that tolerates f≤N faulty robots in the asynchronous setting under one-axis agreement. The proposed algorithm has many interesting properties.

Cyclic Response of Loose Anisotropically Consolidated Calcareous Sand under Progressive Wave–Induced Elliptical Stress Paths

Observations of the performance of coastal and marine structures in weather events that produce standing and/or progressive waves have pointed to liquefaction of the seabed as a contributing cause of damage. The cyclic response of marine sediments under wave loading can serve to improve the understanding of seabed liquefaction triggering and its consequences. This paper presents the results of an experimental study of the cyclic behavior of loose isotropically and anisotropically consolidated calcareous sand under elliptical stress paths representing progressive waves. Various ratios, λ, of the axial stress difference and torsional shear stress amplitudes were investigated in a hollow-cylinder torsional shear apparatus. The results indicate that the failure mode of isotropically and anisotropically consolidated (IC and AC, respectively) specimens are cyclic mobility and residual deformation failure, respectively. The difference in the observed failure mode appears to be related to particle shape and is independent of λ. However, the cyclic resistance of the calcareous sand is strongly influenced by λ and increases with decreasing consolidation stress ratio, Kc. The cyclic resistance of IC specimens is relatively independent of the orientation of elliptical stress paths, whereas the AC specimens exhibited a marked dependence. The terminal peak excess pore pressure ratio, ru,t, and shear work required for cyclic failure, Wf, are independent of λ; however, ru,t and Wf increases with increasing and decreasing Kc, respectively. Moreover, the relationship between the normalized peak excess pore pressure ratio and normalized shear work is related to the type of soil, but is independent of λ and Kc.

Patients' needs and perspectives for using mobile phone interventions to improve heart failure self-care: A qualitative study.

To explore heart failure patients' needs and perspectives for using mobile health technology at home before developing a mobile phone-based heart failure self-care intervention. A qualitative interview study. Purposive sampling was used to conduct semi-structured individual interviews with patients diagnosed with chronic heart failure (N=20). Data were collected from November 2018 - May 2019. All interviews were audio-recorded and transcribed verbatim and data were analysed using qualitative content analysis. The four themes that emerged from the interviews were as follows: 'The demand for reliable and customized health information', 'Valuable features of mobile phone applications', 'Barriers to adopting mobile health service', and 'Expected benefits of using mobile health technology'. Participants in this study required personalized health-related information and reminders for improving their self-care behaviours. However, while difficulties in using mobile phone applications posed the main obstacle, users expected mobile health services to improve their overall quality of life. Despite mobile phone technology's potential benefits for effective self-care strategies at home, there were some obstacles such as security issues, application costs, and the need for user friendly designs and reliable information for patients' optimal use. This study highlights that healthcare professionals should consider patients' needs and preferences to promote the acceptability of mobile health technology. This study's findings can guide the future design and implementation of mobile health interventions for improving self-care among patients with heart failure.

A Local Communication System Over Wi-Fi Direct: Implementation and Performance Evaluation

Wireless communication demands increase sharply with the explosive growth of mobile devices. The communications mainly depend on the infrastructure-based networks, e.g., WLANs and cellular networks. However, such wireless connections may be unavailable in crowded areas (e.g., concert and conference hall) or interrupted by infrastructure failures caused by earthquake or tsunami. These promote the evolution of local communication systems over device-to-device communication, such as Bluetooth and Wi-Fi Direct (WFD). However, none of the existing studies construct a full-featured local communication system, and they do not consider how to support the user mobility either. In this article, we implement and evaluate the performance of a WFD-based local communication system. First, we improve the intragroup communication by the native implementation of WFD on the Android platform, and propose an application-layer forwarding solution for the intergroup communication, which can be applied to three or more connected groups. Then, we put forward a self-adaptive handover mechanism taking user mobility and node failures into account. To deal with the uncertainty in the handover decision procedure, a fuzzy-logic-based normalized quantitative decision algorithm (FNQD) with the weights derived from the fuzzy analytic hierarchy process (FAHP) is utilized. Finally, we evaluate the performance of the system through both simulation and experiment analysis. Results show that we can get a maximum throughput of 31.7 Mb/s for the intragroup communication and a maximum goodput of 4.76 Mb/s for the intergroup communication. What is more, mobile devices could perform various types of handover according to their roles and status, which could improve the robustness of the local communication system.

Mobilization of Hematopoietic Stem Cells into Peripheral Blood for Autologous Transplantation Seems Less Efficacious in Poor Mobilizers with the Use of a Biosimilar of Filgrastim and Plerixafor: A Retrospective Comparative Analysis.

IntroductionBiosimilars of granulocyte colony-stimulating factors (G-CSF) have shown similar efficacy to originator filgrastim (Neupogen® [NEU]; Amgen Inc.) as prophylaxis in neutropenia and in the mobilization of stem cells in patients receiving combination chemotherapy with G-CSF.MethodsThis was a retrospective study in which the characteristics of stem cell mobilization treated with a G-CSF alone were compared in 216 patients and 56 donors. The two G-CSF compared were NEU and the biosimilar filgrastim Zarzio® (Sandoz GmbH) (referred to hereafter as BIO). Primary objectives were mobilization rate (minimum of 10 × 103/ml CD34+ on day 4 of treatment [day +4]) and use of the immunostimulant plerixafor (PLEX) in each group.ResultsThe general characteristics of the patients receiving NEU (n = 138) and those receiving BIO (n = 78) did not differ significantly. PLEX was used in 24% of BIO patients and in 25.7% of NEU patients. The median CD34+ cell count on day +4 was significantly lower in BIO patients who needed PLEX than in those who did not (2.4 vs. 4.8 × 103/ml; p = 0.002), as was the final CD34+ cell count (2.5 vs. 3.3 × 106/kg; p 0.03). Mobilization failure rate was higher in the BIO group than in the NEU group (20 vs. 0%; p = 0.01). With respect to donors, more than one apheresis was needed in three BIO donors, one of them with PLEX. The use of BIO was the only risk factor for mobilization failure in patients who needed PLEX (hazard ratio 10.3; 95% confidence interval 1.3–77.8).ConclusionThe study revealed that BIO had a lower efficacy for stem cell mobilization when the only treatment was G-CSF, especially in poor mobilizers needing PLEX.

RETRACTED ARTICLE: Congestion control load balancing adaptive routing protocols for random waypoint model in mobile ad-hoc networks

Congestion is the main issue for routing in the mobile system which overall degrading performance in the network due to inadequate accessibility of resources of the wireless network of the nature, node mobility and dynamic topology of the wireless network. Congestion causes packet loss, time and energy wastage by connection failure and by mobile node failure. Congestion could be recognized as a base of deployment, link capacity node and routing routes of the network. The congestion detected on node-link by a source node along with the node of the path, which distributes traffic flow over the alternative node paths by considering routing path availability of the network. This paper has proposed a congestion control load balancing adaptive routing protocol (CCLBARP) algorithms on the direction to reduce delay, system routing overhead, congestion and enhances the life of network in MANET. The proposed congestion control technique is compared with original existing routing protocols such as DYMO and DSR of MANET in terms of throughput, end-to-end delay, packet drops average jitter, packet delivery ratio and normalized routing overhead of the network and this CCLBARP get outperformed the DSR and DYMO.

Nutritional Physiology and Biochemistry of Dairy Cattle under the Influence of Heat Stress: Consequences and Opportunities.

Simple SummaryModern dairy cows have elevated internal heat loads caused by high milk production, and the effects of accumulating incremental heat are exacerbated when temperature and humidity increases in the surroundings. To shed this additional heat, cows initiate a variety of adaptive mechanisms including increased respiration rate, panting, sweating, reduced milk yield, vasodilatation, and decreased reproductive performance. Hormonal changes based on reciprocal alterations to the energetic metabolism are particularly accountable for reduced efficiency of the dairy production under the heat stress. As animals experience negative energy balance; glucose, which is also a precursor of milk lactose, becomes the preferential energy fuel. In the absence of proper mitigations, heat stress possesses potential risk of economic losses to dairy sector. Besides physical measures for the timely prediction of the actual heat stress coupled with its proper amelioration, nutritional mitigation strategies should target modulating energetic metabolism and rumen environment.Higher milk yield and prolificacy of the modern dairy cattle requires high metabolism activities to support them. It causes high heat production by the body, which coupled with increasing environmental temperatures results in heat stress (HS). Production, health, and welfare of modern cattle are severely jeopardized due to their low adaptability to hot conditions. Animal activates a variety of physiological, endocrine, and behavioral mechanisms to cope with HS. Traditionally, decreased feed intake is considered as the major factor towards negative energy balance (NEBAL) leading to a decline in milk production. However, reciprocal changes related to insulin; glucose metabolism; failure of adipose mobilization; and skeletal muscle metabolism have appeared to be the major culprits behind HS specific NEBAL. There exists high insulin activity and glucose become preferential energy fuel. Physiological biochemistry of the heat stressed cows is characterized by low-fat reserves derived NEFA (non-esterified fatty acids) response, despite high energy demands. Besides these, physiological and gut-associated changes and poor feeding practices can further compromise the welfare and production of the heat-stressed cows. Better understanding of HS specific nutritional physiology and metabolic biochemistry of the dairy cattle will primarily help to devise practical interventions in this context. Proper assessment of the HS in cattle and thereby applying relevant cooling measures at dairy seems to be the basic mitigation approach. Score of the nutritional strategies be applied in the eve of HS should target supporting physiological responses of abatement and fulfilling the deficiencies possessed, such as water and minerals. Second line of abatement constitutes proper feeding, which could augment metabolic activities and synergizes energy support. The third line of supplemental supports should be directed towards modulating the metabolic (propionates, thiazolidinediones, dietary buffers, probiotics, and fermentates) and antioxidant responses (vitamins). Comprehensive understanding of the energetic metabolism dynamics under the impact of incremental heat load and complete outlook of pros and cons of the dietary ameliorating substances together with the discovery of the newer relevant supplementations constitutes the future avenues in this context.

Higher efficacy of intermediate dose cytarabine + G-CSF compared to cyclophosphamide + G-CSF in hematopoietic stem cell mobilization in patients with multiple myeloma.

There are several regimens used in hematopoietic stem cell (HSC) mobilization in multiple myeloma (MM). Cyclophosphamide (Cy) is one of the most commonly used agents, although it does not always result in collecting adequate number of CD34+ cells. Recently, cytarabine (Ara-C) has been proposed as potentially efficient and safe option. Since the data regarding Ara-C in HSC mobilization is limited, the aim of our study was to compare retrospectively the efficiency and toxicity of G-CSF combined with either Ara-C or Cy in MM patients. Of a total of 89 patients, 43 received low or intermediate doses of Cy, and 46 were treated with 800 mg/m2 /day of Ara-C administered for two days. The mean peak of CD34+ cells/ul in peripheral blood was 132 (range, 84-202) in Ara-C and 51 (range, 29-69) in Cy cohort (p < 0.001). The median number of collected CD34+ cells (×106/kg) was 10.3 (range, 4.2-17.9) vs 4.5 (range, 2.7-8.9), respectively (p < 0.001). Mobilization failure was observed in one patient in Ara-C cohort (2%) and in 8 patients treated with Cy (19%) (p = 0.013). In the Ara-C group 98% of patients obtained more than 4×106 CD34+ cells/kg required for tandem transplantation. Moreover, we observed a trend toward increased paraprotein levels measured at transplant compared to before HSC mobilization in Ara-C cohort and significantly higher transfusion rates in that group. Our findings confirm higher HSC mobilization efficacy of Ara-C compared to Cy in MM patients. However, lower transfusions rate and better disease control of Cy may justify its use in some cases.