Mobilization Regimen Research Articles

Estimation of Reproduction Number for Covid-19 with Statistical Correction of Notifications Delay

The pandemic of Covid-19 began in Brazil in February 2020. To evaluate the evolution of pandemics some metrics can be estimated, such as the reproduction number, Rt, and the basic reproduction number, R0. Due to the delay in the notifications, these estimates may present a bias. Taking the reported data, besides a sample of individuals who reported the day of symptoms onset, it is possible to estimate delay probabilities and to perform a deconvolution to correct the notifications' delay. In this work, it was performed a corrected estimate of Rt. This estimate is done based on the curve of notifications corrected through deconvolution. The approach is applied in three country cities and in the capital of Minas Gerais state. The behavior of Rt concerning the Minas Consciente program was evaluated. It was observed that the corrected Rt was more suitable to measure the effect of the program when compared to the raw Rt. When it was determined a more rigid mobility and activities regime by the program, it was observed a decrease in the median of the variation of the Rt of the cities studied.

PB2185: MINIMAL RESIDUAL DISEASE AND THE NUMBER OF CD34+ CELLS CIRCULATING IN THE PERIPHERAL BLOOD OF MULTIPLE MYELOMA PATIENTS ON THE DAY OF THE FIRST SESSION OF LEUKOCYTAPHERESIS DURING AUTOGRAFT HARVESTING

Background: The efficiency of autograft harvesting, i.e. the number of CD34+ cells in terms of the patient’s weight is determined by factors characterizing the intensity of the mobilization regimen, describing the type and duration of therapy preceding the collection of hematopoietic stem cells (HSC), and also assessing the activity of the disease. The significance of the volume of residual myeloma cells on the quantitative composition of the autograft of patients with multiple myeloma (MM) is not clear. Therefore, the question of the appropriateness of choosing the appropriate mobilization regimen depending on the status of minimal residual disease (MRD) remains open. Aims: To evaluate the possible influence of MRD status on the mobilization HSCs from the bone marrow into the peripheral blood in patients with MM. Methods: A retrospective analysis of the results of HSC mobilization in 64 patients with MM was performed. Mobilization of HSCs was carried out by regimens with introduction of cyclophosphamide 3 g/m/2 (n=14), vinirelbine 35 mg/m/2 (n=30), granulocyte colony-stimulating factor (G-CSF) (n=16) and plerixafor (n=4). When using cyclophosphamide, vinorelbine and plerixafor, patients additionally prescribed G-SCF. The efficiency of mobilization was assessed by the number of CD34+ cells circulating in one mkL of peripheral blood on the day of the first session of leukocytapheresis. To initiate leukocytoapheresis, this indicator had to be at least 20. Thus, cases of unsuccessful mobilization were excluded from the analysis. The status of MRD was assessed by the results of flow cytometry performed before the start of the mobilization regimen. An indicator of >0,01% was considered positive. Results: There were 20 and 44 patients with MRD (-) and MRD (+) status in the study, respectively. The number of CD34+ cells circulating in the peripheral blood on the day of the first session of leukacytapheresis in the patients in the group did not differ: 154 and 88.5/mkL, respectively; p=0.164. The difference was also not significant depending on the mobilization regimen used, despite the trend towards a negative effect of less intensive courses in the case of a significant volume of residual cells. So if in the group of cyclophosphamide CD34+ cells in 1 mkL of blood of patients with MRD (-) status and MRD (+) status were 97 and 90, respectively; p=0.540, then when prescribing vinirelbine 276 and 109, respectively; p=0.116 and 117 and 47, respectively, with the introduction of G-SCF; p=0.173. Summary/Conclusion: The potential of the used mobilization regimens does not depend on the MRD status of patients with MM. However, the trend towards a decrease in the number of CD34+ cells circulating in the peripheral blood on the day of the first session of leukacytapheresis with the use of less intensive schemes (G-CSF, vinorelbine with G-CSF) gives reason to take into account the status of MRD when choosing a mobilization regimen.

PB2195: MOBILIZATION WITH CYTARABINE AND GRANULOCYTE COLONY STIMULATING FACTOR (G-CSF) GIVES BETTER YIELD THAN MOBILIZATION WITH G-CSF ALONE OR COMBINED WITH CYCLOPHOSPHAMIDE

Background: Patients with multiple myeloma are poor mobilizers and often require multiple cytapheresis procedures. Most popular mobilization regimens are with G-CSF given as a sole treatment or in combination with cyclophosphamide. Recently, several reports indicated that higher yields could be obtained following chemomobilization with cytarabine and G-CSF. Aims: Our aim was to compate the effectiveness of chemomobilization with cytarabine and G-CSF with the other regimens which we have used. Methods: Patients received 2x400mg/m2 cytarabine for two days, followed by 5mcg/kg G-CSF two days after for at least nine days. Cytapheresis was initiated with WBC count above 5x109/L, PLT count above 30x109/L and CD34+ cell count above 20/µl. Results of this group of patients were compared with results from a historic group of myeloma patients harvested between 2018 and 2020. Results: The new regimen showed markedly higher initial counts of CD34+ cells resulting in significantly better average yields (12.6x10^6/kg for the cytarabine + G-CSF group; 3.98 x10^6/kg for the G-CSF group and 4.998 x10^6/kg for the Cyclophosphamide+ G-CSF group). Summary/Conclusion: Compared with other hematological malignancies, patients with multiple myeloma are hard to mobilize for collection of sufficient CD34+ cells. Possible explanations are advanced age and bone marrow involvement. Chemomobilization with cytarabine and G-CSF seem to overcome poor mobilization and collection yields for this patient group.

Vélomobility is to degrowth as automobility is to growth: prefigurative cycling imaginaries

ABSTRACT At the end of the nineteenth century, the autonomous mobility provided by bicycles and tricycles created a mobile imaginary that paved the way for automobility. Through the course of the twentieth century, the growth and decline of cycling mobilities was inseparably entangled with the rise of a range of motor-mobilities (two and four wheeled). Yet cycling persists and is championed widely as a contender for future mobility in post-growth societies. However, the hegemonic position reached by automobility as a dominant system has led to closure of political non-car mobility imaginaries. Reaching targets for Carbon reduction. will entail dramatic transformation of mobility scapes. This paper explores the possibilities and problems inherent in formulating vélomobility as a system of autonomobility, paying special attention to its alignment with the range of radical alternatives clustered around degrowth and pluriversal thought as promising ways to think and act beyond the unsustainable carbon economy. It first examines the challenges of imagining vélomobility not just as a set of practices but cognitively, through its conceptual construction not as an inverse of automobility but as challenge to the political underpinnings of automobility. Second, it considers vélomobility through a set of propositions to reimagine mobility regimes and assess relevant resources from political theory. The final section reverses the gaze and asks what the reconsideration of vélomobility as described previously can bring to the broader discussion of autonomobility.

Cycling and transitions theories: A conceptual framework to assess the relationship between cycling innovations and sustainability goals

Through its novel and systematic application of the multi-level perspective (MLP), sustainable mobility paradigm (SMP), and strategic niche management (SNM) principles, this article provides a framework for evaluating the relationship between cycling innovations and sustainability goals within a given institutional context. It then demonstrates the practical application of this framework with an analysis of the implementation of three comparable cycling innovations in three different mobility regimes. The article contributes to the literature on the transition to sustainable transportation systems by showing how the application of the SMP to transition theories provides an improved understanding of the role that cycling innovations play in transition processes. It also critically evaluates the limited amount of literature examining cycling innovations through the lens of transition theories and how this literature has been adopted by other scholars.

Journeys of Violence: Trajectories of (Im-)Mobility and Migrants’ Encounters with Violence in European Border Spaces

On their journeys to and through Europe, refugees and other migrants are commonly subjected to violence in its multifaceted forms. We argue that these “journeys of violence” are a direct effect of a fundamentally uneven and asymmetric global mobility regime that creates frictions and fragmentations in the European border space and beyond. Our argument is based on: (1) a state-of-the-art literature review on refugees’ mobilities towards Europe and new patterns of involuntary immobilisation through border regimes, (2) a secondary analysis of recent quantitative data from the Socio-Economic Panel (SOEP), which includes a large data set on refugee’s journeys to Germany, and (3) original qualitative interviews that were conducted with migrants in Germany and Bosnia-Herzegovina. We will first show that mobility in the context of violence is highly selective and that trajectories of mobility significantly depend on mobility capital. Second, we consider the fortification of European borders and the externalisation of control regimes as facets of structural violence and demonstrate their effects on refugees’ mobility, namely the fragmentation of journeys and the systemic production of situations of protracted immobility at multiple border sites. Third, we provide insights into refugees’ exposure to and experiences of direct violence on their journeys, which must be understood as immediate consequences of the structurally violent conditions that govern their mobility and the cultural violence of delegitimising and illegalising refugees’ movements.
 * This article belongs to a special issue on "Refugee Migration to Europe – Challenges and Potentials for Cities and Regions".

Mobilization with high-dose granulocyte colony-stimulating factor alone at 12 μg/kg twice a day in high-risk pediatric patients: A retrospective analysis of the experience in a single center.

Mobilization regimes in pediatric patients at high risk for poor mobilization are not standardized across different institutions. We present a retrospective analysis of our experience with a high-dose granulocyte colony-stimulating factor (G-CSF) regime of 12μg/Kg per body weight (BW) twice a day for 4 days used in high-risk patients. We report the results of all pediatric patients mobilized with high-dose G-CSF between January 1999 and February 2021 in our center. A successful mobilization was defined as a peripheral blood (PB) CD34+ cell count of ≥10 CD34+ cells/μl on the fifth day of mobilization immediately before leukapheresis. A minimum cell yield of ≥2× 106 CD34+ cells/Kg of BW was required for a successful collection. Of the 262 patients included in the analysis, mobilization failure was found in 27 (10.3%). In a univariate analysis, this was associated with age, weight, baseline diagnosis, and having undergone a previous mobilization cycle, the latter being the only factor that remained significantly associated in a multivariate analysis (P= 0.03). The 54 patients (20.6%) did not reach the minimum required CD34+ cell yield. 50.4% of the patients reported adverse events (AEs) during the mobilization period, and 23 (9.1%) reported 3 or more concomitant AEs. However, all of them were mild and did not affect the mobilization schedule. Although most high-risk pediatric patients are successfully mobilized with the high-dose G-CSF regime, this approach does not salvage all of them and significantly increases the presence of AEs in comparison to standard-dose regimes.

Opera Fans: Female Stratagems and Social Power

During the eighteenth century, both at close quarters and in crowds, folding fans served two kinds of femininity—flirtatiousness and modesty—allowing women to communicate a variety of affects, interrogatives, and illocutionary acts. Cheaply printed "maps" of the King's Opera House annual box subscribers' lists mounted as fans for seasons between 1787 and 1808 open up an additional perspective. Within the opera house, women dominated social affairs and wielded political influence over elite London society and national politics. This essay posits scenarios about how the information on these convenient box-plan objects was utilized by women aristocrats, gentry, and commoners with respect to sociability, regimes of observation, celebrity, social status, and social mobility that enhanced both social control and self-advancement in a constantly recalibrated register of prestige.

Family and space – an interpretive perspective on two central concepts in population geography

Abstract. Introductory texts in population geography are often organized using a sociological approach to demography (Barcus and Halfacree 2018:2; Newbold 2014:6). This is particularly evident in discussions on the concept of family. Both sociology and geography center concepts like marriage, divorces, births, the number of children in a household, and the composition of households. However, many of these concepts are outdated, with limited value for understanding contemporary social change. As the editorial to this special issue suggests, population geography must look to other fields for concepts that describe subjects' meaning-making. Interpretive family studies' conceptual and methodological approaches can help reconfigure established assumptions about the term “population” (Gubrium and Holstein 1993; LaRossa and Reitzes 1993; Bösel, 1980; Burgess, 1926). While classic population geography research does engage with new mobility and flexibility regimes and pluralization tendencies, it often fails to identify their consequences for lived experiences and intergenerational relationships. This limits scholars' understandings of new living conditions and practices, as well as their consequences for central concepts of mobility, for example, co-presence, absence, relocation, and residential location. This also occurs with the concept of “family”, which is generally applied to mono-local nuclear families in a household unit. In this contribution, we draw on classic and contemporary interpretive research to (re-)evaluate the multi-locality of families and theories of co-presence to extend the concepts of family and space within population geography (see also Halatcheva-Trapp et al., 2019a). By transcending standard quantitative categories (e.g., the household, fertility, simplified models of mobility), we offer interpretive insights to better conceptualize an important topic in population geography – the family.

INTELLIGENT TRANSPORT SYSTEMS AS TRAFFIC FLOW MANAGEMENT TOOL (THE CASE OF KYIV)

The low quality of public transport services, the inconvenience of routes, the long duration of trips and several other problems encourage Kyiv residents to increasingly choose a car for everyday correspondence, which, in turn, increases delays, travel time and leads to environmental pollution of territories. These problems are especially acute in large cities, where numerous industrial, labour, and cultural and household connections are within the city. There is a need to create a single efficient transport system that serves as a city and implement effective traffic flow management approaches. 
 First of all, the article defines the concepts of "traffic flow management", "urban mobility" and "urban mobility regime". Four groups of problems of urban transport systems were identified and two ways of solving them were formed: extensive and intensive. Using the instrumental case of Kyiv, the level of implementation of systems for monitoring and managing traffic flows in Ukrainian cities was evaluated. The levels of the legal framework regulating the urban mobility of the population in Ukraine are described. The characteristics of intelligent transport systems and their key subject areas have been studied. Commonly accepted services for users of intelligent transport systems (ITS) are distinguished and segmented according to the needs of these system users. Features, methods of application and technologies of intelligent transport systems are presented. Services that are a priority for potential users of intelligent transport systems in Ukrainian cities are highlighted. The world experience of the formation and development of intelligent transport systems, as well as European programs for their implementation, is characterized. A SWOT analysis of the implementation of intelligent transport systems in Kyiv was carried out and recommendations were made for the creation of an ITS implementation program in Kyiv. 
 The information base of the article consists of publications by prominent Ukrainian and foreign researchers, data from the Tom Tom transport analytics service, the current legal framework of Ukraine, which regulates urban transport systems, and urban development strategies. The following methods of scientific research are used in the research process: dialectical method; method of scientific abstraction, analysis and synthesis; method of induction and deduction; comparative method; method of systematization and graphic method.

Climate mobilities: migration, im/mobilities and mobility regimes in a changing climate

ABSTRACT The discussion on the relation between human mobility and climate change has moved beyond linear and exceptional terms. Building on these debates, this article, and the Special Issue on Climate Mobilities: Migration, im/mobilities and mobilities regimes in a changing climate that it introduces, conceptualises this relation in terms of climate mobilities. Through the concept of climate mobilities, we highlight the multiplicity of mobility in the context of a changing climate, including the interrelations between human mobilities and immobilities and their interplay with other mobile flows, such as the mobilities of ideas, information, or climate risk. We furthermore delve into the politics of climate mobilities, defining climate mobility regimes, and implications for mobility justice among those whose mobility is impacted by these regimes. We argue for research to pay more attention to acts of resistance against dominant climate mobility regimes, including voluntary immobilities and re-emplacements that challenge mass migration frames or imposed relocation policies. The articles in this issue empirically examine these dimensions, reflecting on the plurality of climate mobilities and its politics, each analysing how these evolve in a situated cultural or political context.

Anti-displacement mobilities and re-emplacements: alternative climate mobilities in Funafala

ABSTRACT If there is a dominant global imaginary of climate change in low-lying islands, it is of displacement risk. This paper uses a mobilities perspective to consider anticipated displacement as a contested concept, reporting on emerging anti-displacement mobilities and re-emplacements in a rural, low-lying islet of Tuvalu named Funafala. Anti-displacement mobilities are defined as processes in which ideas, people and/or matter become mobile in order to counter anticipated displacement materially or symbolically, while re-emplacements are the new ideas, people and/or matter which together constitute the remaking of place through anti-displacement mobilities. These hitherto relatively unexplored mobilities and place-making practices are pragmatic and political acts that resist climate displacement, through reclaiming and redefining territory that has been categorised as highly exposed to climate change impacts and potentially unliveable. Grassroots anti-displacement and re-emplacement are interpreted in internal population mobility to Funafala, where Indigenous culture is being revitalised by re-emplacing homes and livelihoods in a remote, rural area. Mobilities are a way to repossess and revitalise place, and reclaim the meaning of habitability in the face of climate risk. These anti-displacement mobilities and re-emplacements reject dominant climate mobility regimes and reaffirm Indigenous rights and identities.

Death and Afterlives in the Middle East

Abstract This special section draws on the associations between the dead and the living, and approaches death as not something final and complete but rather as a regenerative force for afterlives. Engaging with this framework, this section addresses the following questions: How do people process death into meaning and life for their communities, subjectivities, and political projects? How do sovereign and intimate claims on bodies, and the contestation among these multiple claims, shape the meaning of death and the production of afterlives? How does the symbolic and material life around death produce and shape people's emotional, religious, communal, and political worlds, as well as political economy and regimes of mobility and securitization? How do people create and/or transgress normative boundaries of religious, familial, political, and gender subjectivities through their negotiations over dying, rituals of death, and mourning? How do death and its afterlives help us develop new tropes to think about migration, mobility, regimes of security, war on terror, belonging, intimacy, and care?

Time-lapse imaging of flow instability and rock heterogeneity impacts on CO2 plume migration in meter long sandstone cores

Our understanding and modelling of flow instabilities (e.g. viscous, gravitational) in the presence of geological heterogeneity is limited by a lack of experimental observations at relevant scales in consolidated media. Typically, small sample sizes (<50 mm diameter) restrict the scale of heterogeneity, and the development of unstable fingers may be damped by the sample boundaries. Furthermore, there is a lack of 3D dynamic data, resolved at a level to observe finger growth and interaction. To this end, we conduct a series of drainage & imbibition fluid-flow experiments with nitrogen and brine in meter-long, 100 mm-diameter Bentheimer and Boise sandstone samples using an advanced, high-pressure setup with medical X-Ray CT (XCT) imaging. Using novel beam-hardening and noise removal methods, we can resolve fluid distributions with a spatial resolution of 1.2 mm3 and temporal resolution of 90 s. The mobility (M) regime in each case is weakly unstable, M ≈ 0.5-5, with flow velocities equivalent to field scale injection rates. In the case of the weakly heterogeneous Bentheimer sample (porosity 0.26 ± 0.025), we find the plume migration is mainly controlled by buoyancy. On the other hand, the fluid distribution in the Boise sample is controlled by the strong unstructured heterogeneity (porosity 0.3 ± 0.1). The heterogeneity increases the gas trapping as less of the core is ultimately bypassed, and residual gas saturation increases behind local capillary barriers. We see little viscous instability in each experiment despite the unstable regime; structural heterogeneity and buoyancy largely control the flow under these field-relevant conditions. The meter scale 3D experimental dataset is provided open-access and represents an ideal benchmark to calibrate and improve multiphase flow models and upscaling methods.

Design considerations for gallium arsenide pulse compression photoconductive switch

In this paper, we present the physics and design-space exploration of a novel pulse compression photoconductive switch (PCPS) using semi-insulating gallium arsenide (GaAs) operating in the negative differential mobility (NDM) regime of electron transport. We systematically quantify the relationship between the PCPS performance and various design options, including contact separation, laser energy and placement, and trap dynamics. Specifically, we report the full-width at half-maximum and the peak output current generated by the PCPS as a function of applied electrical and optical bias. We discuss the optimal spacing between the electrodes and the distance of the laser spot to the anode to achieve higher electron confinement and superior radio-frequency (RF) metrics. Reducing the laser energy is important to prevent the appearance of secondary peaks due to diffusive transport, but there exists a trade-off between the bandwidth and the maximum current of the PCPS. We also compare the PCPS response with and without trap dynamics and find that the electrostatic screening from the trap-induced space charge is time-independent when the trapping time constant is set larger than the recombination lifetime. Overall, trap dynamics are detrimental to performance, unless the compensation doping scheme to achieve semi-insulating GaAs is carefully selected. Results presented in this paper can be used by experimentalists to fine-tune the PCPS design parameters to meet the specifications of various RF applications. Moreover, our results will provide a strong theoretical basis to the measurements of PCPS devices using GaAs and other NDM materials under investigation.

Growing up and belonging in regimes of geographical mobility. Young cosmopolitans in Berlin

ABSTRACT The focus on geographical mobility is consolidating within youth studies. Mobility now increasingly characterises contemporary youth, and seems to play a crucial role in marking the transition to adulthood, conveying the complexity of youth cultures. Moving abroad represents an opportunity that fuels the transition to adulthood, by enabling young people to experience cultural diversity, experiment with practices of cosmopolitanism and reframe their sense of belonging in terms of places, times and relationships. The paper draws on a qualitative study of young Italians who have recently moved to Berlin, and explores the relationships between the transition to adulthood, mobility, cosmopolitanism and sense of belonging. It highlights the deep structural and cultural roots of their mobility practices: mobility is present from an early age in their desires, regardless of their class of origin or educational qualifications. Their mobility practices also involve a daily reworking of their sense of belonging, which sees them navigating family and friendship bonds, and new relationships of intimacy that ‘make home’ and often arise in the context of a cosmopolitan generation on the move. The paper shows how these young cosmopolitans piece together this mosaic of belonging and explores its link with the coming of age process.

Efficacy of hematopoietic stem cell mobilization regimens in patients with hematological malignancies: a systematic review and network meta-analysis of randomized controlled trials

BackgroundEfficient mobilization of hematopoietic stem cells (HSCs) from bone marrow niche into circulation is the key to successful collection and transplantation in patients with hematological malignancies. The efficacy of various HSCs mobilization regimens has been widely investigated, but the results are inconsistent.MethodsWe performed comprehensive databases searching for eligible randomized controlled trials (RCTs) that comparing the efficacy of HSCs mobilization regimens in patients with hematological malignancies. Bayesian network meta-analyses were performed with WinBUGS. Standard dose of granulocyte colony-stimulating factor (G-CSF SD) was chosen as the common comparator. Estimates of relative treatment effects for other regimens were reported as mean differences (MD) or odds ratio (OR) with associated 95% credibility interval (95% CrI). The surface under the cumulative ranking curve (SUCRA) were obtained to present rank probabilities of all included regimens.ResultsDatabases searching and study selection identified 44 eligible RCTs, of which the mobilization results are summarized. Then we compared the efficacy of mobilization regimens separately for patients with multiple myeloma (MM) and non-Hodgkin lymphoma (NHL) by including 13 eligible trials for network meta-analysis, involving 638 patients with MM and 592 patients with NHL. For patients with MM, data are pooled from 8 trials for 6 regimens, including G-CSF in standard dose (SD) or reduced dose (RD) combined with cyclophosphamide (CY), intermediate-dose cytarabine (ID-AraC) or plerixafor. The results show that compared with G-CSF SD alone, 3 regimens including ID-AraC + G-CSF SD (MD 14.29, 95% CrI 9.99–18.53; SUCRA 1.00), G-CSF SD + Plerixafor SD (MD 4.15, 95% CrI 2.92–5.39; SUCRA 0.80), and CY + G-CSF RD (MD 1.18, 95% CrI 0.29–2.07; SUCRA 0.60) are associated with significantly increased total number of collected CD34+ cells (× 106/kg), among which ID-AraC + G-CSF SD ranked first with a probability of being best regimen of 100%. Moreover, ID-AraC + G-CSF SD and G-CSF SD + Plerixafor SD are associated with significantly higher successful rate of achieving optimal target (collecting ≥ 4–6 × 106 CD34+ cells/kg). For patients with NHL, data are pooled from 5 trials for 4 regimens, the results show that compared with G-CSF SD alone, G-CSF SD + Plerixafor SD (MD 3.62, 95% CrI 2.86–4.38; SUCRA 0.81) and G-CSF SD plus the new CXC chemokine receptor-4 (CXCR-4) antagonist YF-H-2015005 (MD 3.43, 95% CrI 2.51–4.35; SUCRA 0.69) are associated with significantly higher number of total CD34+ cells collected. These 2 regimens are also associated with significantly higher successful rate of achieving optimal target. There are no significant differences in rate of achieving optimal target between G-CSF SD + Plerixafor SD and G-CSF + YF-H-2015005.ConclusionsIn conclusion, ID-AraC plus G-CSF is associated with the highest probability of being best mobilization regimen in patients with MM. For patients with NHL, G-CSF in combination with plerixafor or YF-H-2015005 showed similar improvements in HSCs mobilization efficacy. The relative effects of other chemotherapy-based mobilization regimens still require to be determined with further investigations.

Increased serum pro-B-type natriuretic peptide in hematopoietic progenitor cell donors stimulated with G-CSF.

Hematopoietic stem cells (HPCs) donors mobilized by granulocyte-colony-stimulating factor (G-CSF) can develop various signs and symptoms. proBNP (pro-B-type natriuretic peptide) is a serum marker of heart failure. A donor who developed severe adverse reactions after G-CSF mobilization was found to have high serum proBNP levels. We followed additional donors who received identical mobilization regimen to investigate the prevalence of this phenomenon. Eighteen healthy donors underwent a mobilization regimen of 10μg/Kg G-CSF daily for 5 days prior to allogeneic HPC collection using Spectra Optia between January 2016 and February 2017 were included in this study. Serum proBNP levels were measured before and after G-CSF stimulation and immediately after apheresis. Apheresis collection parameters and other laboratory results were also reviewed. The majority of donors (86.7%) had post-G-CSF elevation of serum proBNP. Seven of those had elevated proBNP above upper normal range (124 pg/ml). The subgroup of donors with normal proBNP is younger (median age of 37 vs 42 years), with majority being male (90.9% vs 28.6%) and with smaller processed blood volume (2.2 vs 3 × total blood volume). This case series demonstrates an increase of serum proBNP can be common in HPC donors stimulated with 5 days of 10 mcg/kg G-CSF. This is an adverse reaction that has not been described before. The temporary elevation of proBNP in these donors is not associated with ventricular dysfunction of the heart. The risk factors for marked elevation of proBNP post-G-CSF should be further investigated.

‘Waiting for an opportunity'. Future, transit and higher education among Eritrean refugees in Ethiopia

ABSTRACT This article investigates the experience of waiting of Eritrean refugees attending Ethiopian universities and the role they attribute to higher education. Young Eritreans usually experience Ethiopia as a temporary stage within longer migratory trajectories towards their desired destinations. However, due to the current regimes of mobility, they often remain stuck. Drawing from an ethnography conducted in the Northern Ethiopian town of Mekelle, this article scrutinises the circular relation between refugees’ daily life, their feelings of being both stuck and in transit, and their hopes for the future. It intends to demonstrate how people in waiting not only experience boredom and despair and focus on the present, but can also constantly seek ways to move towards their desired future. In the impossibility of making accurate plans, student refugees are constantly looking for any opportunity that might arise, readapting themselves to contingencies. The article also shows how in this tension between present and future defined by their condition of waiting, higher education loses its future-oriented character. For the student refugees, attending university in Ethiopia was primarily a way of filling time in the present and making it meaningful, while ‘waiting for an opportunity’ for reactivating their geographical and existential mobility.

Are we choosing mobilization regimens for autologous stem cell transplantation in multiple myeloma wisely: A single center comparison of GCSF+/-plerixafor vs cyclophosphamide/GCSF+/-plerixafor.

Autologous stem cell transplantation (ASCT) is a standard consolidation treatment for eligible patients with multiple myeloma (MM). There is no standardized mobilization regimen for collection of CD34+ stem cells, which is crucial to the success of ASCT. Cyclophosphamide/GCSF is an effective regimen, although reported associated toxicities include risk of febrile neutropenia (FN). Since plerixafor was introduced in Canada, this mobilization agent has been increasingly used as needed with GCSF at Kingston Health Science Centre (KHSC), with elimination of cyclophosphamide. This single center, retrospective, quality improvement study evaluates mobilization and ASCT outcomes of MM patients who had undergone stem cell mobilization at KHSC with cyclophosphamide/GCSF+/-plerixafor without antibiotics, cyclophosphamide/GCSF+/-plerixafor with antibiotics, and GCSF+/-plerixafor without antibiotics. A retrospective chart review was conducted evaluating 137 patients. The primary outcome measure was FN rates with mobilization. Balancing measures include CD34+ cell collected, plerixafor usage, days of apheresis and transplant outcomes. Chi-square, ANOVA, or Kruskal-Wallis methods were used to test statistical significance where appropriate. Our study noted a higher total and day one CD34+ count in the two groups utilizing cyclophosphamide in mobilization. All nine cases of FN occurred in these two groups (P < .05). Addition of antibiotics decreased, but did not eliminate risk of FN. There were no significant differences in the rate of plerixafor usage and number of apheresis days. Difference in transplant outcomes, including engraftment and transfusion support, were statistically but not clinically significant. A larger sample size may be needed to explore this fully. There was no significant difference in length of transplant hospital stay. The elimination of cyclophosphamide from mobilization regimens for MM appears to significantly reduce FN rates, without increasing balancing measures such as total number of apheresis days, plerixafor usage, duration of transplant hospitalization or mortality outcomes.