Successful Mobilization Research Articles

EVALUATION OF BLOOD CELL COUNT USING THE SYSMEX XN-1000 AUTOMATIC HEMATOLOGY ANALYZER TO OPTIMIZE COLLECTION OF PERIPHERAL BLOOD PROGENITOR CELLS BY LEUKAPHERESIS

Autologous stem cell transplantation (ASCT) is a treatment modality for several diseases. Prediction of successful mobilization may be useful to optimize hematopoietic stem cell (HSC) collection. The objective was to identify characteristics that can influence the effectiveness of mobilization and create a model to predict the success of mobilization in candidates for ASCT. This was a retrospective study, and data from patient candidates for ASCT between 09/2015 and 12/2021 were analyzed. Participants were assisted in five hospitals and laboratory procedures were performed at the Cell Processing Center (CPC) of Cetebio/Fundação Hemominas, Brazil. The medical records of the participants were reviewed to obtain the following information: gender, age, weight, diagnosis, mobilization, mobilization cycle, number of previous chemotherapy regimens and previous radiotherapy. The laboratory data analyzed were CD34+ cell enumeration and pre-collection peripheral blood (PB) blood count. Enumeration of CD34+ cell was performed using the ISHAGE protocol. The blood count was performed using an automated counter (SYSMEX XN-1000 AS-01). The studied outcome, good mobilization, was defined as a viable CD34+ cell count ≥ 20/uL in the PB. Model derivation was performed using logistic regression. The level of classification accuracy of model was tested in a subset of participants. The study population included 807 patients, 413 (51%) of whom were male. The median age was 54 (1-74) years. Multiple myeloma was the most common diagnosis (58,2%), followed by lymphoma. Of the 807 participants, 74 failed in previous mobilization attempts, totaling 881 cycles of mobilizations and collection attempts. Of the 623 participants, 353 were good mobilizers. Increasing patient weight, lower mean corpuscular volume (MCV), higher nucleated red blood cells (nRBC), peripheral blood mononuclear cells (PBMC), and immature granulocyte count were significantly associated with good mobilization. In addition, participants diagnosed with multiple myeloma were two times more likely to be good mobilizers than patients with lymphoma (OR=1.92; 95%CI: 1.21 – 3.05; P=0.006). The model was applied to the validation set to identify patients who underwent apheresis (CD34+ cells count ≥ 10 μL), resulting in a sensibility of 69%, a specificity of 95%, positive predictive value of 98%, a negative predictive value of 50%. The results of our study are extremely relevant to institutions that do not have a flow cytometer and rely on other institutions to define HSC collection by apheresis. Cetebio serves nine transplant centers. The centers that perform the collection of HSC are located between 40 to 568 km away from Cetebio (place of quantification of CD34+ cells). Predicting the outcome of mobilization may allow the adoption of complementary measures, such as the use of plerixafor. Furthermore, it would better optimize the collection of CPH by apheresis. Thus, it would be possible to avoid additional collection days, reducing costs and risks related to administration of additional doses of G-CSF, catheter maintenance and prolonged hospital stay. Success in mobilization was greater in participants who underwent the first mobilization cycle and who had a diagnosis of multiple myeloma. Furthermore, higher weight and levels of nRBC, immature granulocytes, and PBMC, as well as lower levels of MCV, were associated with successful mobilization.

Sweden, Inc.: Temporal Sovereignty of the Realm and People from the Middle Ages to Modernity

Sweden, Inc.: Temporal Sovereignty of the Realm and People from the Middle Ages to Modernity

A nonparametric method for classification trees using grouped covariates.

A group of variables are commonly seen in diagnostic medicine when multiple prognostic factors are aggregated into a composite score to represent the risk profile. A model selection method considers these covariates as all-in or all-out types. Model selection procedures for grouped covariates and their applications have thrived in recent years, in part because of the development of genetic research in which gene-gene or gene-environment interactions and regulatory network pathways are considered groups of individual variables. However, little has been discussed on how to utilize grouped covariates to grow a classification tree. In this paper, we propose a nonparametric method to address the selection of split variables for grouped covariates and their following selection of split points. Comprehensive simulations were implemented to show the superiority of our procedures compared to a commonly used recursive partition algorithm. The practical use of our method is demonstrated through a real data analysis that uses a group of prognostic factors to classify the successful mobilization of peripheral blood stemcells.

Roma Youth and Roma Student Societies in the Hungarian Higher Education in the Light of Process-based Model of Inclusion

Organisations and their programmes that specifically address target groups play an important role in creating inclusive educational environments. In this study, through the life stories of Roma students and by examining, describing, and analysing their formalcommunity (the Roma Student Society Network), the authors present principles and dynamics in a model, which may be used as a basis for creating an inclusive environment in the specific context of a university. Our aim in writing this paper is to detail and embed in a process-based model of inclusion the capital accumulation provided by the Roma Student Society, an organisational structure that offers successful social mobility pathways for Roma students. Furthermore, by presenting the results of an empirical study about the Wlislocki Henrik Roma Student Society (WHSz) at the University of Pécs in Hungary and comparing this data to the research results of Roma student societies in other educational institutions across the country, the authors will try to demonstrate and model the necessity, success, and adaptability of WHSz as a support programme.

Management of palatally ectopic canines part 1: Importance of histological developmental understanding in improving outcomes

Successful mobilisation of palatally ectopic canines requires an understanding of the embryological and histological processes involved in tooth eruption, in order to optimise conditions for eruption and achieve a positive outcome. Part one of this two part series presents the reader with the important characteristics of the oral tissues which feature in the eruption process and discusses techniques in tissue handling when performing exposure of impacted teeth. The following paper will provide data on our experience in addition to reviewing the alternative methods available for exposure of teeth.

Shift from smart mobility to responsive mobility for metro stations in Chennai, India

The responsive city explores citizen as centre of decision making in the smart city ideas, that is "From For the citizen to By the citizen". Last-mile connectivity is the connection between stations transit stops, to the final destination. It is one of the major factors in a successful smart mobility plan. This research is an attempt to explore responsive last mile connectivity. The two newly opened station (Tiruvottiyur metro station and Wimco nagar metro station) of Chennai metro rail phase I extension is selected as the study area, which provide wide scope for research. The issues identified and solved at the early stage of the development of transit network will improve the quality of life of citizens and also increase commuters, which has a relationship with economic development on the other hand. Two park analysis was undertaken in this research, one based on the questionnaire survey on five major aspects i.e. exact location of the commuters, General information about the commuters, trip information, parameters of Chennai Metro rail limited, Suggestions and recommendations of commuters and other is the statistical analysis for predicting the mode choice using multinomial logit regression method. From the findings it was evident that lack of quality infrastructure, pedestrian-friendly facility and high peak hour traffic are the major problems felt by the commuters. From the Multinomial logit model it is found that there is an increase in usage of public transport in one station and decrease in the other station. The pure participatory approach was involved in arriving at the proposal from the finding of the analysis in this research.

Plerixafor use in New Zealand 2016-2019: an observational study.

Plerixafor is used to mobilise CD34-positive stem cells for autologous transplantation to treat haematological malignancy. Funded in New Zealand since 2016, plerixafor can be used 'pre-emptively' to salvage a failing first attempt or as a 'rescue' strategy involving re-mobilising after 4 weeks. The rate of failed mobilisation and plerixafor uptake in New Zealand is not known, while international practice varies widely. To establish success rates for conditioning regimes used in New Zealand. We reviewed 203 consecutive patients with myeloma (n = 122) or lymphoma (n = 81) undergoing stem cell mobilisation between 1 January 2016 and 5 August 2019 at Christchurch hospital. We recorded demographics, conditioning regimens, harvest outcome and apheresis duration. Successful harvest was defined as collection of >2 × 106 CD34+ cells/kg. Seventeen percent of patients received plerixafor. Harvest success rates for lymphoma and myeloma respectively were 77% and 86% with standard conditioning, 95% and 100% with 'pre-emptive' plerixafor and 71% and 89% with 'rescue' plerixafor. 'Pre-emptive' plerixafor was non-inferior to standard conditioning. Following local guidelines resulted in at least one successful harvest for 96% lymphoma and 99% myeloma patients. Plerixafor strategies in New Zealand allow successful stem cell mobilisation for ≥96% of patients. Further research is required to investigate whether increased use would be cost-effective through reduced chemotherapy and apheresis duration, and improved graft quality.

Successful Mobilization of Autologous Hematopoietic Peripheral Blood Stem Cells after Salvage Chemotherapy in Patients with Low CD34 Blood Cell Counts

A major barrier for proceeding to autologous stem cell transplantation (ASCT) is an inability to mobilize and collect an adequate number of peripheral blood (PB) stem cells (PBSC) for the transplant graft. Plerixafor added to granulocyte colony stimulating factor (G-CSF) alone, without prior chemotherapy, significantly improves the mobilization of autologous PBSC in patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). However, the efficacy of plerixafor and the best timing to give the drug to poorly mobilizing patients with very low PB CD34+ cell counts after salvage chemotherapy and G-CSF are not well defined. We hypothesized that PBSC mobilization and collection might be improved in heavily treated patients who mobilized very poorly after salvage chemotherapy and G-CSF by alternating the days of plerixafor administration and leukapheresis. A day of rest between plerixafor doses, while continuing G-CSF, could allow time for some replenishment of the marrow stem/progenitor cell pool before the next mobilization. A retrospective review of collection results in poorly mobilizing patients at our center was undertaken. Three cohorts were identified: those who got every-other-day plerixafor and leukapheresis, those who got sequential plerixafor and leukapheresis and those who got risk adapted plerixafor. Overall, 69% of patients with NHL and MM with PB CD34+ cell counts <5/µL after salvage chemotherapy and G-CSF were ultimately able to collect adequate CD34+ cells to support ASCT using daily plerixafor and leukapheresis. On the alternating plerixafor and leukapheresis schedule, all 17 patients achieved the cumulative CD34+ cell product goals required for ASCT. This positive observation after salvage chemotherapy and G-CSF led to the incorporation at our center of an alternate-day schedule of plerixafor and leukapheresis into our real-time risk adapted strategy for poor mobilizers.© 2023 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Apheresis of Deceased Donors as a New Source of Mobilized Peripheral Blood Hematopoietic Stem Cells for Transplant Tolerance.

Solid organ transplantation is the therapy of choice for many patients with end-stage organ failure; however, recipients must remain on lifelong immunosuppression, leaving them susceptible to infections and cancer. The study of transplant tolerance to prolong graft survival in the absence of immunosuppression has been restricted to recipients of living donor allografts; however, deceased donors significantly outnumber living donors. Mobilization of hematopoietic stem cells (HSCs) from the bone marrow to peripheral blood (PB) could allow PB-HSCs to be used to induce tolerance in deceased donor kidney recipients; however, a major concern is the well-known concomitant mobilization of immune cells into the liver. We mobilized HSCs to the PD using a protocol of 2 doses of granulocyte colony-stimulating factor and 1 dose of plerixafor, followed by the collection of mobilized cells via apheresis in 3 deceased donors. The physiological, laboratory, and radiographic parameters were monitored throughout the procedure. Longitudinal biopsies were performed to assess the potential for ectopic liver mobilization. The use of both agents led to the successful mobilization of peripheral blood CD34+ cells, demonstrating the potential for use in transplant tolerance protocols. Increased immune cell trafficking into the liver was not observed, and apheresis of mobilized cells resulted in a uniform decrease in all liver leukocyte subsets. HSCs can be mobilized and collected from the PB of brain-dead donors. This new approach may facilitate the dissemination of immune tolerance trials beyond living-donor kidney transplantation to deceased-donor transplantation, without sacrificing the transplantability of the liver.

Framing COVID-19: Political Discourse of the SNP, ERC and Junts during the 2021 Scottish and Catalan Regional Elections

Adding to the growing scholarship on discourse analysis, cognitive frame theory and minority nationalism, this study examines how three of the most successful regional powers in Europe, the SNP in Scotland and Junts and ERC in Catalonia framed the ongoing COVID-19 pandemic to mobilize voters during the 2021 Scottish and Catalan regional elections. The quantitative and qualitative assessment of their Facebook communication suggests that diagnostic, prognostic and motivation framing was applied which are key elements of successful voter mobilization. Communication directly related to COVID-19 was used strategically during the campaigns to criticize the central governments and ascribe blame for the health and economic crisis. Posts about the virus also offered a platform for parties to highlight the successes of regional crisis management and to depict nationalist party candidates for regional governance as truly experienced politicians. Lastly, the SNP, ERC and Junts all argued that the crisis highlighted the weaknesses of the state structures that Scotland and Catalonia belong to. By framing independence as the only viable path to end the COVID-19 crisis, parties offered citizens a clear plan that was entirely dependent on voters casting their ballot papers in favour of nationalist politics.

GBIF’s (Global Biodiversity Information Facility) New Strategic Framework to Address Biodiversity Data Needs

Every five years the Global Biodiversity Information Facility (GBIF) reevaluates its work in an updated Strategic Framework. The latest was recently approved and will be in effect 2023–2027. In responding to our Governing Board and network expectations to accelerate data mobilization and capacity enhancement to improve science for research and policy relevance, the new Framework specifically responds to the biodiversity crisis in its Vision, Mission and Values statements. In addition to the successful national data mobilization framework, GBIF is developing thematic data use cases to accelerate towards the goals set forth in the Framework's priority areas. The thematic data mobilization will identify critical data gaps in areas of research and policy importance and work with new communities to mobilize this data into the GBIF network. Additionally, we will work with user communities to facilitate and track data use. These thematic topics will include areas of interest to global policy initiatives, such as human health, invasive species, agricultural biodiversity, eDNA and others. Aligned with this work is the enhancement of the GBIF Data Model, based on DwC, to better integrate data from diverse sources. We expect that this advancement will encourage the publishing of more and diverse data types that can be used to improve science for research and policy relevance of GBIF-mediated data. In order to accomplish this ambitious Strategic Framework, GBIF will also need to evolve how we operate. The pandemic has taught us that virtual interactions are positive, but have limits. We are developing a more distributed workforce and importantly expanding collaborations, such as with the Atlas of Living Australia, Biodiversity Information Standards (TDWG), and the Catalogue of Life on joint infrastructure and models. These alliances build interoperability, enlarge and improve data mobilization and use, and quicken knowledge growth to strengthen the entire biodiversity knowledge network to meet our critical needs.

‘I was told the position has already been filled’

The article investigates educational and career paths of educated Roma youth in Hungary as striving to enter quality employment in the business sector. While the employment rate of well-educated Roma youth is high compared to the general Roma population, their sectoral distribution is skewed towards self-employment, and towards the public sector vis-à-vis private sector. Our article investigates the reasons for the low presence of educated Roma in the business sphere, a sector which holds the greatest potential of occupational and social mobility. We use a survey dataset of educated young Roma (N=381), and also rely on in-depth interviews with youth from the same group, which provided us with a better understanding of the individual experiences of social mobility. We identify some of the main barriers linked to business sector employment of the Roma youth. By utilising the Bourdesian theoretical lens, we focus on the importance of cultural habitus and its misrecognition in professional settings. The paper analyses successful capital mobilizations of those striving towards/ experiencing social mobility, while discussing experiences of failures too. These findings are unique in their nature as they pinpoint individual mobility strategies, the role of different forms of capitals in strive for jobs and later in early professional career.

Role of large unstained cells in predicting successful stem cell collection in autologous stem cell transplantation

IntroductionSufficient stem cell collection is mandatory for Autologous stem cell transplantation (ASCT). Peripheral CD34+ stem CD34 + stem cell counting by flow cytometry is the gold standard method in both the predicting and timing of successful stem cell collection. Large unstained cells (LUC) are large peroxidase-negative cells that are displayed on certain automatic cell counters and present large lymphocytes, virocytes, blasts, abnormal cells and hematopoietic stem cells. In this study, we evaluated the role of LUC parameters in the timing and prediction of successful stem cell collection. MethodsPatients with a diagnosis of multiple myeloma, lymphoma and testis tumor who proceed to ASCT were included in this study. Preapheresis LUC parameters were analyzed with Siemens ADVIA® 2120i system., Kruskal Wallis, Mann-Whitney U, Spearman Rho and receiver–operator curve (ROC) tests were used for analyses. ResultsNinety patients were evaluated. Peripheral CD34 + cell count was positively correlated with both LUC count (p = 0014) and LUC percentage (p = 0,01). LUC percentage in peripheral blood was positively correlated with mobilized stem cell count in the yield (p = 0.003). We found a LUC count of > 0.485 × 109/L as a cut-off value for detecting > 20 × 106/L CD34 +cells in the peripheral blood with a sensitivity of 64.6% and specificity of 75%. We defined > 2.15% as a cut-off value for LUC percentage to collect > 5 × 106/kg of stem cells with a sensitivity of 64% and specificity of 63%. Additionally, total nucleated cell (TNC) count was negatively correlated with LUC percentage (p = 0.014) and positively correlated with LUC count (p = 0.001). ConclusionLUC parameters are readily available, simple and cheap tools that can be useful in both timing of CD34 count by flow cytometry in peripheral blood and in the prediction of successful mobilization. LUCs can also be an indicator of graft composition.

A strike in the time of COVID-19 pandemic: The 2020 health workers’ dispute in Hong Kong

A short health workers’ strike held in early 2020 in Hong Kong at the start of the Covid-19 pandemic demonstrates the importance of democratic framing of social movement unionism. A trade union was established during a period of massive civil unrest against the local government in 2019 and then proceeded to organise a strike within 2 months of formation to pressure both their employer and the government to enhance citizen and health workers’ safety as the pandemic entered Hong Kong. The paper explains the organisation, progress and reaction to the strike by different stakeholders. The case exemplifies mobilisation through strong democratic trade unionism and provides an example of social movement framing that combined membership and societal interests. The strike represents the last instance of successful independent union mobilisation in Hong Kong as governance shifted from laisse-faire industrial relations that favoured the local capitalist elite to state authoritarianism focussed on obedience to the national political elite.

News of Constitutions

This article examines the spread of constitutionalist ideas in the city of Rio de Janeiro in the 1810s and early 1820s. Successful pro-constitutionalist mobilization in early 1821 raises questions of how residents of Rio learned of constitutionalist projects taking shape elsewhere in the Atlantic world, most notably that of the Spanish Constitution of Cádiz written in 1812. By examining the record of efforts both to prevent the spread of news from Spain and to disseminate and interpret the constitution written there, especially by Hipólito da Costa (1774-1823) in his London-based Correio Braziliense, this article examines how encounters with news of the Spanish constitution transformed Luso-Brazilian understandings of constitutional government. As Costa’s readers learned, the constitution written in Cádiz in 1812 was a turning point not because it offered a model to be adopted wholesale but rather because it illuminated constitutionalism as a political path forward in an era of trans-Atlantic crisis.

Water for whom? Desalination and the cooptation of the environmental justice frame in Southern California

The environmental justice frame is a key feature of successful grassroots mobilization against the uneven distribution of environmental problems. However, what happens when this discursive framework is questioned, that is, when features of its established definition are made to serve, rather than contest, industry? The article examines this dynamic through an ethnography of a high-volume desalination (potable ocean water) proposal. Findings indicate community groups and non-governmental organizations make normative environmental justice arguments about the high costs of desalination, community disruption, and industrial burden. By contrast, organized labor and public sector actors align with the private sector to promote desalination, using a competing series of arguments about local independence, regional responsibility, and employment. Disentangling these discourses, the author argues that claims in favor of desalination are a part of what this paper calls a cooptation of the environmental justice frame that ultimately facilitates community division in favor of a class bias for a luxury commodity. Interpreting this socio-ecological problem through a political economic lens, this research contributes to discussions about industrial infrastructure conceived within public–private partnership frameworks, calling scholars, activists, and decision-makers to attend to how environmental (in)justice politics can take on surprising meanings amid the expansion of financial capitalism.

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.

Qualitative analysis of the organisational response of a university hospital during the first wave of the COVID-19 crisis

BackgroundThe COVID-19 pandemic has required urgent organisational and managerial adaptation, with hospital medical and administrative leaders under considerable pressure.MethodsAt a single French university hospital, we performed a sociological analysis of...

2D BP/InSe Heterostructures as a Nonlinear Optical Material for Ultrafast Photonics.

The BP/InSe heterojunction has attracted the attention of many fields in successful combined high hole mobility of black phosphorus (BP) and high electron mobility of indium selenide (InSe), and enhanced the environmental stability of BP. Nevertheless, photonics research on the BP/InSe heterostructure was insufficient, while both components are considered promising in the field. In this work, a two-dimensional (2D) BP/InSe heterostructure was fabricated using the liquid-phase exfoliation method. Its linear and non-linear optical (NLO) absorption was characterized by ultraviolet−visible−infrared and Open-aperture Z-scan technology. On account of the revealed superior NLO properties, an SA based on 2D BP/InSe was prepared and embedded into an erbium-doped fiber laser, traditional soliton pulses were observed at 1.5 μm with the pulse duration of 881 fs. Furthermore, harmonic mode locking of bound solitons and dark-bright soliton pairs were also obtained in the same laser cavity due to the cross-coupling effect. The stable mode-locked operation can be maintained for several days, which overcome the low air stability of BP. This contribution further proves the excellent optical properties of 2D BP/InSe heterostructure and provides new probability of developing nano-photonics devices for the applications of double pulses laser source and long-distance information transmission.

Differential Regulation of NK Cell Receptors in Acute Lymphoblastic Leukemia.

Cancer immunotherapies are preferred over conventional treatments which are highly cytotoxic to normal cells. Focus has been on T cells but natural killer (NK) cells have equal potential. Concepts in cancer control and influence of sex require further investigation to improve successful mobilization of immune cells in cancer patients. Acute lymphoblastic leukemia (ALL) is a hematological malignancy mainly of B cell (B-ALL) and T cell (T-ALL) subtypes. Influence of ALL on NK cell is still unclear. Targeted next-generation sequencing was conducted on 62 activating/inhibitory receptors, ligands, effector, and exhaustion molecules on T-ALL (6 males) and normal controls (NC) (4 males and 4 females). Quantitative PCR (q-PCR) further investigated copy number variation (CNV), methylation index (MI), and mRNA expression of significant genes in T-ALL (14 males), NC (12 males and 12 females), and B-ALL samples (N = 12 males and 12 females). Bioinformatics revealed unique variants particularly rs2253849 (T>C) in KLRC1 and rs1141715 (A>G) in KLRC2 only among T-ALL (allele frequency 0.8-1.0). Gene amplification was highest in female B-ALL compared to male B-ALL (KLRC2, KLRC4, and NCR3, p < 0.05) and lowest in male T-ALL cumulating in deletion of KLRD1 and CD69. MI was higher in male ALL of both subtypes compared to normal (KIR2DL1-2 and 4 and KIR2DS2 and 4, p < 0.05) as well as to female B-ALL (KIR3DL2 and KIR2DS2, p < 0.05). mRNA expressions were low. Thus, ALL subtypes potentially regulated NK cell suppression by different mechanisms which should be considered in future immunotherapies for ALL.