Allograft and patient survival after sequential HSCT and kidney transplantation from the same donorA multicenter analysis

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Climate geoengineering: issues of path-dependence and socio-technical lock-in

As academic and policy interest in climate geoengineering grows, the potential irreversibility of technological developments in this domain has been raised as a pressing concern. The literature on socio-technical lock-in and path dependence is illuminating in helping to situate current concerns about climate geoengineering and irreversibility in the context of academic understandings of historical socio-technical development and persistence. This literature provides a wealth of material illustrating the pervasiveness of positive feedbacks of various types (from the discursive to the material) leading to complex socio-technical entanglements which may resist change and become inflexible even in the light of evidence of negative impacts. With regard to climate geoengineering, there are concerns that geoengineering technologies might contribute so-called ‘carbon lock-in’, or become irreversibly ‘locked-in’ themselves. In particular, the scale of infrastructures that geoengineering interventions would require, and the issue of the so-called ‘termination effect’ have been discussed in these terms. Despite the emergent and somewhat ill-defined nature of the field, some authors also suggest that the extant framings of geoengineering in academic and policy literatures may already demonstrate features recognizable as forms of cognitive lock-in, likely to have profound implications for future developments in this area. While the concepts of path-dependence and lock-in are the subject of ongoing academic critique, by drawing analytical attention to these pervasive processes of positive feedback and entanglement, this literature is highly relevant to current debates around geoengineering

Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial

Background. Pediatric hematopoietic cell transplant (HCT) is a lifesaving treatment that often results in physical and psychological discomfort. An acupressure-massage intervention may improve symptom management in this setting. Methods. This randomized controlled pilot trial compared a combined massage-acupressure intervention to usual care. Children were offered three practitioner-provided sessions per week throughout hospitalization. Parents were trained to provide additional acupressure as needed. Symptoms were assessed using nurses' reports and two questionnaires, the behavioral affective and somatic experiences scale and the Peds quality of life cancer module. Results. We enrolled 23 children, ages 5 to 18. Children receiving the intervention reported fewer days of mucositis (Hedges' g effect size ES = 0.63), lower overall symptom burden (ES = 0.26), feeling less tired and run-down (ES = 0.86), having fewer moderate/severe symptoms of pain, nausea, and fatigue (ES = 0.62), and less pain (ES = 0.42). The intervention group showed trends toward increasing contentness/serenity (ES = +0.50) and decreasing depression (ES = −0.45), but not decreased anxiety (ES = +0.42). Differences were not statistically significant. Discussion. Feasibility of studying massage-acupressure was established in children undergoing HCT. Larger studies are needed to test the efficacy of such interventions in reducing HCT-associated symptoms in children

Massage for Children Undergoing Hematopoietic Cell Transplantation: A Qualitative Report

Background. No in-depth qualitative research exists about the effects of therapeutic massage with children hospitalized to undergo hematopoietic cell transplantation (HCT). The objective of this study is to describe parent caregivers' experience of the effects of massage/acupressure for their children undergoing HCT. Methods. We conducted a qualitative analysis of open-ended interviews with 15 parents of children in the intervention arm of a massage/acupressure trial. Children received both practitioner and parent-provided massage/acupressure. Results. Parents reported that their child experienced relief from pain and nausea, relaxation, and greater ease falling asleep. They also reported increased caregiver competence and closeness with their child as a result of learning and performing massage/acupressure. Parents supported a semistandardized massage protocol. Conclusion. Massage/acupressure may support symptom relief and promote relaxation and sleep among pediatric HCT patients if administered with attention to individual patients' needs and hospital routines and may relieve stress among parents, improve caregiver competence, and enhance the sense of connection between parent and child

SOPHIE velocimetry of Kepler transit candidates. V. The three hot Jupiters KOI-135b, KOI-204b and KOI-203b (alias Kepler-17b)

We report the discovery of two new transiting hot Jupiters, KOI-135b and KOI-204b, that were previously identified as planetary candidates by Borucki et al. 2011, and, independently of the Kepler team, confirm the planetary nature of Kepler-17b, recently announced by Desert et al. 2011. Radial-velocity measurements, taken with the SOPHIE spectrograph at the OHP, and Kepler photometry (Q1 and Q2 data) were used to derive the orbital, stellar and planetary parameters. KOI-135b and KOI-204b orbit their parent stars in 3.02 and 3.25 days, respectively. They have approximately the same radius, Rp=1.20+/-0.06 R_jup and 1.24+/-0.07 R_jup, but different masses Mp=3.23+/-0.19 M_jup and 1.02+/-0.07 M_jup. As a consequence, their bulk densities differ by a factor of four, rho_p=2.33+/-0.36 g.cm^-3 (KOI-135b) and 0.65+/-0.12 g.cm-3 (KOI-204b). Our SOPHIE spectra of Kepler-17b, used both to measure the radial-velocity variations and determine the atmospheric parameters of the host star, allow us to refine the characterisation of the planetary system. In particular we found the radial-velocity semi-amplitude and the stellar mass to be respectively slightly smaller and larger than Desert et al. These two quantities, however, compensate and lead to a planetary mass fully consistent with Desert et al.: our analysis gives Mp=2.47+/-0.10 M_jup and Rp=1.33+/-0.04 R_jup. We found evidence for a younger age of this planetary system, t<1.8 Gyr, which is supported by both evolutionary tracks and gyrochronology. Finally, we confirm the detection of the optical secondary eclipse and found also the brightness phase variation with the Q1 and Q2 Kepler data. The latter indicates a low redistribution of stellar heat to the night side (<16% at 1-sigma), if the optical planetary occultation comes entirely from thermal flux. The geometric albedo is A_g<0.12 (1-sigma).Comment: submitted to Astronomy and Astrophysic

long term treatment outcome in ipex syndrome patients an international multicenter retrospective study

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Hematopoietic Cell Transplantation in Patients With Primary Immune Regulatory Disorders (PIRD): A Primary Immune Deficiency Treatment Consortium (PIDTC) Survey.

Primary Immune Regulatory Disorders (PIRD) are an expanding group of diseases caused by gene defects in several different immune pathways, such as regulatory T cell function. Patients with PIRD develop clinical manifestations associated with diminished and exaggerated immune responses. Management of these patients is complicated; oftentimes immunosuppressive therapies are insufficient, and patients may require hematopoietic cell transplant (HCT) for treatment. Analysis of HCT data in PIRD patients have previously focused on a single gene defect. This study surveyed transplanted patients with a phenotypic clinical picture consistent with PIRD treated in 33 Primary Immune Deficiency Treatment Consortium centers and European centers. Our data showed that PIRD patients often had immunodeficient and autoimmune features affecting multiple organ systems. Transplantation resulted in resolution of disease manifestations in more than half of the patients with an overall 5-years survival of 67%. This study, the first to encompass disorders across the PIRD spectrum, highlights the need for further research in PIRD management

Author Correction: A consensus-based transparency checklist.

An amendment to this paper has been published and can be accessed via a link at the top of the paper