Prevalence of Steroid-Induced Hyperglycemia in Patients with Mantle Cell Lymphoma Receiving High Dose Steroids

Background Hyperglycemia as a result of glucocorticoid administration (steroid-induced hyperglycemia [SIH]) occurs in 32-37% of adult patients with cancer both with and without previous history of diabetes. Patients diagnosed with mantle cell lymphoma (MCL) are often treated with chemotherapy regimens that include high dose steroids as first line therapy. Little is known about the prevalence of steroid-induced hyperglycemia in patients with MCL receiving high dose steroids. Moreover it is not known if how the resulting hyperglycemia is managed impacts time to relapse or death. Purpose The primary aim of this study was to determine the prevalence of SIH in MCL patients with and without pre-existing diabetes receiving high dose steroids. The secondary aims were to: (1) determine the persistence of resulting hyperglycemia, (2) determine how hyperglycemia was managed, (3) and to examine the association between hyperglycemia and time to relapse or time to death. Methods A retrospective chart review was conducted, of electronic health records of patients over the age of 18, with diagnosis of MCL, receiving treatment at UT MD Anderson Cancer Center between 1/1/2000 through 12/31/2010. Results SIH occurred in 127 patients (70% of the cohort), with 57% of SIH being associated with the first cycle of chemotherapy (during or following the 1st course of steroids). Higher mean baseline blood glucose (p=0.0290) and history of diabetes (p=0.0013) were the only factors found to be related to the development of SIH. Hyperglycemia was found to be persistent at 3-6 months in 3 (7%) of the 46 patients with history of diabetes and 4(5%) of the 81 patients with no history. There was no significant difference in SIH management between those with and without persistent hyperglycemia (p=0.8839) and management of SIH did not show a significant impact on time to relapse or death. Although occurrence of SIH did not have a statistically significant impact on time to relapse(p=0.0763) those who experienced SIH had a median time to relapse of 4.58 years and those without SIH had yet to reach median time to relapse. Conclusions Steroid-Induced hyperglycemia is prevalent in patients receiving high dose steroids with and without history of diabetes and glucose elevations persistent in 5-7% of patients after steroids have been discontinued. Each 10mg/dL increase in baseline blood glucose increases the odds of patients developing SIH. However, this retrospective study does not show that SIH has a significant impact on time to relapse or time to death. Prospective studies designed to examine the relationship between the degree of hyperglycemia, the number of hyperglycemic events and time to relapse and death are needed

"One Great World of Fire": Judith Wright's 'Australia, the Land of Fire'

Judith Wright stands within a tradition, a tradition of hope but also of anxiety. Colonising is not an easy business, nor is it merely material. "Settlement in a new, unknown, uncultivated country", according to Mircea Eliade, "is equivalent to an act of creation ... [It involves] the transformation of chaos into cosmos" . Put another way, the settler becomes Christopher Brennan's "Wanderer on the way to the self", attempting to fuse new physical realities and the energies and hungers within the self. This is the task Wright has pursued through her long and significant career. In this task the land itself has been central

Aboriginal Spirituality

'Spirituality' is a fashionable word. What it refers to, however, is beyond fashion, even beyond speech. Kees Waauman links it with the scene in the fifth chapter of John, to the healing of the cripple and to the reference to the angel 'stirring up the water'. Spirituality, he says, has to do with disturbance, disturbance by 'something beyond our world, our situation ... [the Spirit] that blows wherever it pleases'. It therefore has to do with the in-breaking of the other and thus with transformation. The growing interest in Aboriginal spirituality may therefore represent a moment of grace, of this kind of inflowing from within ourselves, from some hidden spring, but also from beyond our world and our situation

Proposal for Austere Light Attack Aircraft – Project Aardvark

The WickedAir senior design team at the University of Alabama in Huntsville is developing the preliminary design of an aircraft for the AIAA Undergraduate Team Aircraft Design Competition. The RFP calls for an affordable light attack aircraft capable of executing missions currently only feasible with attack helicopters. The aircraft must be able to operate from short austere fields and accommodate a crew of two. Additional design goals include enhanced survivability and the ability for deploying a variety of weapons including an integrated gun for ground targets. The aircraft must accomplish an attack mission with a full weapons load and a long-range ferry mission with a 60% weapons load. Through evaluation of existing attack aircraft and helicopters and initial trade studies, the team has produced a conceptual design for the ZA-13 “Aardvark”. The 12,000 lbf Aardvark has twin turboprop engines mounted on a 6.9 aspect ratio swept wing. Two sponsons offer weapons attachment points similar to those of a helicopter. This design offers low speed performance, a high payload capacity, and a short takeoff length. Specific consideration was given to the effects of foreign object debris and particulate matter pollution with regards to the lifespan and vulnerability of the aircraft in various austere environments. This paper summarizes the detailed design, cost analysis, and mission capabilities behind the current aircraft

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM