Late Cardiotoxicity from the Tyrosine Kinase Inhibitor, Dasatinib: Pleural Effusions, Pulmonary Arterial Hypertension, and Right Heart Failure

Despite the remarkable progress made over the past few decades in the management of patients with both solid and hematologic malignancies, radiation- and chemotherapy-related cardiotoxicity remains an ongoing problem. This is true even for newer highly targeted therapies, including tyrosine kinase inhibitors (TKIs). This report presents a case of late/severe right heart dysfunction secondary to pulmonary hypertension, developed after ten years of therapy with dasatinib. We also review the history of this known, but often unrecognized, and potentially reversible complication, and we suggest treatment options. Additionally, this case highlights the remarkable effectiveness of TKIs in patients with chronic myelogenous leukemia while also emphasizing the ever-present concern that even in the absence of clinical or laboratory evidence of residual leukemic disease, discontinuing chemotherapeutic agents may result in prompt recrudescence and death

Corticosteroid Weaning in Stable Heart Transplant Patients: Guidance by Serum Cortisol Level

Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement. Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol \u3c 8 micrograms/deciliter were assigned to a maintenance group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks. Patients were monitored on subsequent office visits for adrenal insufficiency and allograft rejection. Results: Thirty-one patients were enrolled (6 patients in the maintenance group and 25 in the steroid-weaning group). Mean follow-up was 10.2 ± 4 years for the weaning group and 9.0 ± 4.9 years in the maintenance group (p = 0.6). No cases of rejection were noted, nor did any patient resume steroid treatment following discontinuation. Conclusion: Steroids can be safely discontinued in stable heart transplant patients with an AM serum cortisol ≥ 8 micrograms/deciliter with appropriate outpatient follow-up. In this study, no patient suffered late rejection or clinically noted adrenal insufficiency

Development of a scale to measure individuals’ ratings of peace

Background: The evolving concept of peace-building and the interplay between peace and health is examined in many venues, including at the World Health Assembly. However, without a metric to determine effectiveness of intervention programs all efforts are prone to subjective assessment. This paper develops a psychometric index that lays the foundation for measuring community peace stemming from intervention programs. Methods: After developing a working definition of ‘peace’ and delineating a Peace Evaluation Across Cultures and Environments (PEACE) scale with seven constructs comprised of 71 items, a beta version of the index was pilot-tested. Two hundred and fifty subjects in three sites in the U.S. were studied using a five-point Likert scale to evaluate the psychometric functioning of the PEACE scale. Known groups validation was performed using the SOS-10. In addition, test-retest reliability was performed on 20 subjects. Results: The preliminary data demonstrated that the scale has acceptable psychometric properties for measuring an individual’s level of peacefulness. The study also provides reliability and validity data for the scale. The data demonstrated internal consistency, correlation between data and psychological well-being, and test-retest reliability. Conclusions: The PEACE scale may serve as a novel assessment tool in the health sector and be valuable in monitoring and evaluating the peace-building impact of health initiatives in conflict-affected regions

PAndAS' cubs: discovery of two new dwarf galaxies in the surroundings of the Andromeda and Triangulum galaxies

We present the discovery of two new dwarf galaxies, Andromeda XXI and Andromeda XXII, located in the surroundings of the Andromeda and Triangulum galaxies (M31 and M33). These discoveries stem from the first year data of the Pan-Andromeda Archaeological Survey (PAndAS), a photometric survey of the M31/M33 group conducted with the Megaprime/MegaCam wide-field camera mounted on the Canada-France-Hawaii Telescope. Both satellites appear as spatial overdensities of stars which, when plotted in a color-magnitude diagram, follow metal-poor, [Fe/H]=-1.8, red giant branches at the distance of M31/M33. Andromeda XXI is a moderately bright dwarf galaxy (M_V=-9.9+/-0.6), albeit with low surface brightness, emphasizing again that many relatively luminous M31 satellites still remain to be discovered. It is also a large satellite, with a half-light radius close to 1 kpc, making it the fourth largest Local Group dwarf spheroidal galaxy after the recently discovered Andromeda XIX, Andromeda II and Sagittarius around the Milky Way, and supports the trend that M31 satellites are larger than their Milky Way counterparts. Andromeda XXII is much fainter (M_V=-6.5+/-0.8) and lies a lot closer in projection to M33 than it does to M31 (42 vs. 224 kpc), suggesting that it could be the first Triangulum satellite to be discovered. Although this is a very exciting possibility in the context of a past interaction of M33 with M31 and the fate of its satellite system, a confirmation will have to await a good distance estimate to confirm its physical proximity to M33. Along with the dwarf galaxies found in previous surveys of the M31 surroundings, these two new satellites bring the number of dwarf spheroidal galaxies in this region to 20.Comment: 10 pages, 6 figures, accepted for publication in ApJ; v2: minor typographical correction

What is a galaxy? How Cold is Cold Dark Matter? Recent progress in Near Field Cosmology

There has been a vast recent improvement in photometric and kinematic data for star clusters, Ultra Compact dwarfs, galactic nuclei, and local dSph galaxies, with Subaru contributing substantially to the photometric studies in particular. These data show that there is a bimodal distribution in half-light radii, with stable star clusters always being smaller than 35pc, while stable galaxies are always larger than 120pc. We extend the previously known observational relationships and interpret them in terms of a more fundamental pair of intrinsic properties of dark matter itself: dark matter forms cored mass distributions, with a core scale length of greater than about 100pc, and always has a maximum central mass density with a narrow range. The dark matter in dSph galaxies appears to be clustered such that there is a mean volume mass density within the stellar distribution which has the very low value of about 0.1$M_{\odot}$ pc$^{-3}$. None of the dSphs displays kinematics which require the presence of an inner cusp, while in two dSphs there is evidence that the density profile is shallow (cored) in the inner regions. The maximum central dark matter density derived is model dependent, but is likely to have a mean value (averaged over a volume of radius 10pc) of about 0.1$M_{\odot}$ pc$^{-3}$, which is 5GeV/c$^2$cm$^{-3}$). Galaxies are embedded in dark matter halos with these properties; smaller systems containing dark matter are not observed.Comment: proceedings of The 1st Subaru International Conference, "Panoramic Views of Galaxy Formation and Evolution" (Hayama, Japan, 11-16 Dec 2007) ASP Conf se

Hostility, Race, and Glucose Metabolism in Nondiabetic Individuals

OBJECTIVE— The present study was designed to determine whether hostility is differentially related to measures of glucose metabolism in African-Americans and Caucasians. RESEARCH DESIGN AND METHODS— The relationship of hostility, as measured by a subset of the Cook-Medley hostility scale (CMHOST) inventory items, to various parameters of glucose metabolism were examined in a young, healthy sample of male and female African-American and Caucasian volunteers. Fasting blood samples were collected during an inpatient admission, at which time the CMHOST was also administered. RESULTS— In the entire sample, the CMHOST was found to be significantly correlated with fasting glucose and insulin sensitivity, as measured by the homeostatic model assessment (HOMA). However, the relationship of hostility to these parameters of glucose metabolism was different in African-American and Caucasian subjects. Hostility was significantly related to fasting glucose in African-Americans and to insulin sensitivity and fasting insulin in Caucasian subjects. The relationship of hostility to insulin sensitivity and fasting insulin was partially dependent on BMI in Caucasians, but the relationship of hostility to fasting glucose was unrelated to BMI in African-Americans. CONCLUSIONS— Our data suggest that the relationship of hostility to measures of glucose metabolism is mediated differently in these two ethnic groups. Therefore, hostility seems to be part of a constellation of risk-related behaviors related to BMI in Caucasians but independently related to fasting glucose in African-Americans

The Effects of Patchy Reionization on Satellite Galaxies of the Milky Way

We combine the high-resolution Aquarius simulations with three-dimensional models of reionization based on the initial density field of the Aquarius parent simulation, Millennium-II, to study the impact of patchy reionization on the faint satellite population of Milky Way halos. Because the Aquarius suite consists of zoom-in simulations of halos in the Millennium-II volume, we follow the formation of substructure and the growth of reionization bubbles due to the larger environment simultaneously, and thereby determine the reionization redshifts of satellite candidates. We do this for four different reionization models, and also compare results to instantaneous reionization. Using a simple procedure for selecting satellites and assigning luminosities in the simulations, we compare the resulting satellite populations. We find that the overall number of satellites depends sensitively on the reionization model, with a factor of 3-4 variation between the four models for a given host halo, although the difference is entirely in the population of faint satellites (M_V > -10). In addition, we find that for a given reionization model the total number of satellites differs by 10%-20% between the patchy and homogeneous scenarios, provided that the redshift is chosen appropriately for the instantaneous case. However, the halo-halo scatter from the six Aquarius halos is large, up to a factor of 2-3, and so is comparable to the difference between reionization scenarios. In order to use the population of faint dwarf galaxies around the Milky Way as a probe of the local reionization history, then, it is necessary to first better understand the general distribution of substructure around Milky Way-mass halos.Comment: Matches published version. Reionization discussion expanded, major conclusions unchange

Evaluation Research and Institutional Pressures: Challenges in Public-Nonprofit Contracting

This article examines the connection between program evaluation research and decision-making by public managers. Drawing on neo-institutional theory, a framework is presented for diagnosing the pressures and conditions that lead alternatively toward or away the rational use of evaluation research. Three cases of public-nonprofit contracting for the delivery of major programs are presented to clarify the way coercive, mimetic, and normative pressures interfere with a sound connection being made between research and implementation. The article concludes by considering how public managers can respond to the isomorphic pressures in their environment that make it hard to act on data relating to program performance.This publication is Hauser Center Working Paper No. 23. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

The Lantern Vol. 62, No. 1, December 1994

• Hollow • A Little Knowledge is Dangerous • My Old Block • Life • The Natural Born Fool • Oracle • Formation of a Triangle • Marie on the Beach • The Tweed Derby • Tripping • In Vitro • The Character • Coming Home for Christmas • Unkempt • Too Much • Reimertanti-Ode • Seeds • Secrethttps://digitalcommons.ursinus.edu/lantern/1145/thumbnail.jp

Galactic Center Research: Manifestations of the Central Black Hole

This review summarizes a few of the frontiers of Galactic center research that are currently the focus of considerable activity and attention. It is aimed at providing a necessarily incomplete sketch of some of the timely work being done on phenomena taking place in, or originating in, the central few parsecs of the Galaxy, with particular attention to topics related to the Galactic black hole (GBH). We have chosen to expand on the following exciting topics: 1) the characterization and the implications for the variability of emission from the GBH, 2) the strong evidence for a powerful X-ray flare in the Galactic center within the past few hundred years, and the likelihood that the GBH is implicated in that event, 3) the prospects for detecting the "shadow" of the GBH, 4) an overview of the current state of research on the central S-star cluster, and what has been learned from the stellar orbits within that cluster, and 5) the current hypotheses for the origin of the G2 dust cloud that is projected to make a close passage by the GBH in 2013.Comment: Review article, in press with Review of Astronomy and Astrophysic