bluuebunny/crossref_metadata_2025 huggingface dataset:
Responsibility: the State of the Question Fault Lines in the Foundations
Authors: Shoemaker David
Published: June 2020

In this article, I discuss five major fault lines in the foundations of responsibility theory—a relatively new field—fault lines traceable to P. F. Strawson's groundbreaking “Freedom and Resentment.” They are about the proper methods and content of responsibility theory, and disputes over these foundational issues have led to a messy and wildly divergent set of theories and approaches in the field. My aim is simply to identify and sort out these fault lines so that we can at least agree on the source of our disagreements, and so that we may also perhaps realize the pressing need to address these fault lines first, in order to help resolve some of our downstream disputes and nurture responsibility theory into a more unified and theoretically sophisticated philosophical enterprise.
FREE YOUR MIND: BUDDHISM, CAUSALITY, AND THE FREE WILL PROBLEM
Authors: Coseru Christian
Published: June 2020

The problem of free will is associated with a specific and significant kind of control over our actions, which is understood primarily in the sense that we have the freedom to do otherwise or the capacity for self‐determination. Is Buddhism compatible with such a conception of free will? The aim of this article is to address three critical issues concerning the free will problem: (1) what role should accounts of physical and neurobiological processes play in discussions of free will? (2) Is a conception of mental autonomy grounded in practices of meditative cultivation compatible with the three cardinal Buddhist doctrines of momentariness, dependent arising, and no‐self? (3) Are there enough resources in Buddhism, given its antisubstantialist metaphysics, to account for personal agency, self‐control, and moral responsibility?
THE ANIMAL BODY MULTIPLE: SCIENCE, RELIGION, AND THE INVENTION OF HALAL STUNNING
Authors: Chao En‐Chieh
Published: June 2020

This article proposes a specific kind of ontological investigation in the field of science and religion. I argue that science and religion can create distinct practices that enact multiple realities, and thus they should be seen as more than different views of the same world. By analyzing the details of scientific experiments crucial for the invention of halal stunning, I demonstrate that religion and science are both permeable to the social, the biological, and to each other, and that seemingly incommensurable realities can co‐occur in the body of an animal. Here, animals’ modes of existence are interdependent with the technologies being used, and with the web of interactions that they are drawn into. In the process of inventing halal stunning, it is not so much about the same animal body that is thought about differently as it is about animals spanning across multiple, physiological, realities as they are recruited into different webs of interactions to create a new slaughter method.
INTRODUCING THE BRAVE NEW CRISPR WORLD
Authors: Gouw Arvin M.
Published: June 2020

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) has been the buzzword for genome editing in the past few years, especially with the birth of Lulu and Nana, twin girls who were genetically edited using the CRISPR/Cas system. To discuss this, a group of scientists, theologians, and ethicists gathered at the 2019 Institute on Religion in the Age of Science (IRAS) conference to discuss the implications of CRISPR gene editing. It became quickly apparent through our discussions that this CRISPR revolution will impact not only human medicine, but any application that involves DNA in every organism from bacteria to plants and animals. Moreover, there are multiple stakeholders in this technology—not only the scientific community, but also the business, legal, and religious communities, to name a few. As a scientist myself, I am providing a brief overview of the scientific hopes and concerns about this powerful technology.
ARTIFICIAL INTELLIGENCE AND ROBOTICS: CONTRIBUTIONS FROM THE SCIENCE AND RELIGION FORUM
Authors: Straine Gillian K.
Published: June 2020

The Science and Religion Forum (SRF) seeks to be the premier organization promoting the discussion between science and religion in the United Kingdom for academics, professionals, and interested lay people. Each year, the SRF holds a conference tackling a topical issue, and in 2019 focused on artificial intelligence and robotics. This article introduces the thematic section which is made up of three papers from that conference and provides a summary of the event.
THE ARTIFICIALIZATION OF MIND AND WORLD
Authors: Chaudhary Mohammad Yaqub
Published: June 2020

The rapid advancement of artificial intelligence (AI) has led to renewed ambitions of developing artificial general intelligence. Alongside this has been a resurgence in the development of virtual and augmented reality (V/AR) technologies, which are viewed as “disruptive” technologies and the computing platforms of the future. V/AR effectively bring the digital world of machines, robots, and artificial agents to our senses while entailing the transposition of human activity and presence into the digital world of artificial agents and machine forms of intelligence. The intersection of humans and machines in this shared space brings humans and machines into ontological continuity as informational entities in a totalizing informational environment, which subsumes both cyber and physical space in an artificially constructed virtual world. The reconstruction of mind (through AI) and world (through V/AR) thus has significant epistemological, ontological, and anthropological implications, which constitute the underlying features in the artificialization of mind and world.
ENCOUNTERS WITH EMERGENT DEITIES: ARTIFICIAL INTELLIGENCE IN SCIENCE FICTION NARRATIVE
Authors: Hipple David
Published: June 2020

In the mid‐twentieth century, theorists began seriously forecasting possibilities for artificial intelligence (AI). As related research gathered momentum and resources, the topic made impressions on public discourse. One effect was increasingly pointed emphasis on AI in popular narratives. Although considerably earlier thematic examples may be located, we can observe swelling and generally pessimistic threads of speculation in science fiction of the 1950s and 1960s. This discussion identifies some pertinent science fiction texts from that period, alongside public discussion arising from contemporary research. One consistent theme is human receptiveness to the numinous, and the capacity to ascribe personality and even divinity to sufficiently impressive manifestations, even artificial ones. Science fiction has long contemplated such reactions, prefiguring today's anticipations of AIs that might abruptly develop themselves beyond any possible human comprehension or control. This body of exploratory projections is a useful resource for the engineers and philosophers currently grappling with realistic prospects for Western humanity's shifting conception of itself.
Cultural Practices Generated by Structural Biodiversity of Two Urban Forests in Johor Bahru, Malaysia
Authors: Mohd Fauzi Amalina , Abd Ghafar Azmiah
Published: June 2020

The use of urban green space is a determinant for urban inhabitant’s well-being. However, increasing urbanisation lessened the opportunity for urban inhabitants to engage with green space. This situation requires landscape planners to design an urban green space with maximum benefits that fulfil inhabitants’ needs for their well-being. Structural biodiversity is an essential element in generating the benefits and values interpreted through the activities at the urban green space. This paper aims to identify the cultural practices that influenced by structural biodiversity of two urban forests in Johor Bahru, Malaysia. Multiple Response Analysis was used to analyse the data from on-site questionnaire surveys completed by 253 visitors of both urban forests. The result shows that a high-density urban forest offers an opportunity for visitors to get attached to nature and attract visitors to involve in sedentary and moderate activities. In contrast, a moderate density urban forest offers a less natural value that attracts visitors to take part in moderate and vigorous activities with less engagement with nature. This study would contribute to a better understanding of the structural biodiversity that influenced visitors’ cultural practices, where the present condition of the two urban forests has illustrated the current benefits that visitors obtained from the ecosystem.
Assessment of Residents’ Socio-demographic Factors Associated with Visit to Green Infrastructure Facilities in Lagos Metropolis, Nigeria
Authors: Ayodele Dipeolu Adedotun , Ralph Aluko Olusola , Samuel Omoniyi Sunday , Abiodun Oyinloye Michael
Published: June 2020

Despite global efforts at promoting environmental sustainability through development of Green Infrastructure (GI) facilities at urban centres; social menaces, depletion and wrong use of green spaces still persists in many developing nations. Indeed, attitude of residents towards the use of these facilities have not been commensurate to the reasons why the GI facilities were created. This study therefore examines the socio-demographic factors associated with visiting GI sites among residents of Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1560 participants in a questionnaire survey. Descriptive statistics was used to explore data distributions while Chi-square test was used to investigate residents’ socio-demographic characteristics associated with visit to green infrastructure sites in the study area. Participants were mostly men (58.6%) and younger than 50 years old (85.8%). Percentages of residents visiting GI facilities for either spiritual exercises (male=26.4%, female=23.8%) or joblessness (male=48.9%, female=52.1%) is higher than percentages of residents visiting GI facilities for recreation/relaxation (male=24.7%, female=24.1%) activities in Lagos Metropolis. The study suggests among others that, the Lagos State government should develop GI facilities to enhance more opportunity for job generation, while more public orientation on positive attitude toward use of GI facilities should be emphasized ABSTRACT Despite global efforts at promoting environmental sustainability through development of Green Infrastructure (GI) facilities at urban centres; social menaces, depletion and wrong use of green spaces still persists in many developing nations. Indeed, attitude of residents towards the use of these facilities have not been commensurate to the reasons why the GI facilities were created. This study therefore examines the socio-demographic factors associated with visiting GI sites among residents of Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1560 participants in a questionnaire survey. Descriptive statistics was used to explore data distributions while Chi-square test was used to investigate residents’ socio-demographic characteristics associated with visit to green infrastructure sites in the study area. Participants were mostly men (58.6%) and younger than 50 years old (85.8%). Percentages of residents visiting GI facilities for either spiritual exercises (male=26.4%, female=23.8%) or joblessness (male=48.9%, female=52.1%) is higher than percentages of residents visiting GI facilities for recreation/relaxation (male=24.7%, female=24.1%) activities in Lagos Metropolis. The study suggests among others that, the Lagos State government should develop GI facilities to enhance more opportunity for job generation, while more public orientation on positive attitude toward use of GI facilities should be emphasized.
Interdisciplinary Science to Confront Coccidioidomycosis
Authors: Sarafoglou Nikias , Laniado-Laborin Rafael , Sprigg William A. , Kafatos Menas
Published: June 2020

The long journey of research to lower risks of Coccidioidomycosis (CM) began in the late 19th century in Argentina and continued north to Mexico, the US and other countries. During this trip, medical science led the way. Although interdisciplinary research is not alien to medical science, e.g. geographic epidemiology, interaction with other disciplines has been low priority. This paper argues that the efficacy of CM mitigation and treatment can be improved through multi- and inter-disciplinary information exchange, particularly with earth and environmental sciences. Greater interaction and open publication practice are essential. Section 1 describes CM-epidemiology, the clinical features, the diagnosis and finally, the treatment.Section 2 discusses epidemiological evidence for atmospheric influence on cases of CM.Section 3 highlights the most important contributions and controversies in the history of CM-research through scientometric or bibliometric evaluations of research that are based on Garfield’s work on the propagation of scientific thinking.
Clinical Decision-Making: Developing a 4 C Model Using Graph Theoretic Approach
Authors: Mishra Rajesh P. , Mundra Nidhi , Upreti Girish , Villa-Marulanda Marcela
Published: June 2020

The purpose of this paper is to propose a graph-theoretic mathematical model to measure how conducive the environment of a hospital is for decision-making. We propose a 4-C model, developed from four interacting factors: confidence, complexity, capability, and customer. In this graph-theoretic model, abstract information regarding the system is represented by the directed edges of a graph (or digraph), which together depict how one factor affects another. The digraph yields a matrix model useful for computer processing. The net effect of different factors and their interdependencies on the hospital's decision-making environment is quantified and a single numerical index is generated. This paper categorizes all the major factors that influence clinical decision-making and attempts to provide a tool to study and measure their interactions with each other. Each factor and each interaction among factors are to be quantified by healthcare experts according to their best judgment of the magnitude of its effect in a local hospital environment.A hospital case study is used to demonstrate how the 4-C model works. The graph-theoretic approach allows for the inclusion of new factors and generation of alternative environments by a combination of both qualitative and quantitative modeling. The 4-C model can be used to create both a database and a simple numerical scale that help a hospital set customized guidelines, ranging from patient admittance procedures to diagnostic and treatment processes, according to its specific situation. Implementing this methodology systematically can allow a hospital to identify factors that will lead to improved decision-making as well as identifying operational factors that present roadblocks.
Higher-Order Stabilized Perturbation for Recursive Eigen-Decomposition Estimation
Authors: Mucchielli Paul , Bhowmik Basuraj , Hazra Budhaditya , Pakrashi Vikram
Published: June 2020

Eigen-decomposition remains one of the most invaluable tools for signal processing algorithms. Although traditional algorithms based on QR decomposition, Jacobi rotations and block Lanczos tridiagonalization have been proposed to decompose a matrix into its eigenspace, associated computational expense typically hinders their implementation in a real-time framework. In this paper, we study recursive eigen perturbation (EP) of the symmetric eigenvalue problem of higher order (greater than one). Through a higher order perturbation approach, we improve the recently established first-order eigen perturbation (FOP) technique by creating a stabilization process for adapting to ill-conditioned matrices with close eigenvalues. Six algorithms were investigated in this regard: first-order, second-order, third-order, and their stabilized versions. The developed methods were validated and assessed on multiple structural health monitoring (SHM) problems. These were first tested on a five degrees-of-freedom (DOF) linear building model for accurate estimation of mode shapes in an automated framework. The separation of closely spaced modes was then demonstrated on a 3DOF + tuned mass damper (TMD) problem. Practical utility of the methods was probed on the Phase-I ASCE-SHM benchmark problem. The results obtained for real-time mode identification establishes the robustness of the proposed methods for a range of engineering applications.
Parametric Resonance of Axially Accelerating Unidirectional Plates Partially Immersed in Fluid
Authors: Li Hongying , Zhang Shumeng , Li Jian , Wang Xibo
Published: June 2020

This paper investigates the nonlinear vibration of an axially accelerating moving plate considering fluid–structure interaction. Nonlinear coupled equations of motion are derived by means of Kármán plate theory, the Galerkin method is then applied to transform the nonlinear partial differential equations into nonlinear ordinary differential equations. The steady-state response, various bifurcations, and chaotic behavior of the system are studied by the multiple scales method and Runge–Kutta method. The dynamical characteristics of the system are examined via response curves and bifurcation diagrams of Poincaré maps. By three-dimension bifurcation diagrams, change of motion state can be easily observed along with the variation of system parameters during the whole parametric space; meanwhile, it is found that fluctuation amplitude plays a most significant role in the change of motion state for the fluid–structure coupling system.
Unequivocally Nonconservative Results From One Method of Imperfection Quantification in RCC-MR
Authors: Kumar Ashok , Chatterjee Anindya
Published: June 2020

Design against buckling of thin shells at high temperatures often follows the code RCC-MR. RCC-MR allows three methods to quantify shell imperfections for use in safe load calculations, where lower imperfection values raise the safe load estimates. In recent work, we showed that the third of these methods can sometimes yield remarkably low imperfection values, leading to potentially nonconservative designs, but nonconservatism of the method was not proved. Here, we prove nonconservatism in two designs based on the third method. Proving such nonconservatism is difficult using experiments or with large material nonlinearity in simulations. We first discuss these difficulties to motivate our approach. We then present two examples: a spherical shell and a torispherical shell, both under external pressure. The shell walls are thin enough so that plasticity is not encountered before structural collapse. For specific shape imperfections, we show with geometrically nonlinear, purely elastic, highly refined, post-buckling analysis using abaqus that the physical loads at which the imperfect shells collapse are overpredicted via RCC-MR's third method by factors of about 8/7 and 11/10, respectively. We emphasize that code-based design using nonlinear simulation prescribes a further safety factor of 2.5, which we have denied ourselves here in order to give the third method the benefit of doubt. We conclude that the third imperfection quantification method in RCC-MR should be reexamined.
Heat Conduction and Temperature Rise for a Planar Movable Tooth Drive
Authors: Xu Lizhong , Yao Peini
Published: June 2020

Planar movable tooth drives have a compact structure. However, as the size decreases, the heat dissipation capacity decreases; therefore, temperature control is required. A heat conduction model of the drive system, including the central wheel and movable tooth, is established, and the meshing point of the movable tooth and center wheel is considered the heat source. The heat flux density at the meshing point is determined, and the analytical equations describing the temperature increases of the center wheel and the movable tooth are derived. The effects of the input power and system parameters on the temperature increase of the system are analyzed. The results show that the temperature difference of the movable tooth is about 1.5 times the temperature of the center wheel, and the temperature increase near the heat source decreases by more than 15 °C as the movable tooth radius increases from 2 mm to 2.5 mm. The movable tooth radius and center distance have significant effects on the temperature increase and can be used as control parameters to prevent a temperature increase of the drive.
Performance Improvement of a Domestic Liquefied Petroleum Gas Cook Stove Using an Extended Spill-Tray and an Annular Metal Insert
Authors: Das Mithun , Ganguly Ranjan , Datta Amitava , Verma Meenam M. , Bera Ashis K.
Published: June 2020

Liquefied petroleum gas (LPG) is widely used as a cooking fuel as it has higher energy content and produces lower emissions compared to other traditional fuels. Due to massive demand for LPG, aside from its limited reserve, performance improvement of the LPG cook-stoves is essential. In the present work, the thermal efficiency of a traditional cook stove has been studied both experimentally and numerically for LPG fuel. Based on the knowledge from the computational model concerning flow field and species transport parameters, the conventional cook-stove design has been modified for improving the efficiency. In the modified design of the stove, attachment of an annular metal plate insert and introduction of an extended spill-tray to close the gap around the burner are considered. The modifications result in favourable guidance of the flow of secondary air and hot product gases of combustion to ensure better heat transfer rate to the loading vessel. The thermal efficiency of the modified cook-stove is around 73.6%, which is about 4.7 percentage point improvement from that of an identical stove without the insert and extended spill-try.
Optimization for Liquid Cooling Cylindrical Battery Thermal Management System Based on Gaussian Process Model
Authors: Li Wei , Garg Akhil , Xiao Mi , Gao Liang
Published: June 2020

The power of electric vehicles (EVs) comes from lithium-ion batteries (LIBs). LIBs are sensitive to temperature. Too high and too low temperatures will affect the performance and safety of EVs. Therefore, a stable and efficient battery thermal management system (BTMS) is essential for an EV. This article has conducted a comprehensive study on liquid-cooled BTMS. Two cooling schemes are designed: the serpentine channel and the U-shaped channel. The results show that the cooling effect of two schemes is roughly the same, but the U-shaped channel can significantly decrease the pressure drop (PD) loss. The U-shaped channel is parameterized and modeled. A machine learning method called the Gaussian process (GP) model has been used to express the outputs such as temperature difference, temperature standard deviation, and pressure drop. A multi-objective optimization model is established using GP models, and the NSGA-II method is employed to drive the optimization process. The optimized scheme is compared with the initial design. The main findings are summarized as follows: the velocity of cooling water v decreases from 0.3 m/s to 0.22 m/s by 26.67%. Pressure drop decreases from 431.40 Pa to 327.11 Pa by 24.18%. The optimized solution has a significant reduction in pressure drop and helps to reduce parasitic power. The proposed method can provide a useful guideline for the liquid cooling design of large-scale battery packs.
Experimental and Numerical Investigation of a Miniature Additively Manufactured Vortex Tube
Authors: Wallace Gregory , Bunge Carl , Leachman Jacob , Matveev Konstantin I.
Published: June 2020

Ranque–Hilsch vortex tubes are simple devices that can produce a cooling effect using compressed air. A key advantage of vortex tubes is the lack of moving solid parts; however, their efficiencies are relatively low. The present study focuses on the development of a miniature variable-diameter tube using additive manufacturing. A metal-based 3D printing technique was utilized to fabricate this vortex tube monolithically. Computational fluid dynamics simulations employing software star-ccm+ with a compressible Reynolds-Averaged Navier–Stokes (RANS) approach and the elliptic-blending lag k-epsilon turbulence model have been applied to model thermofluid processes inside the vortex tube, to good agreement with the experiment. A temperature decrease of 13.3 °C and a cooling power of approximately 4 W were experimentally achieved with a pressure ratio of 4 in the air at normal conditions. This result shows promise for the goal of utilizing additive manufacturing to design and build complex-geometry vortex tubes intended for use with cryogenic fluids.
Protein adsorption to poly(tetrafluoroethylene) membranes modified with grafted poly(acrylic acid) chains
Authors: Mohd Hidzir Norsyahidah , A Anitha , Kępa Katarzyna , Hill David J. T. , Jorgensen Lene , Grøndahl Lisbeth
Published: June 2020

Protein adsorption to biomaterial surfaces is important for the function of such materials with anchorage-dependent cell adhesion requiring the presence of adsorbed proteins. The current study evaluated five solid surfaces with poly(acrylic acid) (PAA) grafted from the surface of a poly(tetrafluoroethylene) membrane with respect to the adsorption of serum albumin (SA), lactoferrin (Lf), and lysozyme (Lys) from a phosphate buffer and NaCl solution or water for specific combinations. With the use of x-ray photoelectron spectroscopy, the relative amounts and protein layer thickness were evaluated. SA adsorption was governed by ionic repulsive forces and hydrophobic interactions as evidenced from an increase in the protein adsorption at lower pH (6.5 compared to 7.4) and a correlation with surface coverage when water (pH 6.5) was used as the medium. The adsorption of Lf and Lys followed similar trends for all samples. In general, ionic attractive forces dominated and a strong correlation of increasing protein adsorption with the PAA chain length was evident. This study concluded that all surfaces appear suitable for use in biomaterial applications where tissue ingrowth is desired and that the enhanced protein adsorption in a medium with high ionic strength (e.g., biological fluid) correlates with the PAA chain length rather than the surface coverage.
Why Do Sport Coaches Adopt a Controlling Coaching Style? The Role of an Evaluative Context and Psychological Need Frustration
Authors: Morbée Sofie , Vansteenkiste Maarten , Aelterman Nathalie , Haerens Leen
Published: June 2020

In this study, involving 585 youth sport coaches (Mage = 35.76), the authors investigated whether coaches who perceive their environment to be highly evaluative would report acting in a more controlling or pressuring way. In a subsample (n = 211, Mage = 38.14), they examined the explanatory role of coaches’ experiences of psychological need frustration in this relation. They also considered whether years of coaching experience would serve as a buffer against the adverse effects of an evaluative context. In line with the tenets of self-determination theory, results of structural equation modeling indicated that an evaluative context was related to the use of a more controlling coaching style, with experiences of need frustration accounting for this relation. Coaching experience did not play any moderating role, suggesting that even more experienced coaches are vulnerable to the harmful correlates of an evaluative sport context.
SHAGGY-like kinase 12 regulates flowering through mediating CONSTANS stability in
Arabidopsis
Authors: Chen Ying , Song Shiyong , Gan Yinbo , Jiang Lixi , Yu Hao , Shen Lisha
Published: June 2020

SHAGGY-like kinase 12 mediates site-specific phosphorylation of CONSTANS to regulate the floral transition in
Arabidopsis
.
The internal origin of the west-east asymmetry of Antarctic climate change
Authors: Jun Sang-Yoon , Kim Joo-Hong , Choi Jung , Kim Seong-Joong , Kim Baek-Min , An Soon-Il
Published: June 2020

The harmony of the Southern Ocean and Antarctic terrain is the pacemaker of Antarctic climate change under global warming.
Big studies dim hopes for hydroxychloroquine
Authors: Kupferschmidt Kai
Published: June 2020

Amid politicization and scandal, a disappointing scientific picture is emerging.
Computing cancer's weak spots
Authors: Khamsi Roxanne
Published: June 2020

An algorithm to unmask tumors' molecular linchpins is tested in patients.
Sequencing seismograms: A panoptic view of scattering in the core-mantle boundary region
Authors: Kim D. , Lekić V. , Ménard B. , Baron D. , Taghizadeh-Popp M.
Published: June 2020

Sequencing for seismic structures

Structures illuminated by seismic waves at the core-mantle boundary of the Earth are traditionally found by focusing on a specific target area. Kim
et al.
used an unsupervised manifold learning algorithm called “the Sequencer” to automatically detect anomalies in seismic data (see the Perspective by Miller). Using this technique, they uncovered structures at the core-mantle boundary across the entire Pacific region all at once. They found many structures previously identified, but also a new, ultra-low-velocity zone beneath the Marquesas Islands.

Science
, this issue p.
1223
; see also p.
1183
Mapping Earth's deepest secrets
Authors: Miller Meghan S.
Published: June 2020

Sequencing seismograms pinpoint new structures near Earth's core-mantle boundary
CRISPR at lightning speeds
Authors: Medhi Darpan , Jasin Maria
Published: June 2020

Breaking the genome with the flick of a (light) switch
Orally Bioavailable Endochin-Like Quinolone Carbonate Ester Prodrug Reduces Toxoplasma gondii Brain Cysts
Authors: Doggett J. Stone , Schultz Tracey , Miller Alyssa J. , Bruzual Igor , Pou Sovitj , Winter Rolf , Dodean Rozalia , Zakharov Lev N. , Nilsen Aaron , Riscoe Michael K. , Carruthers Vern B.
Published: June 2020

Toxoplasmosis is a potentially fatal infection for immunocompromised people and the developing fetus. Current medicines for toxoplasmosis have high rates of adverse effects that interfere with therapeutic and prophylactic regimens. Endochin-like quinolones (ELQs) are potent inhibitors of
Toxoplasma gondii
proliferation
in vitro
and in animal models of acute and latent infection. ELQ-316, in particular, was found to be effective orally against acute toxoplasmosis in mice and highly selective for
T. gondii
cytochrome
b
over human cytochrome
b
.
ATI-2173, a Novel Liver-Targeted Non-Chain-Terminating Nucleotide for Hepatitis B Virus Cure Regimens
Authors: Squires Katherine E. , Mayers Douglas L. , Bluemling Gregory R. , Kolykhalov Alexander A. , Guthrie David B. , Reddy Prabhakar , Mitchell Debbie G. , Saindane Manohar T. , Sticher Zachary M. , Edpuganti Vindhya , De La Rosa Abel
Published: June 2020

ATI-2173 is a novel liver-targeted molecule designed to deliver the 5′-monophosphate of clevudine for the treatment of chronic hepatitis B infection. Unlike other nucleos(t)ides, the active clevudine-5′-triphosphate is a noncompetitive, non-chain-terminating inhibitor of hepatitis B virus (HBV) polymerase that delivers prolonged reduction of viremia in both a woodchuck HBV model and in humans for up to 6 months after cessation of treatment. However, long-term clevudine treatment was found to exhibit reversible skeletal myopathy in a small subset of patients and was subsequently discontinued from development.
Supplemental material: Development of an igneous rock database with geologic functions: Application to Neogene bimodal igneous rocks and mineral resources in the Great Basin
Authors: Yager Douglas B. , Hofstra Albert H. , Fifarek Katheryn , Webbers Ank
Published: June 2020

Microsoft Access relational database and other related files.
Vision Screening Assessment (VISA) tool: diagnostic accuracy validation of a novel screening tool in detecting visual impairment among stroke survivors
Authors: Rowe Fiona J , Hepworth Lauren , Howard Claire , Bruce Alison , Smerdon Victoria , Payne Terry , Jimmieson Phil , Burnside Girvan
Published: June 2020

Purpose

Screening for visual problems in stroke survivors is not standardised. Visual problems that remain undetected or poorly identified can create unmet needs for stroke survivors. We report the validation of a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors.

Methods

We conducted a prospective case cohort comparative study in four centres to validate the VISA tool against a specialist reference vision assessment. VISA is available in print or as an app (Medicines and Healthcare products Regulatory Agency regulatory approved); these were used equally for two groups. Both VISA and the comprehensive reference vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. The primary outcome measure was the presence or absence of visual impairment.

Results

Two hundred and twenty-one stroke survivors were screened. Specialist reference vision assessment was by experienced orthoptists. Full completion of screening and reference vision assessment was achieved for 201 stroke survivors. VISA print was completed for 101 stroke survivors; VISA app was completed for 100. Sensitivity and specificity of VISA print was 97.67% and 66.67%, respectively. Overall agreement was substantial; K=0.648. Sensitivity and specificity of VISA app was 88.31% and 86.96%, respectively. Overall agreement was substantial; K=0.690. Lowest agreement was found for screening of eye movement and near visual acuity.

Conclusions

This validation study indicates acceptability of VISA for screening of potential visual impairment in stroke survivors. Sensitivity and specificity were high indicating the accuracy of this screening tool. VISA is available in print or as an app allowing versatile uptake across multiple stroke settings.
Effect of different communication strategies about stopping cancer screening on screening intention and cancer anxiety: a randomised online trial of older adults in Australia
Authors: Smith Jenna , Dodd Rachael H , Hersch Jolyn , Cvejic Erin , McCaffery Kirsten , Jansen Jesse
Published: June 2020

Objective

To assess different strategies for communicating to older adults about stopping cancer screening.

Design

4 (recommendation statement about stopping screening)×(2; time) online survey-based randomised controlled trial.

Setting

Australia.

Participants

271 English-speaking participants, aged 65–90, screened for breast/prostate cancer at least once in past decade.

Interventions

Time 1: participants read a scenario in which their general practitioner (GP) informed them about the potential benefits and harms of cancer screening, followed by double-blinded randomisation to one of four recommendation statements to stop screening: control (‘this screening test would harm you more than benefit you’), health status (‘your other health issues should take priority’), life expectancy framed positively (‘this test would not help you live longer’) and negatively (‘you may not live long enough to benefit’). Time 2: in a follow-up scenario, the GP explained why guidelines changed over time (anchoring bias intervention).

Measures

Primary outcomes: screening intention and cancer anxiety (10-point scale, higher=greater intention/anxiety), measured at both time points. Secondary outcomes: trust (in their GP, the information provided, the Australian healthcare system), decisional conflict and knowledge of the information presented.

Results

271 participants’ responses analysed. No main effects were found. However, screening intention was lower for the negatively framed life expectancy versus health status statement (6.0 vs 7.1, mean difference (MD)=1.1, p=0.049, 95% CI 0.0 to 2.2) in post hoc analyses. Cancer anxiety was lower for the negatively versus positively framed life expectancy statement (4.8 vs 5.8, MD=1.0, p=0.025, 95% CI 0.1 to 1.9). The anchoring bias intervention reduced screening intention (MD=0.8, p=0.044, 95% CI 0.6 to 1.0) and cancer anxiety (MD=0.3, p=0.002, 95% CI 0.1 to 0.4) across all conditions.

Conclusion

Older adults may reduce their screening intention without reporting increased cancer anxiety when clinicians use a more confronting strategy communicating they may not live long enough to benefit and add an explicit explanation why the recommendation has changed.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN12618001306202; Results).
Does accreditation of general practice promote patient-reported quality of care? A natural cluster randomised experiment
Authors: Riisgaard Helle , Waldorff Frans Boch , Kirstine Andersen Merethe , Pedersen Line Bjørnskov
Published: June 2020

Objective

To investigate whether accreditation of general practice in Denmark promotes patient-reported quality of care and patient satisfaction.

Design

A national cluster randomised case control study based on an online version of the Danish Patients Evaluate Practice questionnaire. Mixed effects ordered logit regression models taking account of clustering of patients in different municipalities were used in the analyses.

Setting

General practice in Denmark.

Participants

A representative sample of the Danish population.

Primary and secondary outcome measures

The primary outcome measure was patient-reported quality of care, and patient satisfaction with general practice and patient satisfaction with the general practitioner served as secondary outcome measures.

Results

In total, 3609 respondents answered the survey. We found no statistically significant relationships between patient-reported quality of care and practice accreditation (2016: OR=0.89, 95% CI 0.73 to 1.07 and 2017: OR=0.85, 95% CI 0.71 to 1.02) and between patient satisfaction with the general practitioner and accreditation (2016: OR=0.93, 95% CI 0.76 to 1.13 and 2017: OR=0.86, 95% CI 0.70 to 1.04). However, there was a statistically significant negative relationship between patient satisfaction with the general practice and recent practice accreditation compared with satisfaction with practices not yet accredited (OR=0.81, 95% CI 0.67 to 0.97) but no significant relationship between patient satisfaction with the general practice and previous accreditation (OR=0.91, 95% CI 0.76 to 1.09).

Conclusion

Accreditation does not promote patient-reported quality of care or patient satisfaction. On the contrary, patient satisfaction with the general practice decreases when general practice is recently accredited.
Quality of healthcare for children with severe acute malnutrition in a refugee setting: cross-sectional study in West Nile Region, Uganda
Authors: Lazzerini Marzia , Wanzira Humphrey , Lochoro Peter , Ndunguste Amos , Ictho Jerry , Katungi Ambrose , Mariani Ilaria , Putoto Giovanni
Published: June 2020

Objectives

5.0 million annual deaths in low-income and middle-income countries are due to poor quality of care (QOC). We evaluated the QOC provided to malnourished children in West Nile Region in Uganda.

Design

Cross-sectional study.

Setting

West Nile Region, an area hosting over one million refugees.

Participants

Among 148 facilities providing nutritional services, 30 randomly selected facilities (20%) and the records of 1467 children with severe acute malnutrition (100% of those attending the 30 facilities during last year) were assessed.

Outcomes

The national Nutrition Service Delivery Assessment (NSDA) tool was used to assess capacity areas related to QOC. Case management, data quality and health outcomes were assessed from official health records. Multivariate analysis was performed to explore factors significantly associated with better cure rates.

Results

Of 305 NSDA scores allocated to 30 participating centres, 201 (65.9%) were ‘good’ or ‘excellent’. However, 20 (66.7%) facilities had ‘poor’ ‘quality improvement mechanisms’ and 13 (43.3%) had ‘poor’ ‘human resources’. Overall data quality in official records was poor, while recorded quality of case management was overall fair. Average cure rate was significantly lower than international Sphere standards (50.4% vs 75% p<0.001) with a higher default rate (23.2% vs 15% p<0.001). Large heterogeneity among facilities was detected for all indicators. Refugee-hosting and non-refugee-hosting facilities had a similar cure rate (47.1% vs 52.1%) though transfer rates were higher for those hosting refugees (21.5% vs 1.9%, p<0.001) despite better ‘equipment and supplies’. ‘Good/excellent’ ‘equipment’ and ‘store management’ were significantly associated with better cure rates in outpatient therapeutic centres (+55.9, p<0.001; +65.4, p=0.041, respectively) in multivariate analysis.

Conclusions

Though most NSDA capacity areas were rated good or excellent, health outcomes of malnourished children in West Nile Region, both in refugee-hosting and non-refugee-hosting facilities, are significantly below international standards. Effective and sustainable approaches to improve malnourished child health outcomes are needed.
Economic evaluation of surgical treatments for women with stress urinary incontinence: a cost-utility and value of information analysis
Authors: Javanbakht Mehdi , Moloney Eoin , Brazzelli Miriam , Wallace Sheila , Ternent Laura , Omar Muhammad Imran , Monga Ash , Saraswat Lucky , Mackie Phil , Becker Frauke , Imamura Mari , Hudson Jemma , Shimonovich Michal , MacLennan Graeme , Vale Luke , Craig Dawn
Published: June 2020

Objectives

Stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MUI) are common conditions that can have a negative impact on the quality of life of patients and serious cost implications for healthcare providers. The objective of this study was to assess the cost-effectiveness of nine different surgical interventions for treatment of SUI and stress-predominant MUI from a National Health Service and personal social services perspective in the UK.

Methods

A Markov microsimulation model was developed to compare the costs and effectiveness of nine surgical interventions. The model was informed by undertaking a systematic review of clinical effectiveness and network meta-analysis. The main clinical parameters in the model were the cure and incidence rates of complications after different interventions. The outcomes from the model were expressed in terms of cost per quality-adjusted life-years (QALYs) gained. In addition, expected value of perfect information (EVPI) analyses were conducted to quantify the main uncertainties facing decision-makers.

Results

The base-case results suggest that retropubic mid-urethral sling (retro-MUS) is the most cost-effective surgical intervention over a 10-year and lifetime time horizon. The probabilistic results show that retro-MUS and traditional sling are the interventions with the highest probability of being cost-effective across all willingness-to-pay thresholds over a lifetime time horizon. The value of information analysis results suggest that the largest value appears to be in removing uncertainty around the incidence rates of complications, the relative treatment effectiveness and health utility values.

Conclusions

Although retro-MUS appears, at this stage, to be a cost-effective intervention, research is needed on possible long-term complications of all surgical treatments to provide reassurance of safety, or earlier warning of unanticipated adverse effects. The value of information analysis supports the need, as a first step, for further research to improve our knowledge of the actual incidence of complications.
Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: data from the international AVERT trial
Authors: Walters Rosy , Collier Janice M , Braighi Carvalho Lillian , Langhorne Peter , Katijjahbe Md Ali , Tan Dawn , Moodie Marj , Bernhardt Julie
Published: June 2020

Objectives

Information about younger people of working age (≤65 years), their post stroke outcomes and rehabilitation pathways can highlight areas for further research and service change. This paper describes: (1) baseline demographics; (2) post acute rehabilitation pathways; and (3) 12-month outcomes; disability, mobility, depression, quality of life, informal care and return to work of working age people across three geographic regions (Australasia (AUS), South East (SE) Asia and UK).

Design

This post hoc descriptive exploration of data from the large international very early rehabilitation trial (A Very Early Rehabilitation Trial (AVERT)) examined the four common post acute rehabilitation pathways (inpatient rehabilitation, home with community rehabilitation, inpatient rehabilitation then community rehabilitation and home with no rehabilitation) experienced by participants in the 3 months post stroke and describes their 12-month outcomes.

Setting

Hospital stroke units in AUS, UK and SE Asia.

Participants

Patients who had an acute stroke recruited within 24 hours who were ≤65 years.

Results

668 participants were ≤65 years; 99% lived independently, and 88% no disability (modified Rankin Score (mRS)=0) prior to stroke. We had complete data for 12-month outcomes for n=631 (94%). The proportion receiving inpatient rehabilitation was higher in AUS than other regions (AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no or little disability (mRS 0–2), 44% were depressed, 28% rated quality of life as poor or worse than death. For those working prior to stroke (n=228), only 57% had returned to work. A noteworthy number of working age survivors received no rehabilitation services within 3 months post stroke.

Conclusions

There was considerable variation in rehabilitation pathways and post acute service use across the three regions. At 12 months, there were high rates of depression, poor quality of life and low rates of return to work.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN12606000185561).
Prevalence of osteoporosis among North Korean women refugees living in South Korea: a comparative cross-sectional study
Authors: Kim Kyeong Jin , An Jee Hyun , Kim Kyoung Jin , Yu Ji Hee , Kim Nam Hoon , Yoo Hye Jin , Kim Hee Young , Seo Ji A , Kim Nan Hee , Choi Kyung Mook , Baik Sei Hyun , Kim Sin Gon
Published: June 2020

Objective

To investigate the prevalence of osteoporosis among North Korean women refugees when compared with South Korean women, who have identical genetic backgrounds but experience different environments.

Design

Comparative cross-sectional study.

Setting

North Korean Refugee Health in South Korea (NORNS) study in South Korea.

Participants

We evaluated 122 North Korean women who participated in NORNS study and 366 age-matched/menopausal status-matched South Korean women from the Korea University Medical Center (KUMC) health examination cohort. The median age of the NORNS participants was 46 years (IQR, 40–60 years) with 52 women (42.6%) being postmenopausal.

Results

Among the postmenopausal women, NORNS participants had a higher body mass index and number of pregnancies and lower physical activity than the KUMC participants. The overall prevalence of osteoporosis was 48% (25/52) and 17% (27/156) in NORNS and KUMC participants, respectively. The bone mineral density (BMD) values at the lumbar spine, femur neck and total hip were significantly lower in postmenopausal NORNS women than in the postmenopausal KUMC women. Old age, low body weight and late age of menarche were associated with low BMD among the postmenopausal North Korean refugees. In premenopausal participants, the NORNS women had lower body weight and physical activity than the KUMC women at baseline. All the NORNS women had normal Z-scores, although the BMD at the lumbar spine was significantly lower in NORNS women than in the KUMC women (0.952 vs 1.002 g/cm2, p<0.001).

Conclusions

Osteoporosis is a prevalent health problem in postmenopausal North Korean women refugees living in South Korea. It is conceivable to prepare vigilant countermeasures for bone health deterioration in this growing population, especially for postmenopausal women. Further research is warranted to determine the cause of the differences between participants of the same ethnic group.