bluuebunny/crossref_metadata_2025 huggingface dataset:
White Habits, Anti‐Racism, and Philosophy as a Way of Life
Authors: Noe Kenneth
Published: June 2020

This paper examines Pierre Hadot’s philosophy as a way of life in the context of race. I argue that a “way of life” approach to philosophy renders intelligible how antiracist confrontation of racist ideas and institutionalized white complicity is a properly philosophical way of life requiring regulated reflection on habits—particularly, habits of whiteness. I first rehearse some of Hadot’s analysis of the “way of life” orientation in philosophy, in which philosophical wisdom is understood as cultivated by actions which result in the creation of wise habits. I analyze a phenomenological claim about the nature of habit implied by the “way of life” approach, namely, that habits can be both the cause and the effect of action. This point is central to the “way of life” philosophy, I claim, in that it makes possible the intelligent redirection of habits, in which wise habits are more the effect than simply the cause of action. Lastly, I illustrate the “way of life” approach in the context of anti‐racism by turning to Linda Martín Alcoff's whiteness antieliminativism, which outlines a morally defensible transformation of the habits of whiteness. I argue that anti‐racism provides an intelligible context for modern day forms of what Hadot calls “spiritual exercises” insofar as the “way of life” philosophy is embodied in the practice of whites seeing themselves seeing as white and seeing themselves being seen as white.
Reactionary Fictionalism
Authors: Dockstader Jason
Published: June 2020

Fictionalism is the view that the claims of a target discourse are best seen as being fictional in some way, as being expressed in some pretense manner, or as not being about the traditional posits of the discourse. The contemporary taxonomy of fictionalist views is quite elaborate. Yet, there is a version of fictionalism that has failed to develop and which corresponds to the earliest form of the view found in the history of philosophy, East and West. I call this view “reactionary fictionalism.” I argue that traces of reactionary fictionalism can be found in Classical Daoism, Madhyamaka Buddhism, and Pyrrhonian Skepticism. Reactionary fictionalism is a kind of fictionalism that differs from both the hermeneutic and revolutionary kinds discussed today. Hermeneutic fictionalism says we already treat the claims of a target discourse in a fictional manner. Revolutionary fictionalism recommends we all start treating the claims of a target discourse in a fictional manner for reasons mostly of social utility. Reactionary fictionalism recommends, by contrast, that only those concerned with obtaining maximal therapeutic release from the pathology of literally asserting genuine beliefs in the claims of a target discourse should react in a pretense manner to inescapable contexts demanding the use of the claims of that discourse. I aim to show that reactionary fictionalism was a technique utilized in premodern skeptical traditions as a means for enduring one's condemnation to near‐permanent sociality. I recommend slotting reactionary fictionalism into our present taxonomy once we note that employing fictionalism can have a primarily therapeutic motivation and not merely a semantic, epistemic, or metaphysical one.
The Absence of the Ordinary in 2020 Presidential Politics: What Politicians Communicate
Authors: Berezin Mabel
Published: June 2020

As the 2020 American presidential election approaches, it is worth thinking about the current electoral moment in terms of lessons from the recent and not‐so‐recent past. This article begins with an unlikely analysis. Ordinary life captures the attention of citizens who vote but do not spend their lives 24/7 on social media or cable news or public radio. Ordinary people do not spend their time discussing social policy over dinner. Ordinary people go to dinner—not dinner parties. The ordinary people are the path to victory in any political contest. This article explores the “ordinary” and its relation to politics.
How Does the Mind Render Streaming Experience as Events?
Authors: Baldwin Dare A. , Kosie Jessica E.
Published: June 2020

Events—the experiences we think we are having and recall having had—are constructed; they are not what actually occurs. What occurs is ongoing dynamic, multidimensional, sensory flow, which is somehow transformed via psychological processes into structured, describable, memorable units of experience. But what is the nature of the redescription processes that fluently render dynamic sensory streams as event representations? How do such processes cope with the ubiquitous novelty and variability that characterize sensory experience? How are event‐rendering skills acquired and how do event representations change with development? This review considers emerging answers to these questions, beginning with evidence that an implicit tendency to monitor predictability structure via statistical learning is key to event rendering. That is, one way that the experience of bounded events (e.g., actions within behavior, words within speech) arises is with the detection of “troughs” in sensory predictability. Interestingly, such troughs in predictability are often predictable; these regions of predictable‐unpredictability provide articulation points to demarcate one event from another in representations derived from the actual streaming information. In our information‐optimization account, a fluent event‐processor predicts such troughs and selectively attends to them—while suppressing attention to other regions—as sensory streams unfold. In this way, usage of attentional resources is optimized for efficient sampling of the most relevant, information‐rich portions of the unfolding flow of sensation. Such findings point to the development of event‐processing fluency—whether in action, language, or other domains—depending crucially on rapid and continual cognitive reorganization. As knowledge of predictability grows, attention is adaptively redeployed. Accordingly, event experiences undergo continuous alteration.
flasher, a novel mutation in a glucosinolate modifying enzyme, conditions changes in plant architecture and hormone homeostasis
Authors: Garrido Ameth N. , Supijono Esther , Boshara Peter , Douglas Scott J. , Stronghill Patti E. , Li Baohua , Nambara Eiji , Kliebenstein Daniel J. , Riggs C. Daniel
Published: June 2020

Meristem function is underpinned by numerous genes that affect hormone levels, ultimately controlling phyllotaxy, the transition to flowering and general growth properties. Class I KNOX genes are major contributors to this process, promoting cytokinin biosynthesis but repressing gibberellin production to condition a replication competent state. We identified a suppressor mutant of the KNOX1 mutant brevipedicellus (bp) that we termed flasher (fsh), which promotes stem and pedicel elongation, suppresses early senescence, and negatively affects reproductive development. Map‐based cloning and complementation tests revealed that fsh is due to an E40K change in the flavin monooxygenase GS‐OX5, a gene encoding a glucosinolate (GSL) modifying enzyme. In vitro enzymatic assays revealed that fsh poorly converts substrate to product, yet the levels of several GSLs are higher in the suppressor line, implicating FSH in feedback control of GSL flux. FSH is expressed predominantly in the vasculature in patterns that do not significantly overlap those of BP, implying a non‐cell autonomous mode of meristem control via one or more GSL metabolites. Hormone analyses revealed that cytokinin levels are low in bp, but fsh restores cytokinin levels to near normal by activating cytokinin biosynthesis genes. In addition, jasmonate levels in the fsh suppressor are significantly lower than in bp, which is likely due to elevated expression of JA inactivating genes. These observations suggest the involvement of the GSL pathway in generating one or more negative effectors of growth that influence inflorescence architecture and fecundity by altering the balance of hormonal regulators.
Numerical Study of Enhanced Oil Recovery Using In Situ Oxy-Combustion in a Porous Combustion Tube
Authors: Hamdy Mohamed , Mahmoud Mohamed , Aladeb Olakane , Mokheimer Esmail M. A.
Published: June 2020

In situ combustion (ISC) in a one-dimensional combustion porous tube has been modeled numerically and presented in this article. The numerical model has been developed using the cmg stars (2017.10) software and it was used to model especial cases for validation against published experimental data. A comprehensive chemical reaction scheme has been developed and used to simulate the ISC process in the lab scale. Moreover, co-injection of oxygen with carbon dioxide (O2/CO2); and co-injection of enriched air (O2/N2) have been further investigated. In the case of using (O2/N2) as an oxidizer, increasing the oxygen ratio from 21% to 50% leads to increasing the oil recovery factor from 31.66% to 66.8%, respectively. In the case of using (O2/CO2) as an oxidizer, increasing the oxygen ratio from 21% to 50% leads to increasing the oil recovery factor from 35.77% to 70.3%, respectively. It was found that the co-injection of (O2/CO2) gives higher values of the oil recovery factor compared with that given when oxygen-enriched air (O2/N2) is injected for ISC. The change in the produced cumulative hydrogen and hydrogen sulfide is considered small whether using (O2/CO2) or (O2/N2) as an oxidizer.
Data-Driven Models to Predict Hydrocarbon Production From Unconventional Reservoirs by Thermal Recovery
Authors: Lee Kyung Jae
Published: June 2020

In the numerical simulations of thermal recovery for unconventional resources, reservoir models involve complex multicomponent-multiphase flow in non-isothermal conditions, where spatial heterogeneity necessitates the huge number of discretized elements. Proxy modeling approaches have been applied to efficiently approximate solutions of reservoir simulations in such complex problems. In this study, we apply machine learning technologies to the thermal recovery of unconventional resources, for the efficient computation and prediction of hydrocarbon production. We develop data-driven models applying artificial neural network (ANN) to predict hydrocarbon productions under heterogeneous and unknown properties of unconventional reservoirs. We study two different thermal recovery methods—expanding solvent steam-assisted gravity drainage for bitumen and in-situ upgrading of oil shale. We obtain training datasets by running high-fidelity simulation models for these two problems. As training datasets of ANN models, diverse input and output data of phase and component productions are generated, by considering heterogeneity and uncertainty. In the bitumen reservoirs, diverse permeability anisotropies are considered as unknown properties. Similarly, in the oil shale reservoirs, diverse kerogen decomposition kinetics are considered. The performance of data-driven models is evaluated with respect to the position of the test dataset. When the test data is inside of the boundary of training datasets, the developed data-driven models based on ANN reliably predict the cumulative productions at the end of the recovery processes. However, when the test data is at the boundary of training datasets, physical insight plays a significant role to provide a reliable performance of data-driven models.
Probing the Effects of NOx and SOx Impurities on Oxy-Fuel Combustion in Supercritical CO2: Shock Tube Experiments and Chemical Kinetic Modeling
Authors: Rahman Ramees K. , Barak Samuel , (Raghu) Manikantachari K.R.V. , Ninnemann Erik , Hosangadi Ashvin , Zambon Andrea , Vasu Subith S.
Published: June 2020

The direct-fired supercritical carbon dioxide cycles are one of the most promising power generation methods in terms of their efficiency and environmental friendliness. Two important challenges in implementing these cycles are the high pressure (300 bar) and high CO2 dilution (>80%) in the combustor. The design and development of supercritical oxy-combustors for natural gas require accurate reaction kinetic models to predict the combustion outcomes. The presence of a small amount of impurities in natural gas and other feed streams to oxy-combustors makes these predictions even more complex. During oxy-combustion, trace amounts of nitrogen present in the oxidizer is converted to NOx and gets into the combustion chamber along with the recirculated CO2. Similarly, natural gas can contain a trace amount of ammonia and sulfurous impurities that get converted to NOx and SOx and get back into the combustion chamber with recirculated CO2. In this work, a reaction model is developed for predicting the effect of impurities such as NOx and SOx on supercritical methane combustion. The base mechanism used in this work is GRI Mech 3.0. H2S combustion chemistry is obtained from Bongartz et al. while NOx chemistry is from Konnov. The reaction model is then optimized for a pressure range of 30–300 bar using high-pressure shock tube data from the literature. It is then validated with data obtained from the literature for methane combustion, H2S oxidation, and NOx effects on ignition delay. The effect of impurities on CH4 combustion up to 16 atm is validated using NOx-doped methane studies obtained from the literature. In order to validate the model for high-pressure conditions, experiments are conducted at the UCF shock tube facility using natural gas identical mixtures with N2O as an impurity at ∼100 bar. Current results show that there is a significant change in ignition delay with the presence of impurities. A comparison is made with experimental data using the developed model and predictions are found to be in good agreement. The model developed was used to study the effect of impurities on CO formation from sCO2 combustors. It was found that NOx helps in reducing CO formation while the presence of H2S results in the formation of more CO. The reaction mechanism developed herein can also be used as a base mechanism to develop reduced mechanisms for use in CFD simulations.
Utilizing Food Waste Product (Date Tree Seeds) to Enhance the Filtration Characteristics in Water-Based Drilling Fluid System: A Comparative Study
Authors: Al-Hameedi Abo Taleb T. , Alkinani Husam H. , Alkhamis Mohammed M. , Dunn-Norman Shari
Published: June 2020

Practically, to regulate filtration characteristics of drilling fluid, non-biodegradable materials used commonly have a high cost with side effects on personnel safety and the environment. Hence, eco-friendly additives are needed as an alternative to replace or at least support the commonly used filtration control agents. This experimental investigation examines the possibility of using date tree seeds’ powder (DTSP), as a new eco-friendly fluid loss agent. Under surface and sub-surface conditions (fresh and aged conditions), experiments were executed utilizing low-temperature and low-pressure (LTLP) and high-temperature and high-pressure (HTHP) American Petroleum Institute (API) filter press to comprehend the influence of DTSP on the seepage loss characteristics. The findings were compared with a commonly utilized chemical additive to regulate filtration characteristics of drilling fluid (low viscosity sodium carboxymethyl cellulose (CMC-LV)). Two concentrations of DTSP and CMC-LV were added separately to a reference fluid (RF) to understand the effect of concentration variations on filtration properties. The findings revealed that both DTSP and CMC-LV significantly improved the filtrate and the filter cake when comparing them with the RF under fresh and aged conditions. The findings for fresh conditions also showed that LTLP filtration measurements for CMC-LV additives had almost similar performance as DTSP additives, while HTHP filtration measurements exhibited that the two concentrations of DTSP additives were marginally better than those of CMC-LV additives. For aged conditions, CMC-LV additives were relatively more efficient than DTSP additives for LTLP filtration control experiments. However, DTSP additives were more efficient in improving the filtration characteristics as compared to CMC-LV additives for HTHP filtration control experiments. These results are in aid of shifting the oil and gas industry from using conventional harmful additives to using unconventional eco-friendly additives. This also helps in transforming unwanted food wastes into valuable commercial products, which can revolutionize the domestic and international industries and create new job opportunities, hence minimizing the total cost of drilling fluid and the wastes disposed to the environment.
Quantifying Engineering Faculty Performance Based on Expectations on Key Activities and Integration Using Flexible Weighting Factors
Authors: Han Hai-Chao , Wan Hung-da , Wang Xiaodu
Published: June 2020

Faculty performance evaluation is an important element of assessment for departments and universities. A quantitative score is often needed for faculty annual evaluation, but its determination is often subjective, and it is hard to incorporate the versatile contributions of individual faculty members. Here, we propose a quantitative and objective faculty performance evaluation method. We established a well-structured quantitative evaluation system which scores faculty performance in key activities using expectation-based formula on key measures and then incorporates personalized flexible weights to integrate them into three area scores in teaching, research, and service as well as an overall score. It was implemented in a programed excel form, making it convenient to both faculty and evaluators and has generated very positive outcomes such as higher faculty satisfactory and improved productivity as indicated by associated increases in publications and new research grants etc. In conclusion, the quantitative faculty evaluation system provides more objective and transparent annual evaluation and a basis for making merit raise and award decisions. In addition, it can be readily adapted to evolving goals and needs of a department as well as different needs and cultures of different departments.
Anisotropic Multicomponent Topology Optimization for Additive Manufacturing With Build Orientation Design and Stress-Constrained Interfaces
Authors: Zhou Yuqing , Nomura Tsuyoshi , Saitou Kazuhiro
Published: June 2020

This paper presents a multicomponent topology optimization method for designing structures assembled from additively manufactured components, considering anisotropic material behavior for each component due to its build orientation, distinct material behavior, and stress constraints at component interfaces (i.e., joints). Based upon the multicomponent topology optimization (MTO) framework, the simultaneous optimization of structural topology, its partitioning, and the build orientations of each component is achieved, which maximizes an assembly-level structural stiffness performance subject to maximum stress constraints at component interfaces. The build orientations of each component are modeled by its orientation tensor that avoids numerical instability experienced by the conventional angular representation. A new joint model is introduced at component interfaces, which enables the identification of the interface location, the specification of a distinct material tensor, and imposing maximum stress constraints during optimization. Both 2D and 3D numerical examples are presented to illustrate the effect of the build orientation anisotropy and the component interface behavior on the resulting multicomponent assemblies.
Evaluating the Performance of a Modified Solar Air Heater With Pierced Cover and Packed Mesh Layers
Authors: Nowzari Raheleh , Saygin Hasan , Aldabbagh L.B.Y.
Published: June 2020

An experimental study was conducted to evaluate the thermal efficiency of a modified solar air heater. In the current design, air enters the collector through holes in front glass, passes through mesh layers, and exits at the backside of the air heater. A centrifugal fan was used to circulate air through the system. The design offers low construction costs and less solar radiation reflected from the collector. The modified collector was examined with various bed heights (30, 50, and 70 mm) and different mass flowrates of air varying from 0.011 kg/(s m2) to 0.043 kg/(s m2). The results showed that a counter flow collector with pierced cover had 5.6–9.7% higher efficiency than the single-pass one. The average efficiencies of the current design collector were found to be 55.2%, 44.6%, and 39.7% for the single-pass and 60.8%, 50.9% and 45.4% for the double-pass collector at 30, 50, and 70 mm bed heights and airflow rate of 0.043 kg/(s m2), respectively. The thermohydraulic efficiency, temperature difference, and perforated cover surface temperature were analyzed at each test and their effects on the system performance were evaluated. The highest amount of pressure drop through the collector was measured in the collector with a 70-mm bed height and a maximum air flowrate.
Influence of acoustic habitat variation on Indo-Pacific humpback dolphin (Sousa chinensis) in shallow waters of Hainan Island, China
Authors: Caruso Francesco , Dong Lijun , Lin Mingli , Liu Mingming , Xu Wanxue , Li Songhai
Published: June 2020

The Indo-Pacific humpback dolphin (IPHD, Sousa chinensis) is a coastal species inhabiting tropical and warm-temperate waters. The presence of this vulnerable dolphin was recently discovered in shallow waters southwest of Hainan Island, China. The influence of the acoustic habitat on the distribution and behavior of IPHD was investigated using an array of passive acoustic platforms (n = 6) that spanned more than 100 km of coastline during a 75-day monitoring period. Its presence was assessed within 19 215 five-min recordings by classifying echolocation clicks using machine learning techniques. Spectrogram analysis was applied to further investigate the acoustic behavior of IPHD and to identify other prominent sound sources. The variation in the ambient noise levels was also measured to describe the spatiotemporal patterns of the acoustic habitat among the different sampling sites. Social and feeding sounds of IPHD (whistles and click-series of pulsed sounds) were identified together with other biological sources (finless porpoise, soniferous fishes, and snapping shrimps) and anthropogenic activities (ship noise, explosions, and sonars). Distribution, acoustic behavior, and habitat use of this nearshore dolphin species were strongly influenced by the abundance of soniferous fishes, and under similar conditions, the species was more acoustically active in locations with lower noise levels.
Semisupervised Physical Exercise and Lifestyle Counseling in Cardiometabolic Risk Management in Sedentary Adults: Controlled Randomized Trial (BELLUGAT)
Authors: Ensenyat Assumpta , Espigares-Tribo Gemma , Machado-Da-Silva Leonardo , Sinfreu-Bergués Xenia , Blanco Alfonso
Published: June 2020

Background: The purpose of this study was to evaluate the feasibility and effectiveness of a high-intensity semisupervised exercise program alongside lifestyle counseling as an intervention for managing cardiometabolic risk in sedentary adults. Methods: A 40-week 3-arm randomized controlled clinical trial (16-wk intervention and 24-wk follow-up) was used. Seventy-five sedentary adults (34–55 y) with at least 1 cardiometabolic risk factor were randomized into one of the following arms: (1) aerobic interval training (AIT) plus lifestyle counseling (n = 25), (2) low- to moderate-intensity continuous training plus lifestyle counseling (traditional continuous training, TCT) (n = 27), or (3) lifestyle counseling alone (COU) (n = 23). Metabolic syndrome severity scores, accelerometer-based physical activity, and self-reported dietary habits were assessed at baseline, after the intervention, and at follow-up. Results: AIT was well accepted with high enjoyment scores. All groups showed similar improvements in metabolic syndrome severity scores (standardized effect size = 0.46) and dietary habits (standardized effect size = 0.30). Moderate to vigorous physical activity increased in all study groups, with the number of responders higher in AIT and TCT groups (50%) than in COU group (21%). Both AIT and TCT had a greater impact on sedentary behavior than COU (63.5% vs 30.4% responders). Conclusions: AIT appears to be a feasible and effective strategy in sedentary individuals with cardiometabolic risk factors. AIT could be included in intervention programs tackling unhealthy lifestyles.
Development and Validation of a Novel Knee-Specific Patient-Reported Outcomes Measure
Authors: Farnsworth James L. , Evans Todd , Binkley Helen , Kang Minsoo
Published: June 2020

Context: Previous research suggests that several knee-specific patient-reported outcome measures have poor measurement properties. The patient-reported outcomes knee assessment tool (PROKAT) was created to improve assessment of knee-specific function. Examination of the measurement properties of this new measure is critical to determine its clinical value. Objective: Examine the measurement properties of the PROKAT. Design: Cross-sectional study. Setting: Clinical athletic training setting. Patients or Other Participants: The pilot study included 32 student-athletes (mean age = 20.78 [1.01], males = 56.30%). The full study included 203 student-athletes (mean age = 21.46 [4.64], males = 54.70%) from 3 separate institutions. The participants were recruited for both the pilot and full study using face-to-face and electronic (eg, email and social media sites) communications. Intervention(s): Evaluation of the measurement properties of the PROKAT occurred using the Rasch partial-credit model. Main Outcome Measures: Infit and outfit statistics, item step difficulties, person ability parameters, category function, item and test information functions, and Cronbach alpha. An independent samples t test was used to evaluate the differences in injured and noninjured athletes’ scores. Results: The Rasch partial-credit model analysis of pilot test items and qualitative participant feedback were used to modify the initial PROKAT. Evaluation of the revised PROKAT (32 items) indicated 27 items had acceptable model–data fit. The injured athletes scored significantly worse than the noninjured athletes (t188 = 12.89; P < .01). The ceiling effects for the PROKAT were minimal (3.9%). Conclusions: A major advantage of this study was the use of the Rasch measurement and the targeted population. Compared with alternative knee-specific patient-reported outcome measures (eg, Knee Injury Osteoarthritis Outcome Score, International Knee Documentation Committee Subjective Knee Form), the PROKAT has low ceiling effects in athletic populations. In addition, evidence suggests the measure may be capable of distinguishing between injured and noninjured athletes.
Validity and Reliability of Hand-Held Dynamometry for Abdominal Flexion Muscular Assessment
Authors: Tarca Brett D. , Wycherley Thomas P. , Meade Anthony , Bennett Paul , Ferrar Katia E.
Published: June 2020

Context: Abdominal musculature underpins core stability, which can allow for optimal performance in many activities of daily living (eg, walking and rising from a chair). Therefore, assessment of the abdominal muscles poses as an important consideration for clinicians in order to identify people at risk of injury or functional decline. Objective: This study aimed to build on the limited amount of knowledge surrounding abdominal muscle strength assessments by investigating the validity and reliability of hand-held dynamometry (HHD) for the assessment of isometric abdominal flexion strength. Study Design and Participants: Comparative analysis for validity and test–retest reliability was employed on a cohort of apparently healthy individuals. HHD was compared with the criterion, isokinetic dynamometry, through an isometric contraction of trunk flexion on both instruments. Hand-held dynamometry assessments only were performed on a subsequent day for reliability analysis. The peak values for all assessments were recorded. Results: A total of 35 participants were recruited from the University of South Australia and the general public. Comparative analysis between the HHD and isokinetic dynamometer showed good agreement (intraclass correlation coefficients = .82), with the Bland–Altman plots confirming no proportional bias. Reliability analysis for the HHD reported good consistency (intraclass correlation coefficients = .87). Conclusion: HHD together with the participant setup (supine, trunk flexed, and supported at 25° with the legs horizontal and remaining unfixed) is a valid and reliable tool to assess isometric abdominal flexion strength.
Bows and arrows and complex symbolic displays 48,000 years ago in the South Asian tropics
Authors: Langley Michelle C. , Amano Noel , Wedage Oshan , Deraniyagala Siran , Pathmalal M.M , Perera Nimal , Boivin Nicole , Petraglia Michael D. , Roberts Patrick
Published: June 2020

Fa-Hien Lena provides evidence for bone-tipped arrows and brilliant symbolic displays 48,000 years ago in tropical Sri Lanka.
The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries
Authors: Walker Patrick G. T. , Whittaker Charles , Watson Oliver J. , Baguelin Marc , Winskill Peter , Hamlet Arran , Djafaara Bimandra A. , Cucunubá Zulma , Olivera Mesa Daniela , Green Will , Thompson Hayley , Nayagam Shevanthi , Ainslie Kylie E. C. , Bhatia Sangeeta , Bhatt Samir , Boonyasiri Adhiratha , Boyd Olivia , Brazeau Nicholas F. , Cattarino Lorenzo , Cuomo-Dannenburg Gina , Dighe Amy , Donnelly Christl A. , Dorigatti Ilaria , van Elsland Sabine L. , FitzJohn Rich , Fu Han , Gaythorpe Katy A. M. , Geidelberg Lily , Grassly Nicholas , Haw David , Hayes Sarah , Hinsley Wes , Imai Natsuko , Jorgensen David , Knock Edward , Laydon Daniel , Mishra Swapnil , Nedjati-Gilani Gemma , Okell Lucy C. , Unwin H. Juliette , Verity Robert , Vollmer Michaela , Walters Caroline E. , Wang Haowei , Wang Yuanrong , Xi Xiaoyue , Lalloo David G. , Ferguson Neil M. , Ghani Azra C.
Published: June 2020

Global prospects for COVID-19 control

Lower-income countries have recognized the potential impact of coronavirus disease 2019 (COVID-19) from observing ongoing epidemics. Many have intervened quickly and early with measures to slow viral transmission, which may partly explain the low rates observed so far in these countries. Walker
et al.
calibrated a global model with country-specific data (see the Perspective by Metcalf
et al.
). Despite the potentially protective effects of younger demographics, the closer intergenerational contact, limitations on health care facilities, and frequency of comorbidities in lower-income countries require sustained nonpharmaceutical interventions (NPIs) to avoid overwhelming health care capacity. As a result of strict NPIs, the protective effects of immunity will be reduced, and it will be important to improve testing capacity. Ensuring equitable provision of oxygen and—when they are ready—pharmaceutical interventions should be a global priority.

Science
, this issue p.
413
; see also p.
368
A singular role for interleukin-9 in the development of asthma
Authors: Coquet Jonathan M.
Published: June 2020

Interleukin-9 expression by T helper cells marks allergic individuals who develop asthma (see the related Research Article by

Seumois
et al
.

).
A 71-year-old man with a rare rhabdoid brain tumour: using a multidisciplinary medical and rehabilitative model of care
Authors: Krill Michael K , Fogarty Alexandra E , Jacob Sindhu
Published: June 2020

Atypical rhabdoid tumours (AT/RTs) of pineal origin are rare in adults with rapid progression and poor prognosis. We present the case of a 71-year-old man with confusion and memory loss who was diagnosed with a pineal AT/RT after genetic analysis. Due to his limited functional capacity and goal to return home with family, a multidisciplinary care approach was essential for coordination of medical management, radiation treatment and acute inpatient rehabilitation. After diagnosis and rehabilitation, his functional ability improved allowing him to tolerate cranial irradiation, initiate systemic chemotherapy and eventually returned home for a brief period with an improved quality of life. His progress was temporary due to rapid progression of the tumour. He required additional aggressive oncological treatment and was admitted for subsequent inpatient rehabilitation before opting for hospice care. This case underscores the importance of a multidisciplinary approach to cancer treatment in a patient with a rare and aggressive brain tumour, while respecting the individual goals of patients and their families.
Neonatal lupus erythematosus presenting with rash, thrombocytopenia compounded by cytomegalovirus colonisation: a diagnostic dilemma
Authors: Agrawal Gopal , Varghese Bincy , Balde Manish , Wazir Sanjay
Published: June 2020

Neonatal lupus erythematosus (NLE) should be considered when a newborn develops atrioventricular heart block along with the presence of autoantibodies to Sjogren’s syndrome autoantigens in the maternal serum. NLE can also present with features such as cutaneous lesions, hepatic dysfunction or haematological abnormalities. Differential diagnosis usually includes congenital infections as there is a significant overlap of symptoms with NLE. We report a case of NLE who had multiorgan involvement with macular erythematous skin lesions present at birth, and on investigation was found to have cytomegalovirus (CMV) infection. The diagnostic dilemma was whether to consider this infection as symptomatic or just colonisation. In the infant described, the absence of end organ damage specific to CMV infection (hearing loss, intracranial calcifications, retinitis, brain involvement) made a diagnosis of symptomatic CMV unlikely.
Adrenocortical neoplasm of uncertain malignant potential with a myelolipomatous component
Authors: Balasubramanian Adithya , Scovell Jason , Dowell Adam E , Mayer Wesley
Published: June 2020

Macroscopic fat inside an adrenal lesion on CT is pathognomonic for myelolipoma, a benign neoplasm. Without macroscopic fat, it can be difficult to discern the nature of an indeterminate adrenal mass on imaging. One possible diagnosis for an indeterminate lesion without macroscopic fat is an adrenal oncocytic neoplasm (AON). Despite its typical benign presentation cases of malignant AON have been reported. Patients with malignant AON are often not surgical candidates and survival for unresected disease is 20%–35%. We present the third report of an AON of uncertain malignant potential (AONUMP) associated with a macroscopic fatty component with the largest reported size and longest duration of follow-up in the literature. This report details diagnostic and therapeutic challenges posed by AONUMP. This case highlights how pathognomonic radiographical findings associated with benign myelolipoma might mask rare, potentially malignant, lipomatous tumours.
Malignant Brenner tumour of the ovary manifesting as distal intestinal obstruction and perforation
Authors: Singh Brijesh Kumar , Saha Sudipta , Agarwal Shilpi , Rathore Yashwant Singh
Published: June 2020

A rare case of malignant Brenner tumour of ovary manifesting with intestinal perforation due to colonic infiltration is elaborated in the present report. Brenner’s tumour accounts for 1%–2% of all ovarian neoplasms and malignant Brenner tumour is even rarer and only about 5% of Brenner tumours are malignant. A 62-year-old woman came to surgical emergency with 1-month history of abdominal pain, vomiting and constipation with a palpable mass in right iliac fossa. Abdominal radiograph was suggestive of colonic obstruction. Contrast-enhanced CT of the abdomen revealed cystic right ovarian mass of 10.2×8.8 cm2with pneumoperitoneum. Exploratory laparotomy was done, which revealed mass arising from right ovary involving terminal ileum, cecum and ascending colon. Possibility of ovarian malignancy was kept. Patient underwent debulking surgery along with ileostomy and descending colon mucous fistula was created. Histology was compatible with malignant Brenner tumour of the ovary.
COVID-19 and immunosuppression: a review of current clinical experiences and implications for ophthalmology patients taking immunosuppressive drugs
Authors: Thng Zheng Xian , De Smet Marc D , Lee Cecilia S , Gupta Vishali , Smith Justine R , McCluskey Peter J , Thorne Jennifer E , Kempen John H , Zierhut Manfred , Nguyen Quan Dong , Pavesio Carlos , Agrawal Rupesh
Published: June 2020

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 in Wuhan city, Hubei province, China. This is the third and largest coronavirus outbreak since the new millennium after SARS in 2002 and Middle East respiratory syndrome (MERS) in 2012. Over 3 million people have been infected and the COVID-19 has caused more than 217 000 deaths. A concern exists regarding the vulnerability of patients who have been treated with immunosuppressive drugs prior or during this pandemic. Would they be more susceptible to infection by the SARS-CoV-2 and how would their clinical course be altered by their immunosuppressed state? This is a question the wider medical fraternity—including ophthalmologists, rheumatologists, gastroenterologist and transplant physicians among others—must answer. The evidence from the SARS and MERS outbreak offer some degree of confidence that immunosuppression is largely safe in the current COVID-19 pandemic. Preliminary clinical experiences based on case reports, small series and observational studies show the morbidity and mortality rates in immunosuppressed patients may not differ largely from the general population. Overwhelmingly, current best practice guidelines worldwide recommended the continuation of immunosuppression treatment in patients who require them except for perhaps high-dose corticosteroid therapy and in patients with associated risk factors for severe COVID-19 disease.
Protocol for the development and validation of a measure of persistent psychological and emotional distress in cardiac patients: the Cardiac Distress Inventory
Authors: Jackson Alun , Rogerson Michelle , Le Grande Michael , Thompson David , Ski Chantal , Alvarenga Marlies , Amerena John , Higgins Rosemary , Raciti Michela , Murphy Barbara M
Published: June 2020

Introduction

Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event.

Methods and analysis

An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI’s psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress.

Ethics and dissemination

Approved by the Monash Health Human Research Ethics Committee (approval number—RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals.
Understanding current practice, identifying barriers and exploring priorities for adverse event analysis in randomised controlled trials: an online, cross-sectional survey of statisticians from academia and industry
Authors: Phillips Rachel , Cornelius Victoria
Published: June 2020

Objectives

To gain a better understanding of current adverse event (AE) analysis practices and the reasons for the lack of use of sophisticated statistical methods for AE data analysis in randomised controlled trials (RCTs), with the aim of identifying priorities and solutions to improve practice.

Design

A cross-sectional, online survey of statisticians working in clinical trials, followed up with a workshop of senior statisticians working across the UK.

Participants

We aimed to recruit into the survey a minimum of one statistician from each of the 51 UK Clinical Research Collaboration registered clinical trial units (CTUs) and industry statisticians from both pharmaceuticals and clinical research organisations.

Outcomes

To gain a better understanding of current AE analysis practices, measure awareness of specialist methods for AE analysis and explore priorities, concerns and barriers when analysing AEs.

Results

Thirty-eight (38/51; 75%) CTUs, 5 (5/7; 71%) industry and 21 attendees at the 2019 Promoting Statistical Insights Conference participated in the survey. Of the 64 participants that took part, 46 participants were classified as public sector participants and 18 as industry participants. Participants indicated that they predominantly (80%) rely on subjective comparisons when comparing AEs between treatment groups. Thirty-eight per cent were aware of specialist methods for AE analysis, but only 13% had undertaken such analyses. All participants believed guidance on appropriate AE analysis and 97% thought training specifically for AE analysis is needed. These were both endorsed as solutions by workshop participants.

Conclusions

This research supports our earlier work that identified suboptimal AE analysis practices in RCTs and confirms the underuse of more sophisticated AE analysis approaches. Improvements are needed, and further research in this area is required to identify appropriate statistical methods. This research provides a unanimous call for the development of guidance, as well as training on suitable methods for AE analysis to support change.
Protocol for a two-cohort randomized cluster clinical trial of a motor skills intervention: The Promoting Activity and Trajectories of Health (PATH) Study
Authors: Robinson Leah E. , Wang Lu , Colabianchi Natalie , Stodden David F , Ulrich Dale
Published: June 2020

Introduction

Data supports that motor skills are an underlying mechanism that influence physical activity along with perceived motor and physical competence, but the relationship between motor skills and physical activity during the early years is unclear. The goal of this study, Promoting Activity and Trajectories of Health (PATH) for Children, is to examine and compare the immediate (pre-test to post-test) and sustained (3-year follow-up) effect of an intervention on motor performance, physical activity and perceived physical competence to a control condition (ie, standard practice) in preschool-age children.

Methods and analysis

The PATH study is a two-cohort, randomised cluster clinical trial. 300 children between the ages of>3.5 to 5 years of age will be randomised to the motor skill intervention (n=153) or control (n=147) condition. Each assessment involves a measure of motor skill performance; product and process, seven consecutive days of physical activity monitoring and perceived physical competence. These measures will be assessed before and after the intervention (pre-test to post-test) and then each academic year across 3 years, grades kindergarten, first grade and second grade (3-year follow-up). To assess the clustered longitudinal effect of the intervention on outcome measures, random-effects models (eg, mixed model regression, growth curve modelling and structural equation modelling) will be used. The PATH study addresses gaps in paediatric exercise science research. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development and active living during the early years.

Ethics and dissemination

Ethical approval for this study was obtained through the Health Sciences and Behavioral Sciences Institutional Review Board, University of Michigan (HUM00133319). The PATH study is funded by the National Institutes of Health. Findings will be disseminated via print, online media, dissemination events and practitioner and/or research journals.

Trial registration number

NHLBI ClinicalTrials.gov Identifier,NCT03189862. Registered 17 August 2017,https://clinicaltrials.gov/ct2/show/NCT03189862
Neurocognitive impairment after neonatal sepsis: protocol for a systematic review and meta-analysis
Authors: Pek Jen Heng , Yap Bei Jun , Gan Ming Ying , Seethor Shu Ting Tammie , Greenberg Rachel , Hornik Christoph Paul Vincent , Tan Bobby , Lee Jan Hau , Chong Shu-Ling
Published: June 2020

Introduction

The effect of neonatal sepsis on the developing brain is not well documented. We aim to perform evidence synthesis to determine the outcome of neurodevelopmental impairment and intellectual disability among survivors of neonatal sepsis. The data gathered will inform on the long-term neurocognitive outcomes of neonates with sepsis and the measures used to document their developmental disability.

Methods and analysis

We will perform a search based on the following parameters: neonates and infants less than 90 days old diagnosed with sepsis who had neurocognitive outcomes or measures of developmental disability reported. We will search PubMed, Cochrane Central, Embase and Web of Science for articles in English language published between January 2010 and December 2019. Clinical trials and observational studies will be included. Two independent reviewers will screen studies for eligibility. Data extraction will then be performed using a standardised form. The quality of evidence and risk of bias will be assessed using Cochrane Collaboration’s tool and Risk of Bias in Non-randomised Studies of Intervention (ROBINS-I). The results will be synthesised qualitatively and pooled for meta-analysis.

Ethics and dissemination

No formal ethical approval is required as there is no collection of primary data. This systematic review and meta-analysis will be disseminated through conference meetings and peer-reviewed publications.

PROSPERO registration number

Registration submitted CRD42020164334