Moons Are Planets: Scientific Usefulness Versus Cultural Teleology in the Taxonomy of Planetary Science

We argue that taxonomical concept development is vital for planetary science as in all branches of science, but its importance has been obscured by unique historical developments. The literature shows that the concept of planet developed by scientists during the Copernican Revolution was theory-laden and pragmatic for science. It included both primaries and satellites as planets due to their common intrinsic, geological characteristics. About two centuries later the non-scientific public had just adopted heliocentrism and was motivated to preserve elements of geocentrism including teleology and the assumptions of astrology. This motivated development of a folk concept of planet that contradicted the scientific view. The folk taxonomy was based on what an object orbits, making satellites out to be non-planets and ignoring most asteroids. Astronomers continued to keep primaries and moons classed together as planets and continued teaching that taxonomy until the 1920s. The astronomical community lost interest in planets ca. 1910 to 1955 and during that period complacently accepted the folk concept. Enough time has now elapsed so that modern astronomers forgot this history and rewrote it to claim that the folk taxonomy is the one that was created by the Copernican scientists. Starting ca. 1960 when spacecraft missions were developed to send back detailed new data, there was an explosion of publishing about planets including the satellites, leading to revival of the Copernican planet concept. We present evidence that taxonomical alignment with geological complexity is the most useful scientific taxonomy for planets. It is this complexity of both primary and secondary planets that is a key part of the chain of origins for life in the cosmos.Comment: 68 pages, 16 figures. For supplemental data files, see https://www.philipmetzger.com/moons_are_planets

A Young Adult with COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C)-like Illness: A Case Report

Abstract Background: A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age.Case Presentation: The patient presented with one week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5.Conclusion: MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.</jats:p

A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report

Abstract Background A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. Conclusion MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population. </jats:sec

Looking Beyond Diabetes: A Case of Worsening Hyperglycemia as a Manifestation of Ectopic Cushing’s Syndrome Secondary to an Adrenocorticotropic Hormone-Producing Pheochromocytoma

Abstract A 76-year-old woman presented with worsening fasting hyperglycemia on routine blood sugar measurement, previously well-controlled on Metformin, requiring initiation of insulin. Her medical history included type 2 diabetes mellitus, hypertension, and aortic stenosis. Over the next few weeks, she developed bilateral upper and lower extremity proximal muscle weakness, episodes of confusion, rapid weight loss and increasing lower extremity edema. She did not have typical Cushingoid features of moon facies, easy bruising, centripetal obesity, abdominal striae, dorsocervical fat padding, or hyperpigmentation. Laboratory data revealed severe hypokalemia, elevated cortisol of 138 (3.7–19.4 ug/dL) and ACTH of 368 (6–50 pg/mL) consistent with ACTH-dependent Cushing’s syndrome. She was hospitalized for emergent therapy with etomidate infusion, potassium supplementation, and started on spironolactone. 24-hour urinary analysis demonstrated elevated catecholamines and metanephrines: epinephrine 552 (2–16 mcg/g cr), norepinephrine 1881 (7-5 mcg/g cr), metanephrine 4095 (21–153 mcg/g cr), normetanephrine 3920 (108–524 mcg/g cr). CT abdomen showed 3.8 cm mass in the left adrenal gland with enhancing walls and central hypoattenuation and a normal contralateral adrenal gland. MR brain showed a partial empty sella without any mass. 123I-metaiodobenzylguanidine scintigraphy showed uptake in the left adrenal mass. Once cortisol was reduced to &amp;lt;25 ug/dL, she was transitioned from etomidate to metyrapone; alpha-methyltyrosine and prazosin was also begun. Following left laparoscopic adrenalectomy, ACTH decreased to &amp;lt;5 pg/mL confirming that the pheochromocytoma was the source of ectopic Cushing’s. Gross examination of the mass was notable for a spongy, tan, roughly spherical medullary neoplasm (3 cm in diameter) with a rim of brown and focally yellow adrenal cortex up to 4 mm thick. Marked diffuse adrenal cortical hyperplasia was noted. The tumor showed varied growth patterns, including solid areas and spongy, angioma-like areas with prominent small blood vessels. Immunohistochemical staining was positive for somatostatin receptor 2A, tyrosine hydroxylase and ACTH in tumor cells and negative for T-PIT. She was discharged on replacement hydrocortisone therapy, minimal insulin for diabetes and has shown substantial clinical improvement. Cushing’s syndrome due to ectopic ACTH-producing pheochromocytoma is rare. Worsening hyperglycemia in the presence of hypertension, even without typical clinical findings of Cushing’s, should prompt further hormonal work up. The absence of the transcription factor TPIT, which is a lineage determinant for pituitary corticotrophs, suggests that novel pathways are involved in differentiation of cells that produce ectopic ACTH.</jats:p

The Europa Imaging System (EIS) Investigation

The Europa Imaging System (EIS) consists of a Narrow-Angle Camera (NAC) and a Wide-Angle Camera (WAC) that are designed to work together to address high-priority science objectives regarding Europa’s geology, composition, and the nature of its ice shell. EIS accommodates variable geometry and illumination during rapid, low-altitude flybys with both framing and pushbroom imaging capability using rapid-readout, 8-megapixel (4k × 2k) detectors. Color observations are acquired using pushbroom imaging with up to six broadband filters. The data processing units (DPUs) perform digital time delay integration (TDI) to enhance signal-to-noise ratios and use readout strategies to measure and correct spacecraft jitter. The NAC has a 2.3° × 1.2° field of view (FOV) with a 10-μrad instantaneous FOV (IFOV), thus achieving 0.5-m pixel scale over a swath that is 2 km wide and several km long from a range of 50 km. The NAC is mounted on a 2-axis gimbal, ±30° cross- and along-track, that enables independent targeting and near-global (≥90%) mapping of Europa at ≤100-m pixel scale (to date, only ∼15% of Europa has been imaged at ≤900 m/pixel), as well as stereo imaging from as close as 50-km altitude to generate digital terrain models (DTMs) with ≤4-m ground sample distance (GSD) and ≤0.5-m vertical precision. The NAC will also perform observations at long range to search for potential erupting plumes, achieving 10-km pixel scale at a distance of one million kilometers. The WAC has a 48° × 24° FOV with a 218-μrad IFOV, achieving 11-m pixel scale at the center of a 44-km-wide swath from a range of 50 km, and generating DTMs with 32-m GSD and ≤4-m vertical precision. The WAC is designed to acquire three-line pushbroom stereo and color swaths along flyby ground-tracks.</p

Report of the first seven agents in the I-SPY COVID trial: a phase 2, open label, adaptive platform randomised controlled trial

BackgroundAn urgent need exists to rapidly screen potential therapeutics for severe COVID-19 or other emerging pathogens associated with high morbidity and mortality.MethodsUsing an adaptive platform design created to rapidly evaluate investigational agents, hospitalised patients with severe COVID-19 requiring ≥6&nbsp;L/min oxygen were randomised to either a backbone regimen of dexamethasone and remdesivir alone (controls) or backbone plus one open-label investigational agent. Patients were enrolled to the arms described between July 30, 2020 and June 11, 2021 in 20 medical centres in the United States. The platform contained up to four potentially available investigational agents and controls available for randomisation during a single time-period. The two primary endpoints were time-to-recovery (&lt;6&nbsp;L/min oxygen for two consecutive days) and mortality. Data were evaluated biweekly in comparison to pre-specified criteria for graduation (i.e., likely efficacy), futility, and safety, with an adaptive sample size of 40-125 individuals per agent and a Bayesian analytical approach. Criteria were designed to achieve rapid screening of agents and to identify large benefit signals. Concurrently enrolled controls were used for all analyses. https://clinicaltrials.gov/ct2/show/NCT04488081.FindingsThe first 7 agents evaluated were cenicriviroc (CCR2/5 antagonist; n&nbsp;=&nbsp;92), icatibant (bradykinin antagonist; n&nbsp;=&nbsp;96), apremilast (PDE4 inhibitor; n&nbsp;=&nbsp;67), celecoxib/famotidine (COX2/histamine blockade; n&nbsp;=&nbsp;30), IC14 (anti-CD14; n&nbsp;=&nbsp;67), dornase alfa (inhaled DNase; n&nbsp;=&nbsp;39) and razuprotafib (Tie2 agonist; n&nbsp;=&nbsp;22). Razuprotafib was dropped from the trial due to feasibility issues. In the modified intention-to-treat analyses, no agent met pre-specified efficacy/graduation endpoints with posterior probabilities for the hazard ratios [HRs] for recovery ≤1.5 between 0.99 and 1.00. The data monitoring committee stopped Celecoxib/Famotidine for potential harm (median posterior HR for recovery 0.5, 95% credible interval [CrI] 0.28-0.90; median posterior HR for death 1.67, 95% CrI 0.79-3.58).InterpretationNone of the first 7 agents to enter the trial met the prespecified criteria for a large efficacy signal. Celecoxib/Famotidine was stopped early for potential harm. Adaptive platform trials may provide a useful approach to rapidly screen multiple agents during a pandemic.FundingQuantum Leap Healthcare Collaborative is the trial sponsor. Funding for this trial has come from: the COVID R&amp;D Consortium, Allergan, Amgen Inc., Takeda Pharmaceutical Company, Implicit Bioscience, Johnson &amp; Johnson, Pfizer Inc., Roche/Genentech, Apotex Inc., FAST Grant from Emergent Venture George Mason University, The DoD Defense Threat Reduction Agency (DTRA), The Department of Health and Human ServicesBiomedical Advanced Research and Development Authority (BARDA), and The Grove Foundation. Effort sponsored by the U.S. Government under Other Transaction number W15QKN-16-9-1002 between the MCDC, and the Government