Richard Rohr, Mysticism and Neoplatonism

This paper explores key themes and doctrines in the writings of popular Franciscan priest Richard Rohr. It examines and evaluates Rohr’s incarnational worldview. It argues that Rohr’s mysticism must be understood in the light of pagan Neoplatonism. Rohr follows Plotinus, the founder of Neoplatonism by asserting that God lives in the deepest part of every human being whereas the New Testament teaches that God lives in every person who welcomes Him. God dwells in people by His Holy Spirit when they repent and believe the good news of Jesus’ death and resurrection.   https://doi.org/10.19108/KOERS.86.1.2498

Dooyeweerd, Modal Aspects and Dynamic Evangelism

The present work identifies the modal aspect theory as a tool capable of evaluating an evangelistic outreach event and an example of such an outreach event is analysed using this theory. The event considered involves the offer, in a public space, of hospitality in the form of refreshments to passers-by. Modal aspect theory is shown to be capable of dynamic and fruitful application. It provides valuable insights into the way in which a biblically faithful outreach event may be organised and executed in such a way as to avoid reductionist influences, including Platonic dualism, and instead facilitate the establishment of a visible instance of the community of God’s people gathered, under his kingdom reign, in a public space into which unbelievers are welcomed. https://doi.org/10.19108/KOERS.88.1.252

Mr Dooyeweerd, Modal Aspects and Dynamic Evangelism

The present work identifies the modal aspect theory as a tool capable of evaluating an evangelistic outreach event and an example of such an outreach event is analysed using this theory. The event considered involves the offer, in a public space, of hospitality in the form of refreshments to passers-by. Modal aspect theory is shown to be capable of dynamic and fruitful application. It provides valuable insights into the way in which a biblically faithful outreach event may be organised and executed in such a way as to avoid reductionist influences, including Platonic dualism, and instead facilitate the establishment of a visible instance of the community of God’s people gathered, under his kingdom reign, in a public space into which unbelievers are welcomed. https://doi.org/10.19108/KOERS.88.1.252

Cardiac magnetic resonance findings predict increased resource utilization in elective coronary artery bypass grafting

Morbidity following CABG (coronary artery bypass grafting) is difficult to predict and leads to increased healthcare costs. We hypothesized that pre-operative CMR (cardiac magnetic resonance) findings would predict resource utilization in elective CABG. Over a 12-month period, patients requiring elective CABG were invited to undergo CMR 1 day prior to CABG. Gadolinium-enhanced CMR was performed using a trueFISP inversion recovery sequence on a 1.5 tesla scanner (Sonata; Siemens). Clinical data were collected prospectively. Admission costs were quantified based on standardized actual cost/day. Admission cost greater than the median was defined as 'increased'. Of 458 elective CABG cases, 45 (10%) underwent pre-operative CMR. Pre-operative characteristics [mean (S.D.) age, 64 (9) years, mortality (1%) and median (interquartile range) admission duration, 7 (6–8) days] were similar in patients who did or did not undergo CMR. In the patients undergoing CMR, eight (18%) and 11 (24%) patients had reduced LV (left ventricular) systolic function by CMR [LVEF (LV ejection fraction) <55%] and echocardiography respectively. LE (late enhancement) with gadolinium was detected in 17 (38%) patients. The average cost/day was $2723. The median (interquartile range) admission cost was$19059 ($10891–157917). CMR LVEF {OR (odds ratio), 0.93 [95% CI (confidence interval), 0.87–0.99]; P=0.03} and SV (stroke volume) index [OR 1.07 (95% CI, 1.00–1.14); P=0.02] predicted increased admission cost. CMR LVEF (P=0.08) and EuroScore tended to predict actual admission cost (P=0.09), but SV by CMR (P=0.16) and LV function by echocardiography (P=0.95) did not. In conclusion, in this exploratory investigation, pre-operative CMR findings predicted admission duration and increased admission cost in elective CABG surgery. The cost-effectiveness of CMR in risk stratification in elective CABG surgery merits prospective assessment

Inadequacy of Existing Clinical Prediction Models for Predicting Mortality after Transcatheter Aortic Valve Implantation

Background: The performance of emerging transcatheter aortic valve implantation (TAVI) clinical prediction models (CPMs) in national TAVI cohorts distinct from those where they have been derived is unknown. This study aimed to investigate the performance of the German Aortic Valve, FRANCE-2, OBSERVANT and American College of Cardiology (ACC) TAVI CPMs compared with the performance of historic cardiac CPMs such as the EuroSCORE and STS-PROM, in a large national TAVI registry. Methods: The calibration and discrimination of each CPM were analyzed in 6676 patients from the UK TAVI registry, as a whole cohort and across several subgroups. Strata included gender, diabetes status, access route, and valve type. Furthermore, the amount of agreement in risk classification between each of the considered CPMs was analyzed at an individual patient level. Results: The observed 30-day mortality rate was 5.4%. In the whole cohort, the majority of CPMs over-estimated the risk of 30-day mortality, although the mean ACC score (5.2%) approximately matched the observed mortality rate. The areas under ROC curve were between 0.57 for OBSERVANT and 0.64 for ACC. Risk classification agreement was low across all models, with Fleiss's kappa values between 0.17 and 0.50. Conclusions: Although the FRANCE-2 and ACC models outperformed all other CPMs, the performance of current TAVI-CPMs was low when applied to an independent cohort of TAVI patients. Hence, TAVI specific CPMs need to be derived outside populations previously used for model derivation, either by adapting existing CPMs or developing new risk scores in large national registries

The Future of UK Cancer – time for a radical and sustainable National Cancer Plan

Cancer affects 1 in 2 people in the UK and incidence is set to increase. The UK NHS is facing major workforce deficits and cancer services have struggled to recover after the COVID-19 pandemic, with waiting times for cancer care being the worst on record. There are significant and widening disparities across the country and survival rates remain unacceptably poor for many cancers. This is at a time when cancer care has become increasingly complex, specialised, and expensive. The current crisis has deep historic roots and to be reversed, the scale of the challenge has to be acknowledged and a fundamental re-set is needed. The loss of a dedicated National Cancer Control Plan in England & Wales, poor operationalisation of plans elsewhere in the UK and the closure of the National Cancer Research Institute have all added to a sense of strategic misdirection. The UK finds itself at a crossroads, where the political decisions of governments, the cancer community and research funders will determine whether we can, together, achieve equitable, affordable and high-quality cancer care for patients to improve our outcomes to amongst the best in the world. In this policy analysis we describe the challenges and opportunities that are needed to develop radical, yet sustainable, plans which are comprehensive, evidence based, integrated, patient focused, and affordable

A planetary system as the origin of structure in Fomalhaut's dust belt

The Sun and >15 percent of nearby stars are surrounded by dusty debris disks that must be collisionally replenished by asteroids and comets, as the dust would otherwise be depleted on <10 Myr timescales (ref. 1). Theoretical studies show that disk structure can be modified by the gravitational influence of planets (ref. 2-4), but the observational evidence is incomplete, at least in part because maps of the thermal infrared emission from disks have low linear resolution (35 AU in the best case; ref. 5). Optical images provide higher resolution, but the closest examples (AU Mic and Beta Pic) are edge-on (ref. 6,7), preventing the direct measurement of azimuthal and radial disk structure that is required for fitting theoretical models of planetary perturbations. Here we report the detection of optical light reflected from the dust grains orbiting Fomalhaut (HD 216956). The system is inclined 24 degrees away from edge-on, enabling the measurement of disk structure around its entire circumference, at a linear resolution of 0.5 AU. The dust is distributed in a belt 25 AU wide, with a very sharp inner edge at a radial distance of 133 AU, and we measure an offset of 15 AU between the belt's geometric centre and Fomalhaut. Taken together, the sharp inner edge and offset demonstrate the presence of planet-mass objects orbiting Fomalhaut.Comment: 8 pages, 3 figures, 1 tabl

COVID-19: Third dose booster vaccine effectiveness against breakthrough coronavirus infection, hospitalisations and death in patients with cancer: A population-based study

Purpose: People living with cancer and haematological malignancies are at increased risk of hospitalisation and death following infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus third dose vaccine boosters are proposed to boost waning immune responses in immunocompromised individuals and increase coronavirus protection; however, their effectiveness has not yet been systematically evaluated. Methods: This study is a population-scale real-world evaluation of the United Kingdom’s third dose vaccine booster programme for cancer patients from 8th December 2020 to 7th December 2021. The cancer cohort comprises individuals from Public Health England’s national cancer dataset, excluding individuals less than 18 years. A test-negative case-control design was used to assess third dose booster vaccine effectiveness. Multivariable logistic regression models were fitted to compare risk in the cancer cohort relative to the general population. Results: The cancer cohort comprised of 2,258,553 tests from 361,098 individuals. Third dose boosters were evaluated by reference to 87,039,743 polymerase chain reaction (PCR) coronavirus tests. Vaccine effectiveness against breakthrough infections, symptomatic infections, coronavirus hospitalisation and death in cancer patients were 59.1%, 62.8%, 80.5% and 94.5% respectively. Lower vaccine effectiveness was associated with a cancer diagnosis within 12 months, lymphoma, recent systemic anti-cancer therapy (SACT) or radiotherapy. Lymphoma patients had low levels of protection from symptomatic disease. In spite of third dose boosters, following multivariable adjustment, individuals with cancer remain at increased risk of coronavirus hospitalisation and death compared to the population control (OR 3.38, 3.01 respectively. p<0.001 for both). Conclusions: Third dose boosters are effective for most individuals with cancer, increasing protection from coronavirus. However, their effectiveness is heterogenous, and lower than the general population. Many patients with cancer will remain at increased risk of coronavirus infections, even after 3 doses. In the case of patients with lymphoma, there is a particularly strong disparity of vaccine effectiveness against breakthrough infection and severe disease. Breakthrough infections will disrupt cancer care and treatment with potentially adverse consequences on survival outcomes. The data support the role of vaccine boosters in preventing severe disease, and further pharmacological intervention to prevent transmission and aid viral clearance to limit disruption of cancer care as the delivery of care continues to evolve during the coronavirus pandemic