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Abstract Indirect standardization, and its associated parameter the standardized incidence ratio, is a commonly-used tool in hospital profiling for comparing the incidence of negative outcomes between an index hospital and a larger population of reference hospitals, while adjusting for confounding covariates. In statistical inference of the standardized incidence ratio, traditional methods often assume the covariate distribution of the index hospital to be known. This assumption severely compromises one’s ability to compute required sample sizes for high-powered indirect standardization, as in contexts where sample size calculation is desired, there are usually no means of knowing this distribution. This paper presents novel statistical methodology to perform sample size calculation for the standardized incidence ratio without knowing the covariate distribution of the index hospital and without collecting information from the index hospital to estimate this covariate distribution. We apply our methods to simulation studies and to real hospitals, to assess both its capabilities in a vacuum and in comparison to traditional assumptions of indirect standardization.

Abstract Pediatric patients with pulmonary hypertension (PH) receive imaging studies that use ionizing radiation (radiation) such as computed tomography (CT) and cardiac catheterization to guide clinical care. Radiation exposure is associated with increased cancer risk. It is unknown how much radiation pediatric PH patients receive. The objective of this study is to quantify radiation received from imaging and compute associated lifetime cancer risks for pediatric patients with PH. Electronic health records between 2012 and 2022 were reviewed and radiation dose data were extracted. Organ doses were estimated using Monte Carlo modeling. Cancer risks for each patient were calculated from accumulated exposures using National Cancer Institute tools. Two hundred and forty‐nine patients with PH comprised the study cohort; 97% of patients had pulmonary arterial hypertension, PH due to left heart disease, or PH due to chronic lung disease. Mean age at the time of the first imaging study was 2.5 years (standard deviation [SD] = 4.9 years). Patients underwent a mean of 12 studies per patient per year, SD = 32. Most (90%) exams were done in children

Regulatory T cells (Tregs) have shown great promise as a means of cellular therapy in a multitude of allo- and auto-immune diseases—due in part to their immunosuppressive potency. Nevertheless, the clinical efficacy of human Tregs in patients has been limited by their poor in vivo homeostasis. To avert apoptosis, Tregs require stable antigenic (CD3ζ/T-cell-receptor-mediated), co-stimulatory (CD28-driven), and cytokine (IL-2-dependent) signaling. Notably, this sequence of signals supports an activated Treg phenotype that includes a high expression of granzymes, particularly granzyme B (GrB). Previously, we have shown that aside from the functional effects of GrB in lysing target cells to modulate allo-immunity, GrB can leak out of the intracellular lysosomal granules of host Tregs, initiating pro-apoptotic pathways. Here, we assessed the role of inhibiting mechanistic target of rapamycin complex 1 (mTORC1), a recently favored drug target in the transplant field, in regulating human Treg apoptosis via GrB. Using ex vivo models of human Treg culture and a humanized mouse model of human skin allotransplantation, we found that by inhibiting mTORC1 using rapamycin, intracytoplasmic expression and functionality of GrB diminished in host Tregs; lowering human Treg apoptosis by in part decreasing the phosphorylation of S6K and c-Jun. These findings support the already clinically validated effects of mTORC1 inhibition in patients, most notably their stabilization of Treg bioactivity and in vivo homeostasis.

Abstract New Onset Diabetes After Transplantation (NODAT) is a serious metabolic complication. While β-cell dysfunction is considered the main contributing factor in the development of NODAT, the precise pathogenesis is not well understood. Cytokines are thought to be involved in the inflammation of islet β-cells in diabetes; however, few studies have investigated this hypothesis in NODAT. A total of 309 kidney transplant recipients (KTRs) were included in this study. An association between kidney transplants, and the development of diabetes after transplant (NODAT) was investigated. Comparison was made between KTRs who develop diabetes (NODAT cases) or did not develop diabetes (control), using key cytokines, IL-6 G (− 174)C, macrophage mediator; IL-4 C (− 490)T, T helper (Th)-2 cytokine profile initiator; Th-1 cytokine profile initiator interferon-γ T (+ 874) A gene and TGF β1 C (+ 869) T gene polymorphisms were investigated. The genes were amplified using well-established polymerase chain reaction (PCR) techniques in our laboratory. Compared to the AA and AT genotypes of interferon gamma (IFNG), there was a strong association between the TT genotype of IFNG and NODAT kidney transplant recipients (KTRs) versus non-NODAT KTRs (p = 0.005). The AA genotype of IFNG was found to be predominant in the control group (p = 0.004). Also, significant variations of IL6 G (− 174) C, IL-4 C (− 590) T, interferon-γ T (+ 874) A gene and transforming growth factor β1 C (+ 869) T may contribute to NODAT. Our data is consistent with theTh-1/T-reg pathway of immunity. Further larger pan Arab studies are required to confirm our findings.

Chordomas account for approximately 1–4% of all malignant bone tumors and 20% of primary tumors of the spinal column. It is a rare disease, with an incidence estimated to be approximately 1 per 1,000,000 people. The underlying causative mechanism of chordoma is unknown, which makes it challenging to treat. Chordomas have been linked to the T-box transcription factor T (TBXT) gene located on chromosome 6. The TBXT gene encodes a protein transcription factor TBXT, or brachyury homolog. Currently, there is no approved targeted therapy for chordoma. Here, we performed a small molecule screening to identify small chemical molecules and therapeutic targets for treating chordoma. We screened 3730 unique compounds and selected 50 potential hits. The top three hits were Ribociclib, Ingenol-3-angelate, and Duvelisib. Among the top 10 hits, we found a novel class of small molecules, including proteasomal inhibitors, as promising molecules that reduce the proliferation of human chordoma cells. Furthermore, we discovered that proteasomal subunits PSMB5 and PSMB8 are increased in human chordoma cell lines U-CH1 and U-CH2, confirming that the proteasome may serve as a molecular target whose specific inhibition may lead to better therapeutic strategies for chordoma.

Abstract Solid organ transplantation is a lifesaving therapy for patients with end-organ disease. Current immunosuppression protocols are not designed to target antigen-specific alloimmunity and are uncapable of preventing chronic allograft injury. As myeloid-derived suppressor cells (MDSCs) are potent immunoregulatory cells, we tested whether donor-derived MDSCs can protect heart transplant allografts in an antigen-specific manner. C57BL/6 (H2Kb, I-Ab) recipients pre-treated with BALB/c MDSCs were transplanted with either donor-type (BALB/c, H2Kd, I-Ad) or third-party (C3H, H2Kk, I-Ak) cardiac grafts. Spleens and allografts from C57BL/6 recipients were harvested for immune phenotyping, transcriptomic profiling and functional assays. Single injection of donor-derived MDSCs significantly prolonged the fully MHC mismatched allogeneic cardiac graft survival in a donor-specific fashion. Transcriptomic analysis of allografts harvested from donor-derived MDSCs treated recipients showed down-regulated proinflammatory cytokines. Immune phenotyping showed that the donor MDSCs administration suppressed effector T cells in recipients. Interestingly, significant increase in recipient endogenous CD11b+Gr1+ MDSC population was observed in the group treated with donor-derived MDSCs compared to the control groups. Depletion of this endogenous MDSCs with anti-Gr1 antibody reversed donor MDSCs-mediated allograft protection. Furthermore, we observed that the allogeneic mixed lymphocytes reaction was suppressed in the presence of CD11b+Gr1+ MDSCs in a donor-specific manner. Donor-derived MDSCs prolong cardiac allograft survival in a donor-specific manner via induction of recipient’s endogenous MDSCs.

The basolateral amygdala (BLA) plays a vital role in associating sensory stimuli with salient valence information. Excitatory principal neurons (PNs) undergo plastic changes to encode this association; however, local BLA inhibitory interneurons (INs) gate PN plasticity via feedforward inhibition (FFI). Despite literature implicating parvalbumin expressing (PV+) INs in FFI in cortex and hippocampus, prior anatomical experiments in BLA implicate somatostatin expressing (Sst+) INs. The lateral entorhinal cortex (LEC) projects to BLA where it drives FFI. In the present study, we explored the role of interneurons in this circuit. Using mice, we combined patch clamp electrophysiology, chemogenetics, unsupervised cluster analysis, and predictive modeling and found that a previously unreported subpopulation of fast-spiking Sst+ INs mediate LEC→BLA FFI.

We provide data in this article related to (C.C. Chen et al.,. Neurosci. Lett., 599 (2015) 152–157.) [1] where the expression of tissue plasminogen activator (tPA) is expressed by the whisker representation in the somatosensory cortex. Here, we provide immunocytochemistry data indicating that tPA is expressed by putative excitatory neurons as well as parvalbumin+ interneurons but not by somatostatin+ inhibitory interneurons. We also provide data showing that microglia do not normally express high levels of tPA, but upregulate their levels following cortical penetration with a recording electrode.

A new coupled ocean-wave model has been developed and tested as a new component of the Coupled Ocean/Atmosphere Mesoscale Prediction System (COAMPS®). The modeling system is comprised of the Simulating WAves Nearshore (SWAN) wave model and the Navy Coastal Ocean Model (NCOM). The models are two-way coupled using the Earth System Modeling Framework (ESMF). The ocean model has been modified to incorporate the effect of the Stokes drift current, wave radiation stresses due to horizontal gradients of the momentum flux of surface waves, enhancement of bottom drag in shallow water, and enhanced vertical mixing due to Langmuir turbulence. The wave model ingests surface currents (wave-current interaction) and water levels. The system is designed to support the Navy's ocean forecast requirements for regional and coastal domains. Validation studies for the Florida Straits and Virginia coastal area are presented. The system will run at the Naval Oceanographic Office and at the Fleet Numerical Meteorology and Oceanography Center.

Abstract Background Multiple lines of evidence support peripheral organs in the initiation or progression of Lewy body disease (LBD), a spectrum of neurodegenerative diagnoses that include Parkinson’s Disease (PD) without or with dementia (PDD) and dementia with Lewy bodies (DLB). However, the potential contribution of the peripheral immune response to LBD remains unclear. This study aims to characterize peripheral immune responses unique to participants with LBD at single-cell resolution to highlight potential biomarkers and increase mechanistic understanding of LBD pathogenesis in humans. Methods In a case–control study, peripheral mononuclear cell (PBMC) samples from research participants were randomly sampled from multiple sites across the United States. The diagnosis groups comprise healthy controls (HC, n = 159), LBD (n = 110), Alzheimer’s disease dementia (ADD, n = 97), other neurodegenerative disease controls (NDC, n = 19), and immune disease controls (IDC, n = 14). PBMCs were activated with three stimulants (LPS, IL-6, and IFNa) or remained at basal state, stained by 13 surface markers and 7 intracellular signal markers, and analyzed by flow cytometry, which generated 1,184 immune features after gating. Results The model classified LBD from HC with an AUROC of 0.87 ± 0.06 and AUPRC of 0.80 ± 0.06. Without retraining, the same model was able to distinguish LBD from ADD, NDC, and IDC. Model predictions were driven by pPLCγ2, p38, and pSTAT5 signals from specific cell populations under specific activation. The immune responses characteristic for LBD were not associated with other common medical conditions related to the risk of LBD or dementia, such as sleep disorders, hypertension, or diabetes. Conclusions and Relevance Quantification of PBMC immune response from multisite research participants yielded a unique pattern for LBD compared to HC, multiple related neurodegenerative diseases, and autoimmune diseases thereby highlighting potential biomarkers and mechanisms of disease.

Does Hebrews 8:5 claim that Israel’s earthly sanctuaries are ‘shadowy copies’ of a heavenly sanctuary, or do these sanctuaries anticipate an eschatological sanctuary where God will dwell with his people, as I have argued? Nicholas J. Moore has critiqued my reading of this verse on the grounds that reading the expression ὑπόδειγμα καὶ σκιά as ‘copy and shadow’ is lexically permissible, that the idea that Israel’s earthly sanctuaries are copies of the heavenly sanctuary is widespread in the Second Temple period, and that my reading involves an awkward switch between temple and tabernacle in Hebrews 8:5. This article argues that it cannot be demonstrated that ὑπόδειγμα can have the sense ‘copy’, that the idea of the temple as an anticipation of God’s eschatological dwelling with his people is present at Qumran in ways that are similar to what is found in Hebrews, and that my reading involves no awkward switch between tabernacle and temple in Hebrews 8:5. Ultimately, it can be shown that a temporal reading of ὑπόδειγμα καί σκιά in Hebrews 8:5 contributes more to its context than does a spatial reading.

Background: Anesthesiology plays a crucial role in perioperative care, critical care, and pain management, impacting patient experiences and clinical outcomes. However, our understanding of the anesthesiology research landscape is limited. Accordingly, we initiated a data-driven analysis through topic modeling to uncover research trends, enabling informed decision-making and fostering progress within the field. Methods: The easyPubMed R package was used to collect 32,300 PubMed abstracts spanning from 2000 to 2022. These abstracts were authored by 737 Anesthesiology Principal Investigators (PIs) who were recipients of National Institute of Health (NIH) funding from 2010 to 2022. Abstracts were preprocessed, vectorized, and analyzed with the state-of-the-art BERTopic algorithm to identify pillar topics and trending subtopics within anesthesiology research. Temporal trends were assessed using the Mann-Kendall test. Results: The publishing journals with most abstracts in this dataset were Anesthesia & Analgesia 1133, Anesthesiology 992, and Pain 671. Eight pillar topics were identified and categorized as basic or clinical sciences based on a hierarchical clustering analysis. Amongst the pillar topics, “Cells & Proteomics” had both the highest annual and total number of abstracts. Interestingly, there was an overall upward trend for all topics spanning the years 2000–2022. However, when focusing on the period from 2015 to 2022, topics “Cells & Proteomics” and “Pulmonology” exhibit a downward trajectory. Additionally, various subtopics were identified, with notable increasing trends in “Aneurysms”, “Covid 19 Pandemic”, and “Artificial intelligence & Machine Learning”. Conclusion: Our work offers a comprehensive analysis of the anesthesiology research landscape by providing insights into pillar topics, and trending subtopics. These findings contribute to a better understanding of anesthesiology research and can guide future directions.

Abstract Background Electronic health records (EHR) contain large volumes of unstructured free-form text notes that richly describe a patient’s health and medical comorbidities. It is unclear if perioperative risk stratification can be performed directly from these notes without manual data extraction. We conduct a feasibility study using natural language processing (NLP) to predict the American Society of Anesthesiologists Physical Status Classification (ASA-PS) as a surrogate measure for perioperative risk. We explore prediction performance using four different model types and compare the use of different note sections versus the whole note. We use Shapley values to explain model predictions and analyze disagreement between model and human anesthesiologist predictions. Methods Single-center retrospective cohort analysis of EHR notes from patients undergoing procedures with anesthesia care spanning all procedural specialties during a 5 year period who were not assigned ASA VI and also had a preoperative evaluation note filed within 90 days prior to the procedure. NLP models were trained for each combination of 4 models and 8 text snippets from notes. Model performance was compared using area under the receiver operating characteristic curve (AUROC) and area under the precision recall curve (AUPRC). Shapley values were used to explain model predictions. Error analysis and model explanation using Shapley values was conducted for the best performing model. Results Final dataset includes 38,566 patients undergoing 61,503 procedures with anesthesia care. Prevalence of ASA-PS was 8.81% for ASA I, 31.4% for ASA II, 43.25% for ASA III, and 16.54% for ASA IV-V. The best performing models were the BioClinicalBERT model on the truncated note task (macro-average AUROC 0.845) and the fastText model on the full note task (macro-average AUROC 0.865). Shapley values reveal human-interpretable model predictions. Error analysis reveals that some original ASA-PS assignments may be incorrect and the model is making a reasonable prediction in these cases. Conclusions Text classification models can accurately predict a patient’s illness severity using only free-form text descriptions of patients without any manual data extraction. They can be an additional patient safety tool in the perioperative setting and reduce manual chart review for medical billing. Shapley feature attributions produce explanations that logically support model predictions and are understandable to clinicians.

Abstract Background Due to the role expansion of radiotherapists in dosimetric aspect, radiotherapists have taken up organs at risk (OARs) contouring work in many clinical settings. However, training of newly qualified radiotherapists in OARs contouring can be time consuming, it may also cause extra burden to experienced radiotherapists. As web-based open-source radiotherapy delineation software (WORDS) has become more readily available, it has provided a free and interactive alternative to conventional one-to-one coaching approach during OARs contouring training. The present study aims to evaluate the effectiveness of WORDS in training OARs contouring skills of newly qualified radiotherapists, compared to those trained by conventional one-to-one coaching approach. Methods Nine newly qualified radiotherapists (licensed in 2017 – 2018) were enrolled to the conventional one-to-one coaching group (control group), while 11 newly qualified radiotherapists (licensed in 2019 – 2021) were assigned to WORDS training group (measured group). Ten OARs were selected to be contoured in this 3-phases quantitative study. Participants were required to undergo phase 1 OARs contouring in the beginning of the training session. Afterwards, conventional one-to-one training or WORDS training session was provided to participants according to their assigned group. Then the participants did phase 2 and 3 OARs contouring which were separated 1 week apart. Phase 1 – 3 OARs contouring aimed to demonstrate participants’ pre-training OARs contouring ability, post-training OARs contouring ability and knowledge retention after one-week interval respectively using either training approach. To prevent bias, the computed tomography dataset for OARs contouring in each phase were different. Variations in the contouring scores for the selected OARs were evaluated between 3 phases using Kruskal-Wallis tests with Dunn tests for pairwise comparisons. Variations in the contouring scores between control and measured group in phase 1 – 3 contouring were analyzed using Wilcoxon signed-rank test. A p-value 0.05) were observed in all OARs between both groups. Conclusions The results in this study have demonstrated that the outcome of OARs contouring training using WORDS is comparable to the conventional training approach. In addition, WORDS can offer flexibility to newly qualified radiotherapists to practice OARs contouring at will, as well as reduce staff training burden of experienced radiotherapists.

Summary: Existing techniques for transcriptional profiling of projection neurons could be applied to only one neuronal population per experiment. To increase throughput, we developed VECTORseq, which repurposes retrogradely infecting viruses to deliver multiplexable RNA barcodes, enabling projection anatomy to be read out in single-cell datasets. In this protocol, we describe the delivery of viral barcodes to mouse brain to label different projection neurons. We then detail single-cell or nuclei isolation for sequencing, followed by the analysis of single-cell sequencing data.For complete details on the use and execution of this protocol, please refer to Cheung et al. (2021). : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract Background Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care. Case presentation A 37-year-old primigravida woman presented with abdominal distension and discomfort, yet otherwise asymptomatic. On ultrasound, an incidental pregnancy at 25 weeks of gestation and a large pelvic lesion were discovered. MRI defined a 28 × 29 cm lobulated, complex cystic mass in the upper abdomen. The patient underwent two ascitic drainages throughout her pregnancy. At 34 weeks of gestation, she had a classical caesarean section. Then at five-weeks postpartum, she underwent a laparotomy and total splenectomy with 16 L of fluid drained. Histopathological analysis revealed an epithelial cyst of the spleen. Her recovery was complicated by complete portal vein thrombosis. Conclusion This case describes the largest splenic cyst ever reported in pregnancy and explores the diagnostic dilemmas and treatment challenges associated. We introduce the utility of serial ascitic drainages in prolonging the pregnancy and emphasise the reliance on imaging for surveillance of splenic size and fetal wellbeing.

Abstract Background Although whole brain radiation therapy (WBRT) provides palliation and prophylaxis, reduces local recurrence probability and improves overall survival, it is evident that WBRT is associated with neurocognitive deficits due to radiation induced damage of the hippocampus. Therefore, minimizing hippocampal dose to the least possible level is of high clinical relevance. In dual-arc conventional volumetric modulated arc therapy (dac-VMAT), the large irradiation field for whole brain planned target volume (PTV) requires a wide jaw opening in which substantial low dose volume to the hippocampus may be produced due to suboptimal multi-leaf collimator (MLC) movements. The present study investigates the potential of a radiation therapy technique with split-arc and reduced field size, namely split-arc partial-field volumetric modulated arc therapy (sapf-VMAT) to spare the hippocampus during WBRT. Methods Computed tomography and magnetic resonance images of 20 patients with brain metastases were retrieved in this retrospective planning study. The hippocampus was manually delineated by single radiation oncologist strictly following the RTOG 0933 atlas definition. Plans delivering 30 Gy in 10 fractions were generated for each patient using dac-VMAT and sapf-VMAT. Dosimetric parameters from both techniques were compared by paired t-test. Results The results demonstrated that radiation dose to the hippocampus was significantly reduced using sapf-VMAT relative to dac-VMAT plans. sapf-VMAT (7.86Gy, p = 0.001) had significantly lowered average D100% compared to dac-VMAT (9.23 Gy). Decrease in hippocampus Dmax using sapf-VMAT (13.23 Gy, p = 0.001) was statistically significant when compared to dac-VMAT (16.33 Gy). The resulting mean dose to the hippocampus was 9.16 Gy for the for sapf-VMAT. Mean dose of sapf-VMAT was significantly lower than dac-VMAT (10.85 Gy, p

Globally, COVID-19-related movement restrictions have caused significant disruption to athlete's training and sporting competitions. “Quarantine” camps are one approach to maintain sport-specific training, whilst minimizing the risk of COVID-19 transmission between athletes and society. This cross-sectional study investigated the effects of a “quarantine” training camp on athlete's routines and wellbeing, performance support, perceived stress and sleep behaviors. A survey was completed at the end of a 30-day “quarantine” camp, by 76 elite athletes (17–46 years), predominantly (~80%) Olympic/Paralympic and/or world championship representatives. Athletes described their experiences in comparison to; pre-lockdown training and/or training during “lockdown” (immediately prior to the “quarantine” camp). Compared to “lockdown,” the “quarantine” camp revealed improvements (p < 0.05; 0.33 ≤ d ≤ 0.90) in access to sport-specific training (28.6%), recovery facilities (22.2%), nutritional choices (17.5%), mental (12.4%) and emotional (11.4%) health, training motivation (20.0%); and perceived stress (7.4%, d = −0.27, p = 0.026). The camp resulted in a lower sleep duration (−8.5%, d = −0.73, p = 0.014), but an improved global sleep behavior score (−5.6%, d = −0.22, p = 0.001). During the camp, the performance support athletes received was not different to pre-lockdown (p > 0.05), but there was greater sports massage (20.4%, d = 0.39) and physiotherapy usage (18.1%, d = 0.36) (both p < 0.05). The adverse effects of lockdown were restored during the camp. A “quarantine” camp may offer comparable training experiences to pre-lockdown training, without inducing additional perceived stress. Coaches and sporting organizations may consider this approach as part of a virus mitigation strategy, whilst maintaining sport-specific training.

Background: Bacteria as etiological agents have been reported to cause many diseases and have increased the rate of mortality globally. Their resistance to conventional medicine has made medicinal plants a credible alternative in the management of diseases caused by bacterial infection. In the recent times many research efforts have been directed towards the exploration of phytoconstituents with antibacterial potentials. Medicinal plants are widely used as antibacterial agents because of their high therapeutic performance, low toxicity, and affordability. Aim: This work was designed to identify secondary metabolites present in root extracts of ethno-medicinally utilised Portulaca oleracea L. and evaluate their antibacterial activities. Setting: The roots of P. oleracea L. were obtained from the Forest Research Institute of Nigeria (FRIN), Ibadan, Nigeria and authenticated in the Forest Research Herbarium, where voucher samples were deposited with specimen voucher number FIH-112030. Methods: Phytochemical screening was carried out using standard qualitative tests and the antibacterial activity of extracts was evaluated using agar well diffusion method whilst the minimum inhibitory concentration (MIC) was evaluated by micro-dilution method. The screening was assessed against Bacillus subtilis, Candida albicans, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Micrococcus luteus, Pseudomonas aeruginosa, Salmonella typhi, Shigella dysenteriae, Staphylococcus aureus and Streptococcus agalactiae, which are responsible for the transmission of common diseases in Nigeria. Statistical analysis was performed by one-way analysis of variance (ANOVA) with GraphPad Prism 8.0 and results were expressed as mean ± s.d. Duncan’s New Multiple range test were applied at 0.05 level of significance (p 0.05). Results: Phytochemical screening of P. oleracea L. showed the presence of carbohydrates, steroids, triterpenes, cardiac glycosides, and saponins. All extracts showed a high level of minimum inhibition concentration against the pathogens except K. pneumoniae, M. luteus and P. aeruginosa. Generally the antibacterial activity of extracts increased with decrease in polarity as compared with ciprofloxacin. The mean (± s.d.) values were significantly different by Duncan’s multiple range tests with p 0.05. Conclusion: Portulaca oleracea L. has been identified for the first time as a good antibacterial agent, which corroborates the ethno-medicinal uses of the plant.

The significance of Hebrews 10:2 for the date of the letter has been the subject of debate, with some scholars finding it decisive for a pre-70 CE date and others denying it any importance, proposing (rightly) that the writer is arguing theoretically about sacrificial activity extending since the time of Aaron. The 2017 publication of the Tyndale House Greek New Testament brings the debate into sharp focus with Hebrews 10:2a punctuated as a statement (‘If the sacrifices were effective, they would not have ceased to be offered’) rather than a question (‘If the sacrifices were effective, would they not have ceased to be offered?’). Reading the clause as a statement implies that the temple has fallen and sacrifices have ceased, leading to the conclusion that Hebrews postdates this event. An examination of the manuscript evidence, the history of interpretation, the syntax, and the context shows that the clause should be read as a rhetorical question expecting a positive answer from the readers: ‘Yes, the sacrifices would have ceased if they were effective.’ Even if the writer were arguing theoretically, this would be a difficult answer had the temple been destroyed. This makes a pre-70 date more likely than a post-70 date.

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Background: Several 2-dimensional and 3-dimensional surfaces are available for cementless acetabular fixation. Plain radiographs are used to assess osseointegration; however, the radiographs are limited by their inability to capture the bone fixation process occurring over the 3-dimensional cup surface. In this cadaveric study, we compared the bone apposition between 2-dimensional and 3-dimensional cups. Methods: Both types of cups were implanted in 6 cadavers and pelvic radiographs obtained. Each cup was resected from the pelvis with adequate bone around it, and subsequently embedded in a polymer. Six sections of each cup were obtained to examine the metal and bone interface. Photographs and contact radiograph images were obtained for each section, and these were graded to arrive at percent metal-bone contact values for the cups. Results: On average,

Background: Medical tourism is increasingly popular for elective cosmetic surgical procedures. However, medical tourism has been accompanied by reports of post-surgical infections due to rapidly growing mycobacteria (RGM). The authors’ experience working with patients with RGM infections who have returned to the USA after traveling abroad for cosmetic surgical procedures is described here. Methods: Patients who developed RGM infections after undergoing cosmetic surgeries abroad and who presented at the Montefiore Medical Center (Bronx, New York, USA) between August 2015 and June 2016 were identified. A review of patient medical records was performed. Results: Four patients who presented with culture-proven RGM infections at the sites of recent cosmetic procedures were identified. All patients were treated with a combination of antibiotics and aggressive surgical treatment. Conclusions: This case series of RGM infections following recent cosmetic surgeries abroad highlights the risks of medical tourism. Close monitoring of affected patients by surgical and infectious disease specialties is necessary, as aggressive surgical debridement combined with appropriate antibiotic regimens is needed to achieve cure. Given the increasing reports of post-surgical RGM infections, consultants should have a low threshold for suspecting RGM, as rapid diagnosis may accelerate the initiation of targeted treatment and minimize morbidity.

Abstract SCADA systems allow users to monitor and/or control physical devices, processes, and events remotely and in real-time. As these systems are critical to industrial processes, they are often run on highly reliable and dedicated hardware. Moving these SCADA systems to an Infrastructure as a Service (IaaS) cloud allows for: cheaper deployments, system redundancy support, and increased uptime. The goal of this work was to present the results of our experimental study of moving/migrating a selected SCADA system to a cloud environment and present major lessons learned. To this end, EclipseSCADA was deployed to the NeCTAR research cloud using the “lift and shift” approach. Performance metrics of a unique nature and large scale of experimentation were collected from the deployed EclipseSCADA system under different loads to examine the effects cloud resources and public networks have on SCADA behavior.

This article examines the asymmetric relationship between electric consumption, economic growth, and carbon dioxide emission in 15 countries over the period 1971−2014. We employed a nonlinear auto-regressive distribution Lag (NARDL) model approach to investigate the asymmetric cointegration between variables. Additionally, we applied the asymmetric causality approach to determine the causal relationship between variables. Results confirm nonlinear cointegration between variables in Cameroon, Congo Republic, Zambia, Canada, and the UK. The Wald test results confirm a long-run asymmetric link between electricity consumption, economic growth, and carbon emission in Canada and Cameroon, while a short-run asymmetric effect in the Congo Republic and the UK. Findings from the granger causality test are volatile across variables. The result provides strong support for the symmetric relationship between electric consumption, economic growth, and carbon emission in the short and long run. This study provides new evidence for policymakers to formulate country-specific policies to obtain better environmental quality while achieving sustainable economic growth.

The suggestion that the author of Hebrews is indebted to Philo sometimes leads to the assertion that he has a negative bias against the creation. One text where scholars have detected this bias is Hebrews 1:10-12, quoting Psalm 102:25-27, seemingly to predict the dissolution of the cosmos. The text is part of a Psalm that predicts the restoration of Zion and the gathering of the nations there to worship, and expresses the confidence that the descendants of the servants of Yahweh will live securely in Yahweh’s presence. This makes it unlikely that verses 25-26 predict the dissolution of the cosmos, and exegesis of the verses in question indicates not dissolution, but renewal after the destruction resulting from the exile. Attention to the context of the quotation in Hebrews indicates that dissolution there is also unlikely. The text supports the claim that the exalted Son upholds all things (Heb. 1:3) and sits alongside a discussion of the dominion of humanity over the world to come (2:5-9). A more remote co-text refers to the gathering of the nations to Zion (12:22-24), itself a further echo of the Psalm. The Psalm quotation functions to predict not the dissolution, but the renewal of the decaying cosmos.

Several Second Temple texts make no explicit mention of the temple, but it cannot be assumed that this silence indicates a lack of interest. While the Apocalypse of Weeks reveres Solomon’s temple and describes it in ways that indicate that it anticipates the eschatological temple, the Second Temple is ignored, implying a strong polemic against it. Hebrews makes no explicit mention of the Second Temple, but several texts reflect a critique of temple, priesthood, and sacrificial system. Hebrews claims that the temple and its associated rituals were a symbolic foreshadowing of the eschatological dwelling of God with his people in the last days, now come with the exaltation of Christ. Since the reality has now come, the readers can no longer be occupied with the symbols.