The Focus of Elisha\u27s Ministry on Atypical, Faithful Individuals

The focus of Elisha\u27s ministry is upon atypical individuals. Understanding the distinct atypical character focus of the Elisha narrative is important, for it connects to God\u27s overall plan to make all peoples know Him. Just as the foreign general, the destitute widow, and the powerful woman all recognize the power of Yahweh through the work of the prophet, so God desires all unlikely characters, regardless of ethnicity or socio-economic standing, to recognize His greatness. Therefore, the thesis will argue that the apostasy of Israel leads Elisha\u27s ministry to focus on unlikely characters, women and a Syrian general, whose faith starkly contrasts with the unbelief of the Israelite kings and the chosen people as a whole. The unlikely characters display genuine faith, whereas those who should demonstrate their faithfulness reject the prophet Elisha and Yahweh

Is acupuncture effective in controlling gagging when taking an alginate impressions?

Our community health project aimed to (1) identify the prevalence of gagging among patients attending the Prince Philip Dental Hospital; and to identify socio-demographic variations in reported gagging experiences; and (2) perform a pilot study to evaluate the effectiveness of acupuncture in the control of gagging in the dental setting. Methods: A survey on reported gagging experiences was conducted among patients attending our hospital involving a convenience sample of 225 patients. Participants who reported to previously gag in the dental setting were invited to participate in a pilot study to evaluate the effectiveness of acupuncture in controlling gagging when taking an upper alginate impression. Participants were randomized to receive acupuncture stimulation at a site reported to be effective in the control of gagging on the lower lip (point CV 24) or at a sham site on the upper lip (point GV 26) on their first visit and at their second visit to receive the alternative acupuncture stimulation. Results: The response rate to the survey was 81.3% (183/225). Approximately a third (58/183) reported to have experienced gagging in the dental setting and most frequently encountered this when having a dental impression (among approximately a quarter of participants - 44/183). Half (95/183) reported gagging while performing oral self-care. Four in ten participants (73/183) reported some stress visiting the dentist related to gagging. Sociodemographic variations in reported gagging experiences were evident with respect to age, gender and education level. The response rate to the pilot study was 92.3% (36/39). There was no significant difference in the prevalence of gagging when acupuncture was applied to the test site compared to when acupuncture was applied to the sham site on dental examination (p>0.05) or when taking an upper alginate impression (p>0.05). Conclusions: Gagging in a relative common experience reported by patients attending our hospital – in daily life, in the dental setting and in performing oral self-care. Socio-demographic variations in the prevalence of gagging were apparent. The pilot study does not support the use of acupuncture in controlling gagging in the dental setting.published_or_final_versio

Biblical Meditation and the Visual Arts: A Method of Biblical Meditation for a Post- Christian, Visually-Saturated Age

In this post-Christian, visually-saturated age, Scripture-guided meditation on the visual arts can serve as a helpful method of biblical meditation. This dissertation argues that a method of biblical meditation—as outlined and practiced in Scripture—can make use of the visual arts as a biblically faithful and exhortative means for healthy biblical spirituality. This dissertation first establishes a strong definition of biblical meditation, contrasting biblical meditation with popular methods and understandings of meditation in today’s culture (particularly transcendental meditation), then presents its definition from Scripture and analyzes it throughout church history (paying special attention to the Puritans). Biblical meditation—a God-centered command for believers—is the careful thinking and pondering primarily upon God’s Word, but also upon God’s works (including his work of creation) and God’s ways, in accordance with Scripture. Biblical meditation is derived from and directed to a Triune God and is a God-given gift for the purpose of the believer’s maturity and sanctification. This project asserts a spirituality based primarily and predominantly upon sola Scriptura that then informs and transforms the understanding of all other avenues of learning as biblically-sound spirituality. Clarifying that the visual arts do not and cannot present new revelation, this dissertation argues that visual arts can be a healthy means for expressing biblical truth and encouraging believers. The dissertation then surveys the varied relationship of the church and the visual arts throughout history, after which a connection from the visual arts to biblical meditation is suggested as one possible method of biblical meditation. Examples are given from various periods of art history, including pieces by Rembrandt van Rijn, Thomas Cole, and Banksy. The last chapter discusses the relevance of applying biblical meditation to the visual arts and its value for the church and individual believers as they navigate a visually-saturated culture in the twenty-first century, as well as provides suggestions on how to implement this method. A development of the relationship between biblical meditation and the visual arts can become a healthy, regular practice for believers to incorporate as they grow into more mature, thoughtful followers of Jesus Christ

Smart Thermostats Plus Heat Pumps: Incompatible? Or Just Need Counseling?

Advanced, colorfully-graphic touch-screen thermostats entered the market over ten years ago, providing a much-needed improvement to the control of home heating and cooling systems. And in the last few years, climate change mitigation concerns and rebates from the Inflation Reduction Act (IRA) have accelerated heat pump installations in homes across the U.S. But the relationship of smart thermostats to typical air source heat pumps (ASHP) has been rocky at best: ASHPs with variable speed drives require a deeper integration with a thermostat, and most third-party smart thermostats have step-level staged control. Proprietary thermostats that come with the ASHP units are typically not as easy to understand and use as the popular smart thermostats on the market. Moreover, heat pumps with supplemental electric resistance heating require a different control approach that respects the lower temperature/long cycle heat transfer of heat pumps and understands the impact on the electrical grid, especially with high power peaks on cold winter mornings. This paper combines a literature review of the smart thermostat+heat pump relationship and interviews with stakeholders to outline trends, issues, barriers, and areas for further study in the relationship between variable capacity heat pumps and smart thermostats

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Online Independent Vocabulary Learning Experience of Hong Kong University Students

In response to the limited vocabulary size of its undergraduates, an independent vocabulary learning platform, VLearn was designed and launched in a university in Hong Kong. As an elearning environment that supports self-directed vocabulary learning of Chinese learners, the primary aim of VLearn is to equip users with appropriate knowledge and skills for vocabulary expansion. This paper introduces the contents of VLearn, and the theoretical underpinnings of its design. It also reports on the vocabulary learning experience of its users during an eight week evaluation study. Suggestions are made on how independent vocabulary building at higher education, as well as comprehensive vocabulary instruction at early years could be supported by means of technology

Current state of treatment for primary cutaneous melanoma.

A review of the current approach to primary cutaneous melanoma.The incidence of malignant melanoma has been rising steadily for the last 30 years. Through physician and patient education, surveillance of high-risk individuals, and biopsy of any suspicious lesions, more lesions are being diagnosed earlier, where there is a high cure rate. Unfortunately many patients will still present with thicker lesions or nodal involvement, which carries a significantly worse prognosis. Over the past decade, there have been several changes in the management of primary cutaneous melanoma. These have stemmed from novel surgical approaches, a new understanding of melanoma biology, and randomized clinical trials designed to improve outcome and decrease the morbidity of therapy. This article will review the clinical evidence behind the current reatment recommendations for primary cutaneous melanoma as well as some of the emerging data on innovative immunologic approaches to melanoma treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/39197/1/current state of melanoma.pd

Effect of chitinase- 3- like protein 1 on glucose metabolism: In vitro skeletal muscle and human genetic association study

We investigated the effect of chitinase- 3- like protein 1 (CHI3L1) on glucose metabolism and its underlying mechanisms in skeletal muscle cells, and evaluated whether the observed effects are relevant in humans. CHI3L1 was associated with increased glucose uptake in skeletal muscles in an AMP- activated protein kinase (AMPK)- dependent manner, and with increased intracellular calcium levels via PAR2. The improvement in glucose metabolism observed in an intraperitoneal glucose tolerance test on male C57BL/6J mice supported this association. Inhibition of the CaMKK was associated with suppression of CHI3L1- mediated glucose uptake. Additionally, CHI3L1 was found to influence glucose uptake through the PI3K/AKT pathway. Results suggested that CHI3L1 stimulated the phosphorylation of AS160 and p38 MAPK downstream of AMPK and AKT, and the resultant GLUT4 translocation. In primary myoblast cells, stimulation of AMPK and AKT was observed in response to CHI3L1, underscoring the biological relevance of CHI3L1. CHI3L1 levels were elevated in cells under conditions that mimic exercise in vitro and in exercised mice in vivo, indicating that CHI3L1 is secreted during muscle contraction. Finally, similar associations between CHI3L1 and metabolic parameters were observed in humans alongside genotype associations between CHI3L1 and diabetes at the population level. CHI3L1 may be a potential therapeutic target for the treatment of diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162777/2/fsb220907.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162777/1/fsb220907_am.pd

A Longitudinal Integrative Course Series to Prepare Students for Advanced Pharmacy Practice Experiences

Background: This paper describes a series of integrative courses intentionally designed to prepare students for Advanced Pharmacy Practice Experiences (APPEs) in a block system curriculum.  Innovation:  Three integration blocks are interspersed throughout the didactic curriculum to serve as checkpoints to ensure competency as students progress in the curriculum, rather than waiting until the end to determine competency. Complex patient case discussions and a series of high-stakes assessments are used to reinforce and evaluate cumulative retention of knowledge, skills, and attitudes.  Findings:  Class of 2022 exam results showed that in the cohort of students who failed the high-stakes comprehensive knowledge assessment (CKA) and pharmacy calculations exams during the first integration block (IB), failure rates decreased in subsequent IBs, indicating early detection of knowledge deficiencies and either exam performance improvement in each IB or failure to progress to the next IB. A survey of the same cohort indicated that the final integration block prior to advanced pharmacy practice experiences (APPEs) helped improve confidence in applying key knowledge and skills into practice.  Conclusion:  The series of integration blocks designed and implemented at WesternU provides opportunities to reinforce knowledge and skills while requiring students to demonstrate maintenance of core competency as they progress through the curriculum

Delays in Blood Work and Disease Burden: A Cross-Sectional Analysis of Unmet Blood Work Need and Seven Key Health Conditions Across 21 Countries

ObjectivesThis study analyzes survey data across 21 countries to explore correlations between delays in blood testing and the prevalence of seven health conditions: thalassaemias, sickle cell disorders, malaria, HIV, high fasting plasma glucose, impaired kidney function, and high LDL cholesterol.MethodsWe analyzed Pandemic Recovery Survey data via multivariable logistic regression to compare blood test delays between individuals with and without medical conditions, while adjusting for sociodemographic factors. We also examined the disease burden using disability-adjusted life years (DALYs) and summary exposure values (SEV) rates.ResultsOur findings indicate profound disparities, with over 60% of respondents in Egypt, Nigeria, and India reporting they have never undergone blood tests. Individuals with existing medical conditions are significantly more likely to experience delays in blood work.ConclusionThere is a pronounced gap in blood work accessibility, particularly in countries with high disease burdens. Findings suggest an urgent need for interventions to improve routine blood test access for high-risk populations to reduce the underdiagnosis of significant medical conditions. Prioritizing timely and accessible blood testing can serve as a step towards mitigating healthcare disparities