Journal of African Christian Biography

A publication of the Dictionary of African Christian Biography with U.S. offices located at the Center for Global Christianity and Mission at Boston University. This issue focuses on: WOMEN --- 1. Biographies of Kimpa Vita by Norbert Brockman, Mark R. Lipschutz and R. Kent Rasmussen, and Tsimba Mabiala. 2. "The Life and Visions of Krəstos Śämra, a Fifteenth-Century Ethiopian Woman Saint,"--chapter from African Christian Biography: Stories, Lives and Challenges (D. L. Robert, editor) by Wendy Laura Belcher 3. "Queen Njinga and Her Faiths: Religion and Politics in Seventeenth-Century Angola"--chapter from African Christian Biography: Stories, Lives and Challenges (D. L. Robert, editor) by Linda Heywood. 4. Book Notes, by B. Restric

Presence of a pre-hospital enhanced care team reduces on scene time and improves triage compliance for stab trauma

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: A reduction in pre-hospital scene time for patients with penetrating trauma is associated with reduced mortality, when combined with appropriate hospital triage. This study investigated the relationship between presence of pre-hospital enhanced care teams (ECT) (Critical Care Paramedics (CCPS) or Helicopter Emergency Medical Service (HEMS)), on the scene time and triage compliance, of penetrating trauma patients in a UK ambulance service. The primary outcome was whether scene time reduces when an ECT is present. A secondary outcome was whether the presence of an ECT improved compliance with the trust's Major Trauma Decision Tree (MTDT). Methods: All suspected penetrating trauma incidents involving a patient's torso were identified from the Trust's computer-aided dispatch (CAD) system between 31st March 2017 and 1st April 2018. Only patients who sustained central penetrating trauma were included. Any incidents involving firearms were excluded due to the prolonged times that can be involved when waiting for specialist police units. Data relevant to scene time for each eligible incident were retrieved, along with the presence or absence of an ECT. The results were analysed to identify trends in the scene times and compliance with the MTDT. Results: One hundred seventy-one patients met the inclusion criteria, with 165 having complete data. The presence of an ECT improved the median on-scene time in central stabbing by 38% (29m50s vs. 19m0s, p = 0.03). The compliance with the trust's MTDT increased dramatically when an ECT is present (81% vs. 37%, odds ratio 7.59, 95% CI, 3.70-15.37, p < 0.0001). Conclusions: The presence of an ECT at a central stabbing incident significantly improved the scene time and triage compliance with a MTDT. Ambulance services should consider routine activation of ECTs to such incidents, with subsequent service evaluation to monitor patient outcomes. Ambulance services should continue to strive to reduce scene times in the context of central penetrating trauma.Peer reviewe

Intermittency and local Reynolds number in Navier-Stokes turbulence: A cross-over scale in the Caffarelli-Kohn-Nirenberg integral

We study space-time integrals, which appear in the Caffarelli-Kohn-Nirenberg (CKN) theory for the Navier-Stokes equations analytically and numerically. The key quantity is written in standard notations δ(r)=1/(νr)∫Qr(∇,u)2dxdtδ(r)=1/(νr)∫Qr∇u2dxdt, which can be regarded as a local Reynolds number over a parabolic cylinder Q r . First, by re-examining the CKN integral, we identify a cross-over scale r∗∝L(∥∇u∥2L2¯¯¯¯¯¯¯¯¯¯¯¯∥∇u∥2L∞)1/3,r*∝L‖∇u‖L22¯‖∇u‖L∞21/3, at which the CKN Reynolds number δ(r) changes its scaling behavior. This reproduces a result on the minimum scale r min in turbulence:r2min∥∇u∥∞∝ν,rmin2‖∇u‖∞∝ν, consistent with a result of Henshaw et al. [“On the smallest scale for the incompressible Navier-Stokes equations,” Theor. Comput. Fluid Dyn.1, 65 (1989)10.1007/BF00272138]. For the energy spectrum E(k) ∝ k −q   (1 < q < 3), we show that r * ∝ ν a with a=43(3−q)−1a=43(3−q)−1. Parametric representations are then obtained as ∥∇u∥∞∝ν−(1+3a)/2‖∇u‖∞∝ν−(1+3a)/2 and r min ∝ ν3(a+1)/4. By the assumptions of the regularity and finite energy dissipation rate in the inviscid limit, we derive limp→∞ζpp=1−ζ2limp→∞ζpp=1−ζ2 for any phenomenological models on intermittency, where ζ p is the exponent of pth order (longitudinal) velocity structure function. It follows that ζ p ⩽ (1 − ζ2)(p − 3) + 1 for any p ⩾ 3 without invoking fractal energy cascade. Second, we determine the scaling behavior of δ(r) in direct numerical simulations of the Navier-Stokes equations. In isotropic turbulence around R λ ≈ 100 starting from random initial conditions, we have found that δ(r) ∝ r 4 throughout the inertial range. This can be explained by the smallness of a ≈ 0.26,with a result that r * is in the energy-containing range. If the β-model is perfectly correct, the intermittency parameter a must be related to the dissipation correlation exponent μ as μ=4a1+a≈0.8,μ=4a1+a≈0.8, which is larger than the observed μ ≈ 0.20. Furthermore, corresponding integrals are studied using the Burgers vortex and the Burgers equation. In those single-scale phenomena, the cross-over scale lies in the dissipative range.The scale r * offers a practical method of quantifying intermittency. This paper also sorts out a number of existing mathematical bounds and phenomenological models on the basis of the CKN Reynolds number

Female sex hormones are necessary for the metabolic effects mediated by loss of Interleukin 18 signaling

Objective: Interleukin (IL)-18 plays a crucial role in maintaining metabolic homeostasis and levels of this cytokine are influenced by gender, age, and sex hormones. The role of gender on IL-18 signaling, however, is unclear. We hypothesized that the presence of female sex hormone could preserve the metabolic phenotype of the IL-18R−/− animals. Methods: We studied female mice with a global deletion of the α isoform of the IL-18 receptor (IL-18R−/−) and littermates control. Three studies were done: 1) animals fed a high fat diet (HFD) for 16 weeks; 2) animals fed chow diet for 72 weeks and 3) animals (3 weeks-old) randomized to either bilateral ovariectomy (OVX) or control surgery (SHAM) and followed for 16 weeks. Results: Female IL-18R−/− mice gained less weight and maintained glucose homeostasis on a chow diet compared with HFD, but no differences between genotypes were observed. The maintenance of body weight and glucose homeostasis in IL-18R−/− mice was lost with aging. By 72 weeks of age, IL-18R−/− mice became heavier compared with WT mice due to an increase in both visceral and subcutaneous adiposity and displayed glucose intolerance. OVX did not affect body weight in IL-18R−/− mice but exacerbated glucose intolerance and impaired liver insulin signaling when compared with SHAM mice. Conclusions: Female mice harboring a global deletion of the IL-18R, only present the same phenotype as reported in male IL-18R−/− mice if they are aged or have undergone OVX, in which circulating estrogen is likely to be blunted. The role of estrogen signaling in the protection against altered metabolic homeostasis in IL-18R−/− mice appears to be mediated by liver insulin signaling. We therefore suggest that the metabolic effects mediated by loss of IL-18 signaling are only present in a female sex hormone free environment. Keywords: IL-18, Obesity, Insulin resistance, Gende

The Next WHO Director-General’s Highest Priority: a Global Treaty on the Human Right to Health

Amidst the many challenges facing the next WHO Director-General, the new WHO head should find WHO’s foremost priority in its most important constitutional pillar: the right to health. The centerpiece of this endeavor should be leadership on the Framework Convention on Global Health (FCGH), the proposed global treaty based in the right to health and aimed at national and global health equity. The treaty would reform global governance for health to enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalyzing governments to institutionalize the right to health at community through to national levels. It would usher in a new era of global health with justice – vast improvements in health outcomes, equitably distributed. With the Framework Convention on Tobacco Control having served as a proof of concept, the FCGH would be an innovative treaty finding solutions to overcome global health failings in accountability, equality, financing, and inter-sectoral coherence. It would include a global health accountability framework, encompassing, civil society engagement, independent monitoring, and plans for redress, while catalyzing national health accountability strategies, accountability mechanisms, disaggregated data, and community participation. National health equity strategies, pro-poor pathways to universal health coverage, and robust non-discrimination provisions could elevate the voices, priorities, and ultimately power of marginalized populations. The FCGH would include a national and global health financing framework, while reaching beyond the health sector with right to health assessments, public health participation in developing international agreements, and responsibility for all sectors for improving health outcomes. The FCGH would reinvigorate WHO’s global health leadership, breathing new life into its founding principles. It could become the platform for reforming WHO as a rights-based 21st century institution, with badly-needed reforms, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability. The next Director-General should launch a historic effort to align national and global governance for with human rights through the FCGH, bringing the world closer to global health with justice

Scaling up HIV testing in resource-constrained settings: debates on the role of VCT and routine ‘opt-in or opt-out’ HIV testing.

Scaling up of the numbers of people voluntarily undergoing HIV testing has become vital, especially in resource-constrained settings, where the need for knowledge of HIV status for both prevention and care is critical. The reality is that for most people in Africa, access to HIV testing and to voluntary counselling and testing (VCT) has been very limited, and this has human rights implications – missing the opportunity to be diagnosed with a disease that is now well understood, manageable and treatable means certain death. The key challenge in our current context is how scaling up of HIV testing should be done. In responding to this challenge, we are guided by Gruskin and Loff,1 who state that ‘A human rights approach mandates that any public strategy, whether or not rights are to be restricted, be informed by evidence and widely debated. This approach protects against unproved and potentially counterproductive strategies, even those motivated by the genuine despair in the face of overwhelming public health challenges.’ This article describes the arguments and discussion raised during a session on models for increasing access to HIV testing at the 2nd National Conference on HIV/AIDS held in Durban in June 2005. It describes the legal framework for HIV testing in South Africa, frames the issues at the heart of the debate, and describes and discusses the various models of HIV testing, routine HIV testing, VCT and mandatory or compulsory HIV testing, within the context of HIV prevention and care. It concludes with recommendations