Narrative Review on the Management of Neck of Femur Fractures in People Living with HIV: Challenges, Complications, and Long-Term Outcomes

Neck of femur (NOF) fractures are a critical orthopaedic emergency with a high morbidity and mortality prevalence, particularly in people living with Human Immunodeficiency Virus (PLWHIV). A combination of HIV infection, combined antiretroviral therapy (cART), and compromised bone health further increases the risk of fragility fractures. Additionally, HIV-related immune dysfunction, cART-induced osteoporosis, and perioperative infection risks further pose challenges in ongoing surgical management. Despite the rising global prevalence of PLWHIV, no specific guidelines exist for the perioperative and post-operative care of PLWHIV undergoing NOF fracture surgery. This narrative review synthesises the current literature on the surgical management of NOF fractures in PLWHIV, focusing on pre-operative considerations, intraoperative strategies, post-operative complications, and long-term outcomes. It also explores infection control, fracture healing dynamics, and ART’s impact on surgical outcomes while identifying key research gaps. A systematic database search (PubMed, Embase, Cochrane Library) identified relevant studies published up to February 2025. Inclusion criteria encompassed studies on incidence, risk factors, ART impact, and NOF fracture outcomes in PLWHIV. Data were analysed to summarise findings and highlight knowledge gaps. Pre-operative care: Optimisation involves assessing immune status (namely, CD4 counts and HIV-1 viral loads), bone health, and cART to minimise surgical risk. Immunodeficiency increases surgical site and periprosthetic infection risks, necessitating potential enhanced antibiotic prophylaxis and close monitoring of potential start/switch/stopping of such therapies. Surgical management of neck of femur (NOF) fractures in PLWHIV should be individualised based on fracture type (intracapsular or extracapsular), age, immune status, bone quality, and functional status. Extracapsular fractures are generally managed with internal fixation using dynamic hip screws or intramedullary nails. For intracapsular fractures, internal fixation may be appropriate for younger patients with good bone quality, though there is an increased risk of non-union in this group. Hemiarthroplasty is typically favoured in older or frailer individuals, offering reduced surgical stress and lower operative time. Total hip arthroplasty (THA) is considered for active patients or those with pre-existing hip joint disease but carries a higher infection risk in immunocompromised individuals. Multidisciplinary evaluation is critical in guiding the most suitable surgical approach for PLWHIV. Importantly, post-operative care carries the risk of higher infection rates, requiring prolonged antibiotic use and wound surveillance. Antiretroviral therapy (ART) contributes to bone demineralisation and chronic inflammation, increasing delayed union healing and non-union risk. HIV-related frailty, neurocognitive impairment, and socioeconomic barriers hinder rehabilitation, affecting recovery. The management of NOF fractures in PLWHIV requires a multidisciplinary, patient-centred approach ideally comprising a team of Orthopaedic surgeon, HIV Physician, Orthogeriatric care, Physiotherapy, Occupational Health, Dietitian, Pharmacist, Psychologist, and related Social Care. Optimising cART, tailoring surgical strategies, and enforcing strict infection control can improve outcomes. Further high-quality studies and randomised controlled trials (RCTs) are essential to develop evidence-based guidelines

Electrocatalytic OER behavior of Bi-Fe-O system: An understanding from the perspective of the presence of oxygen vacancies

This study aims to understand and correlate the role of the nature and relative concentration of the oxygen vacancies with the trend observed in OER with the Bi Fe-O system. To understand this, we first investigated the system of oxides using X-ray Photoelectron Spectroscopy (XPS) and Electron Paramagnetic Resonance (EPR), which revealed the presence of oxygen vacancies in the system. Density functional theory (DFT) was employed to investigate the relative concentration of these vacancies by calculating their formation energies. Positron Annihilation Lifetime Spectroscopy (PALS) was carried out to understand the nature of these oxygen vacancies. We observed that the presence of a higher concentration of monovacancies created by the absence of oxygen from the structure of Bi2Fe4O9 was majorly responsible for the high performance of the oxide towards OER compared to the other oxides viz—BiFeO3 and Bi25FeO40 of the Bi-Fe-O system

Chapter 18: Fashion and design law

This chapter discusses the protection of fashion through design law, focusing on EU Law. It first introduces the relationship between fashion and the concept of design and the requirements for protection and registration. The chapter then explores the concept of Unregistered Community Design. Design ownership within the fashion industry and infringement, a significant concern in the fashion industry, are also examined. The chapter also addresses contemporary issues in the fashion industry, such as the intersection of artificial intelligence and design law in fashion, and discusses the implications of 3D printing technology in fashion and design law. It also explores the relationship between fashion and traditional knowledge, shedding light on the conflict between modern fashion trends and age-old traditional designs. The chapter further investigates the relationship between fashion law and the circular economy, focusing on sustainability in fashion. Lastly, overlapping intellectual property protections for fashion under EU law are discussed

Automation of Violent Activity Recognition Utilising CCTV Video Data

In this era, security trends identified violence as a significant issue plaguing society globally. Statistics depicted alarming thresholds for violence, establishing itself as a momentous challenge for homeland security and defence institutions, predominantly in schools and other public locations. The advent of state-of-the-art closed circuit television (CCTV) surveillance solutions exists to aid in limiting the manifestations of violence and its impact. However, most institutions need proper analysis mechanisms that lead to prevention, apprehension, or conviction in a timely fashion. Manually monitoring and collectively analysing anthropometric data generated by CCTV surveillance devices proved impractical and time-consuming, and its outcome increases the complexity of identifying violent behavioural patterns as substantial evidence. Despite innovative CCTV sensor improvement, the impact of adequately analysing vast amounts of CCTV data adds to the monitoring challenge. This thesis proposed the amalgamation of the ”You Only Look Once version five medium” model (YOLOv5m) as activity recognition and Three Dimensional Convolution Neural Network Single level (3DCNNsl) activity recognition, two state-of-the-art artificial intelligence models incorporating weight embedding procedures to identify primitive stages of violence and weapons artefacts. The approach integrates classification support to confirm the existence of specific weapon objects (knives, bladed instruments, clubs, and guns) of interest belonging to a specific class of violence (beating, shooting, stabbing). It also validates the presence (primitive stages of violence) of violent classes by utilising the existence of weapons belonging to its category group to infer the activity outcome. Utilising classification support concepts to validate the existence of primitive stages of violence enhances the classification outcome of violent activity recognition with robust results. This thesis commenced by conducting a two-stage literature investigation to satisfy the research objectives, which disclosed the state-of-the-art 3DCNNsl at stage one and the YOLOv5m framework for activity with artefact recognition towards violence at stage two. The proposed one-stage (simultaneously performing object localisation and classification) solution combines the models’ processing, reducing the impact of their architectural limitations. 3DCNNsl facilitates behavioural pattern classification, generically associating sub-class labels suggesting the presence of violence at high accuracy. In addition to 3DCNNsl, YOLOv5m architecture serves two functions: operating in an activity recognition capacity, fortifying 3DCNNsl activity output, and detecting artefacts, which establish the presence of weapons, enhancing the action classification and overall accuracy. The thesis optimised the deep learning model selections by identifying violence in scenarios and validating its presence through a redundant weapon artefact classification weight embedding procedure. The concept allows the classification of violence in its primitive stages before its impact escalates to lethal outcomes. The proposal extensively reviewed its operations via transfer learning in multiple fusion scenarios to identify the most optimal strategies to realise the research objective. The evaluation dataset utilised in this thesis encompassed a selection of samples accumulated via the University of Central Florida (UCF) dataset and several social media forums. The violent action samples reflect several multifaceted real-world scenarios representing sporadic accelerated motion attributes in various environments, which aids in reducing the risk of dispensing biased results and affecting the model’s robustness. The proposal disclosed three contributory elements, which reflect the following; 1. Conducted performance testing of two known machine learning techniques (YOLOv5m and 3DCNNsl) in independently recognising violent and non-violent activities in CCTV video footage. 2. Demonstrated violent activity recognition performance in such videos when both machine learning techniques operate in tandem. 3. Implemented performance enhancement by further incorporating threat object detection in the previous combined solution. Contribution one disclosed the effectiveness of YOLOv5m activity recognition at 74% and 3 the state-of-the-art 3DCNN at 75%, conceding high misclassifications utilising data with and without augmentations and resolution modifications. The operations emphasised the obligation to explore alternative processing measures to alleviate the disadvantages of the two machine learning models. Contribution two emphasised the effectiveness of fusion enhancement techniques via decision-level voting at 85.20% over 3DCNNsl and YOLOv5m activity recognition. As a validation strategy, the operations incorporated surplus data encompassing 50 samples designed to enhance the classification complexity. The approach rigorously appraised the operations, thus confirming its applicability. Contribution three showcased the amalgamation of fusion’s activity recognition and the power of object detection to establish its effectiveness in concatenating weight embedding. The experiments maintained data consistency similar to contribution two. Analysis disclosed the dominance of fusion incorporating threat object detection at 88.20% over 3DCNNsl, YOLOv5m activity recognition, and fusion without threat object enhancement. The results underscore the robustness of the proposed method, which has proven its classification competence, particularly in scenarios with surplus data, from an overall accuracy perspective. While the proposal debates the efficiency of individual processing compared to fusion without support, the research endeavour accentuates the effectiveness of integrating classification redundancy through weight embedding to suggest the presence of artefacts confirming the occurrence of violent actions. The findings highlight the effectiveness of the proposed method without artefact processing at 85.20% while incorporating threat object support analysis concatenating weapons (knife, club, gun in the videos) improved the accuracy to 88.20%. This evidence substantiates the solution’s robustness, fulfilling the research objectives to conclude the investigations

When Politics Met Intellectual Property Cooperation in the Pan-American Union

Pan-Americanism and the shaping of the Latin American countries towards markets friendly to the United States saw the arrival of harmonisation of intellectual property in the American region. The ties between the United States and the Central and South American states materialised in January 1889. Yet, while the aim of the Pan-American Union was based on the “Monroe Doctrine”, it was evident that different conceptions were brought to the table by the delegates. This chapter evaluates the Pan-American Union conferences between the years 1919 to 1939, seeking to critically examine the build-up of the intellectual property system in Latin America. For instance, early propositions to adhere to the Protocol of Madrid ended with the resolution to call for a special conference of representatives, specifically trademark specialists, to consider international problems of inter-American trademarks. In general, the formalities and prerequisites required by domestic laws were debated and replaced, aiming to harmonise the law in the region. While the Pan-American Conferences put forward intellectual property treaties and agreements, the extent to which they were implemented is a different story

Finding Yourself: Multiversal Identity Crisis in Ted Chiang’s Anxiety Is the Dizziness of Freedom

We live in a time when theories of the multiverse are everywhere, penetrating our daily lives: be it in film, television, literature, comic books, video games, the idea of alternate universes is both popular and inescapable. But what effect does the existence of multiple—and potentially superior—variants of ourselves have on our conceptions of identity? In a society seemingly obsessed with multiverse theories, the question of nature versus nurture becomes ever more prevalent: is our nature inherent, or is it our circumstances which define us? If exposed to different scenarios, would we still be us? By examining Ted Chiang’s novella, Anxiety is the Dizziness of Freedom (2019), this essay seeks to highlight the dangers of the multiverse on a psychological level, and the damage it can have on an individual’s psyche. The novella’s title is taken from Soren Kierekgaard’s definition of anxiety as the ‘dizziness of freedom’ (1844), and the existential crisis arising from having endless possibilities. Considering the frail nature of identity, the existence of multiple, and more successful, versions of oneself develops an identity crisis which seeks to understand what events may have prevented themselves from becoming this ultimate version; furthermore, if there are never-ending versions of a person, it stands to reason that there is a worst version, and that could very well be you. It is this anxiety of selfhood which Chiang’s novella closely examines. Taking the idea of the double to an infinite degree, the idea of the multiverse simultaneously destroys all certainty of a unique identity while paradoxically suggesting that we are products of experience, and that our identity is subject to change dependent on the life lived. By reading multiversal fiction as a contemporary and science fictional form of double literature, we can examine the concept psychoanalytically to gain further understanding of the insecurity and interchangeability of identity, the battle of nature versus nurture, and the persistent anxiety surrounding ideas of selfhood. If you are in fact everything and everyone, then each one of your multiple selves must come to terms with being nothing and no-one

‘Mrs Thatcher’s Praetorian Guard’: The 92 Group and the defence of Thatcherism, 1979-83

Ever since Mrs Thatcher’s departure from office Conservative politicians have rushed to invoke her name, her legacy, and her policies, in one form or another. Being the ‘Thatcherite’ candidate still has value within the party. This research examines Mrs Thatcher’s backbench supporters and their contribution to the development of Thatcherism, the people we look back and call the first ‘Thatcherites’. It concludes that she needed the 92 Group, her so-called ‘Praetorian Guard’, within her first term. Led by George Gardiner, Ian Gow and William Clark, they were indispensable counterweights to those Conservative MPs who could never accept Mrs Thatcher’s leadership or policies. Using archival material, interviews with contemporaries, and private papers, this thesis demonstrates how the activity of leading members of the 92 Group ensured Mrs Thatcher’s survival in her first term. Without these backbench supporters, she would have been forced into a U-turn in 1981, or toppled from power, and Thatcherism, as we know it, wouldn’t exist. Formed in 1964 the 92 Group got its name from 92 Cheyne Walk, the London home of its first chairman Patrick Wall. To most observers it was solely a dining club. Yet archival material demonstrates that it was more than that. It discussed ‘conservative principles’ and how the Conservative party had lost its way at the end of thirteen years of governance. Intellectually it fit within the New Right. It was unhappy at the increased size of the state, planning, high taxation and universal welfare. To some extent it was uneasy with the permissive society. It was unreservedly nationalistic in sentiment, a reaction to the end of Empire and new Commonwealth immigration. In all of these we see the intellectual hand of Enoch Powell and many of the principles that came to be associated with Thatcherism. The Heath years were as symbolic in shaping the 92 as they were the Thatcherites who became Mrs Thatcher’s key economic ministers. The 92 grudgingly sided with Heath, supporting his prices and incomes policies only because they were a weapon to stifle trade union power. This did not stop them complaining in private at the direction of policy away from the 1970 manifesto. Unsurprisingly, they enthusiastically supported Mrs Thatcher for the leadership in 1975, their opportunity to keep the Conservative party ‘conservative’. With Gardiner and Gow joining the 92 in the late 1970s they saved it from atrophy after the Group’s convenor died. This is key as Gardiner became Mrs Thatcher’s staunchest defender in the press and Ian Gow her assiduous Parliamentary Private Secretary (PPS). With William Clark elected chairman of the backbench finance committee, they had their positions and roles to defend the Prime Minister. The Group supported her economic policy when it looked as if it was not working. Their pressure forced Jim Prior, the Employment Secretary, to concede to more trade union reforms, against his wishes, reforms that were central to the Thatcher project. The 92 organised to ensure her supporters were elected to the backbench policy committees, a vital barometer of opinion in the party. Such was the strength of its activism and support for the Prime Minister that a leadership challenge to Mrs Thatcher was averted in 1981. This is not to say the 92 were the brains trust of Thatcherism. From 1985 the No Turning Back group became the intellectual guard of Thatcherism. They published sophisticated papers developing Thatcherism by calling for the introduction of market mechanisms into public services. Mrs Thatcher recognised their talent and appointed several of them within her administration. Yet had the battles of the early 1980s not been won by the 92, historians must ask whether what followed would have been possible

Neo-liberalism, Human Capital Theory and the Right to Education: Economic Interpretation of the Purpose of Education

With the end of WW II, a new world order emerged that recognised the significance of human rights as part of the remedial measures to institute global peace. This is recognised in Articles 1(3), 13(1)(b) and 55(c) of the 1945 United Nations Charter. Thereafter, the human rights ideals recognised by the UN Charter were codified into the Universal Declaration of Human Rights (UDHR) 1948 (Fait, 2015: 26). Despite not having a binding force, the UDHR became a standard-setting instrument covering all generations of human rights including the right to education. Later, two distinct treaties – i.e., the International Covenant on Civil and Political Rights (ICCPR) 1966 and the International Covenant on Economic, Social and Cultural Rights (ICESCR) 1966 were adopted as a follow-up to the UDHR. Articles 13 and 14 of the ICESCR made more expansive provisions on the right to education than Article 26 of the UDHR. However, the adoption of policies driven by neoliberal ideals and associated neo-classical economic principles in the delivery of education has brought education under market forces, encapsulating it with an economic purpose. This makes education central to the realisation of the neoliberal ideology as schools focus on teaching technical skills and knowledge necessary for the achievement of the economic purposes of education. This paper argues that while the economic purpose of education which is in line with neoliberal and associated neo-classical economic principles is germane for states’ economic development, a holistic approach is consistent with the human rights purpose of education

The Psychology of Creative Performance and Expertise

This much-needed book introduces readers to the related fields of expertise, creativity, and performance, exploring our understanding of the factors contributing to greatness in creative domains. Bringing together research from the fields of creativity and expertise, it provides fresh insights for newcomers and seasoned scholars alike with its approachable guide to the multidimensional complexities of expertise development. It transcends traditionally studied fields such as chess, sports, and music, instead exploring the intersection of expertise with creativity and the performing arts. Dedicated applied chapters cover eight fields, including mind-games, music, dance, creative writing, acting, art, and STEM. The book also examines the facilitators of creative performance, including aesthetic sensitivity, creativity, and mental imagery, as well as the obstacles to performance, such as burnout, procrastination, and gender-related challenges. The book concludes by engaging with pressing issues facing expertise, including the impact of AI. Student-friendly pedagogy is featured throughout, including 'Spotlight on...', 'Check it out...', and 'Consider this...' boxes to position material within context and engage students' learning. Whether revealing how an actor brings their part to life, how writers conjure up their storylines and vibrant characters, or what lies behind scientific invention, The Psychology of Creative Performance and Expertise offers a fascinating insight into the multifaceted journey towards achieving creative excellence. This is a valuable resource for final-year undergraduate and postgraduate students, and scholars across a range of disciplines, including expertise or skill acquisition, the psychology of performance, and creativity

De Facto Precedent at the Court of Justice of the European Union

This paper seeks to demonstrate that although there is no official doctrine of precedent in judgments of the Court of Justice of the European Union (CJEU), the research affirms that there is a de facto system of precedent. This means that whilst, de jure, there is no official precedent status of the case law of the CJEU, the Court does give precedential value to its own case law through interpretive practices to ensure the uniform application of law and legal certainty throughout the Member States of the European Union (EU). When one looks at the elements of precedent it is apparent that this goes beyond its legal value (i.e. authority or bindingness) or conscious jurisprudential choice – language also plays a role. This article will examine discussions and models of precedent in common law and civil law legal systems in both theory and practice, before going on to examine the theories and practices of precedent at the CJEU