Achieving hip fracture surgery within 36 hours: an investigation of risk factors to surgical delay and recommendations for practice

BACKGROUND: The UK hip fracture best practice tariff (BPT) aims to deliver hip fracture surgery within 36 h of admission. Ensuring that delays are reserved for conditions which compromise survival, but are responsive to medical optimisation, would help to achieve this target. We aimed to identify medical risk factors of surgical delay, and assess their impact on mortality. MATERIALS AND METHODS: Prospectively collected patient data was obtained from the National Hip Fracture Database (NHFD). Medical determinants of surgical delay were identified and analysed using a multivariate regression analysis. The mortality risk associated with each factor contributing to surgical delay was then calculated. RESULTS: A total 1361 patients underwent hip fracture surgery, of which 537 patients (39.5 %) received surgery within 36 h of admission. Following multivariate analyses, only hyponatraemia was deduced to be a significant risk factor for delay RR = 1.24 (95 % CI 1.06-1.44). However, following a validated propensity score matching process, a Pearson chi-square test failed to demonstrate a statistical difference in mortality incidence between the hypo- and normonatraemic patients [χ (2) (1, N = 512) = 0.10, p = 0.757]. CONCLUSIONS: Hip fracture surgery should not be delayed in the presence of non-severe and isolated hyponatraemia. Instead, surgical delay may only be warranted in the presence of medical conditions which contribute to mortality and are optimisable. LEVEL OF EVIDENCE: III

‘Hanging by Invitation: Capital Punishment, The Carceral Archipelago and Escalating Homicide Rates in the Caribbean and Africa’

The escalating rate of violent crime in the Caribbean has prompted calls for the resumption of capital punishment as an appropriate response. This paper reviews the philosophical debates and statistical evidence of the effects of previous executions on the rates of homicide and concludes that the role of the Privy Council in permitting capital punishment in the Caribbean allows us to critically reflect on the theory of industrialization by invitation that was attributed to Sir Arthur Lewis. A comparative analysis of evidence from other parts of the world would be used to present a case for the abolition of capital punishment in the Caribbean and Africa

"A Corridor of Corruption": Perception of Kidnappers, Victims of Kidnapping and Their Relations on the Administration of Criminal Justice in Selected States of Nigeria

This study investigated the perception of kidnappers, victims of kidnapping and their relations on the administration of criminal justice in selected states of Nigeria with a view to underscore its implication with regards to the prevalence of kidnapping. The study utilized the qualitative method–in-depth interviews and key informant interviews in generating data from 60 interviewees for the study. The qualitative data collected from the study was analyzed using a manual content analysis. The study showed that there is generally corruption, ineffectiveness and inefficiency amongst the police, court and prison officials and that this has led to public loss of confidence and distrust in them which situation, kidnappers exploit to their advantage. Based on the findings, it is recommended that government should stop paying lip service to the fight against corruption, inefficiency and ineffectiveness in the public service but instead take concrete steps to stem the rising tide. Besides, a review of the conditions of service of the police, prison and judicial officers, there is the need to provide functional vehicles to the police, court and prison authorities as well as renovating and refurbishing dilapidated buildings and furniture in the various courts so as to boost their morale and increase efficient and effective service delivery. Keywords: Kidnapping, Criminal Justice system, Victims of kidnapping, Nigeri

The significance of malpractice claims in the management of child adoption demands in Southwest Nigeria

The wide gap between the demand for children and the available adoptable children in Nigeria meets with anecdotal claims on the existence of corrupt practices and systemic vulnerabilities within the child adoption domains. This study investigated the exactitude of these claims on the corridor of child adoption in Nigeria. Data were collected through sessions of qualitative interviews with adoption officials, legal practitioners, and intending/prospective adopters and orphanage managers. Findings revealed that the claims of corrupt practices within the system were not only significant but appear in various shades such as hoarding of adoptable children, request for extra-adoption charges, diversion of already identified children, and procedural circumventions. The corrupt practices and observed illegalities are enabled by some institutionalized adoption principles that prevail within the system of adoption. These observed illicit practices have tenden- cies to threaten the consideration of the best interest of the child which should be the paramount consideration in the placement of children who are to be adopte

Power Consciousness of Security Operatives: The Bane of Inter-Agency Feud in Nigeria

One of the greatest security challenges Nigeria has to contend with in the 21st century is the repeated cases of violent inter forces clashes in some cities. Most of these clashes involved the personnel of the Nigerian Army and Nigeria Police. The problem made crime control extremely difficult due to lack of synergy between the security operatives. Consequently, the security situation has become porous in recent times, while the nation has been tagged one of the insecure nation of the world and thus tends to scare investors. Adopting the Group Conflict and Culture and Agency theories as background, the study which utilized the qualitative and quantitative methods of data gathering was conducted in four locations (clusters) in Lagos where the clashes have frequently occurred in the recent past. Although, factors such as economic poverty, neglect, gross indiscipline, ignorance, etc., featured prominently as causes, the study further discovered that the consciousness among officers that enormous power and or authority is conferred on them without any institution charged with oversight functions made the aforementioned factors to manifest. It is therefore recommended that civilian oversight on the police and all policing agencies be intensified if security of lives and property of Nigerians must be achieved

Age of Sexual Debut and Patterns of Sexual Behaviour in Two Local Government Areas in Southern Nigeria

The study examines the age of sexual debut and patterns of sexual behavior in Ugep, Cross River State, and Badeku and Olunloyo in Oyo State. A survey of households and individuals was conducted in the three communities; qualitative data were also collected through in-depth interviews and focus group discussion. The median age of first sex among never-married males and females were 17 years and 18 years respectively; more than one in five adolescents have had sex before age 16. Nevermarried males and females initiated sex earlier than ever-married, older respondents. That 14 percent of married men keep other sexual partners besides their wives is indicative of substantial extramarital relationship; also 12 percent of never-married male respondents with regular sex partners have other sexual partners. Condom use is fairly high, especially in sexual relations involving non-regular partners. The higher likelihood of alcohol use in sexual liaison with non-regular sex partners is suggestive of high prevalence of transactional sex and spontaneous or unplanned sex under the influence of alcohol, with their implications for the spread of HIV and AIDS. The study underscores the need for adolescent sexual and reproductive health education and behaviour change communication among all segments of the population and inculcation of values less favourable for the spreadof sexually transmitted infection.(Afr J Reprod Health 2012; 16[4]: 81-94)

Malaria and typhoid fever co-infection: a retrospective analysis of University Hospital records in Nigeria

Studies have long documented the presence of malaria and typhoid fever in sub-Saharan Africa (SSA). However, studies on these diseases have primarily concentrated on rural settings, neglecting the potential impact on urban areas. This knowledge gap hinders effective surveillance and intervention strategies. To bridge this gap, this study investigated the prevalence of malaria and typhoid co-infections in an urban environment. Methods This study, conducted at Lead City University Hospital in Ibadan, Nigeria (West Africa’s largest metropolis), analysed medical records of over 3195 patients seen between April and June 2023. Descriptive statistics and chi-square tests were used to understand how these co-infections were distributed across different age and gender groups. Results The prevalence of co-infection peaked in May (9.7%), followed by June (8.9%) and April (5.7%). Notably, children aged 6–12 years exhibited the highest co-infection rate (18.5%), while those under five had the lowest (6.3%). Gender analysis indicated a slight difference, with 8.8% of females and 7.1% of males co-infected. Malaria prevalence was highest at the beginning of the rainy season and significantly decreased over time. Conversely, typhoid fever displayed the opposite trend, increasing with the rainy season. Children under five years old were most susceptible to malaria, while typhoid fever predominantly affected adults over 25 years old, with prevalence decreasing significantly with age. Conclusion This study sheds light on the previously overlooked risk of malaria and typhoid co-infections in urban settings. These findings highlight the need for enhanced surveillance and targeted public health interventions, particularly for vulnerable groups like young children during peak transmission seasons

Nanocarriers used as probes for super-resolution microscopy

Super-resolution microscopy (SRM) has revolutionized the study of cell biology, enabling researchers to visualize cellular structures with nanometric resolution, single-molecule sensitivity, and with multiple colors using conventional fluorophores. SRM is well-suited for volumetric live-cell imaging and helps in extracting quantitative information on spatial distributions. It can be used to estimate the absolute numbers of proteins or other macromolecules or nanostructured material within subcellular compartments, characterize their structures, and their nano/bio interactions. Although a number of recent general reviews on SRM have elaborated its role in chemical and clinical biology, as well as nanomedicine, herein, we provide an overview of the use of luminescent nanocarriers (LNC) in SRM imaging and single-molecule tracking. The role of LNCs in controlling the brightness and stability of emissive states is discussed with a special focus on organelle-specific delivery and how this approach can be utilized to produce novel optical-switched systems. We also discuss the challenges related to the molecular targeting of such material in biological systems. In doing so, we will provide practical guidance for super-resolution imaging in nanomedicine research, its technical challenges, and the opportunities for future advancement

A novel design of multi-epitope based vaccine against Escherichia coli

Background: Multi-valent based vaccines have advantage over conventional vaccines because of its multi-faceted action targeted at antigen; thereby raising hope of a more sustained actions against allergens. Escherichia coli (E. coli) is a bacterium that is commonly found in the gut of humans and warm-blooded animals. An increasing number of outbreaks are associated with the consumption of fruits and vegetables (including sprouts, spinach, lettuce, coleslaw, and salad) thereby contamination may be due to contact with faeces from domestic or wild animals at some stages during cultivation or handling. Due to the reported increase in resistance to antibiotics used for Escherichia coli control; an effective vaccine is a would-be alternative of proven interest. Hence, a need for a rational, strategic, and efficient vaccine candidate against E.coli is of paramount necessity by the use of the most current bioinformatics tools to achieve this task. Method: In this study, immunoinformatics tools mined from diverse molecular databases were used  for a novel putative epitope based oral vaccine against E.coli. The prospective vaccine proteins were carefully screened and validated to achieve a high thorough-put three-dimensional protein structure. The eventual propsective vaccine candidate proteins was evaluated for its non-allergenicity, antigenicity, solubility, appropriate molecular weight testing and isoelectric point evaluation. Conclusion: The resultant vaccine candidate could serve as a promising anti-E.coli vaccine candidate. Immunoinformatics is a new field over pharmaco-therapeutics; this newest technology should continue to be a rescue from age-long traditional approach in vaccine developments

Emerging challenges in innate immunity: Staphylococcus aureus and healthcare-associated infection

Staphylococcus aureus, a prominent human pathogen, exhibits a remarkable ability to interact with host proteins involved in crucial physiological pathways, such as the complement system, coagulation cascade, and fibrinolysis cascade. This paper explores the ability of this notable bacteria to successfully manipulate and evade the host innate system, expatiating on the strategies that enhance its pathogenicity leading to implications on the healthcare system such as the propagation of diverse nosocomial infections. The investigation focuses on key S. aureus proteins, including Coagulase (Coa), von Willebrand factor-binding protein (vWbp), and Staphylokinase (SAK), which play pivotal roles in blood coagulation, fibrinolysis, and evasion of host antibacterial peptides. Notably, these proteins contribute to the formation of fibrin networks, protecting the bacterium from immune clearance and promoting lethal bloodstream infections in murine models. Additionally, the debate surrounding the role of SAK as a critical virulence factor is addressed, emphasizing its impact on biofilm formation, invasion of internal organs, and bacterial loads in sepsis studies. Furthermore, the interaction of S. aureus with matrix metalloproteinases and the secretion of superantigen-like proteins (SSL1 and SSL5) are explored as additional mechanisms employed by the bacterium to impede immune responses. In addressing emerging challenges in innate immunity, the paper discusses the escalating antibiotic resistance in S. aureus, with a specific focus on methicillin-resistant strains (MRSA) and its capacity to instigate healthcare-associated infections as an effect