Search

Nigeria's neurosurgical field faces profound challenges, including a critically low neurosurgeon-to-patient ratio and significant migration of medical professionals to developed countries. High costs, low socioeconomic status, and the urban-centric location of neurosurgical centers impede access to care. Key barriers to service delivery include lack of manpower, insufficient emergency care, limited imaging modalities, inadequate operative equipment, and ineffective political and administrative policies. Neurotrauma is the primary reason for neurosurgical intervention but is poorly managed due to delayed access and insufficient guidelines. The neurosurgical education system is strained by limited training capacity and the absence of subspecializations, restricting specialized care. Research output is low, hindered by limited infrastructure, lack of databases, insufficient funding, and minimal international collaboration. To address these issues, it is critical to enhance the imaging capabilities, ensure the availability of operative equipment, and establish effective policies for task sharing and communication at different levels of care. Other approaches include expanding training capacity, particularly in rural areas, implementing a uniform match system for residency, addressing gender disparities, and utilizing dual practice to ensure adequate compensation for neurosurgeons. Furthermore, stakeholders should develop subspecialization programs in areas such as neurovascular, neuro-oncology, pediatric neurosurgery, and minimally invasive neurosurgery to expand service scope. To transform the neurosurgical research landscape, efforts should be made to establish electronic medical databases, foster international collaborations to ensure funding, and make research mandatory for accreditation renewal to ensure continuous academic contribution., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Salinization, the increase and accumulation of salts in water and soil, impacts productivity of arable crops and is exacerbated by climate change. The Netherlands, like several other deltas and semi-arid regions, faces increasing salinization that negatively impacts agriculture and freshwater availability. Although a lot of salinity expertise exist in the Netherlands, several knowledge gaps on the impact of salinization in the Netherlands, as well as steps to facilitate closing this knowledge gaps to improve saline agriculture in the Netherlands, still exist. This review/opinion article moves beyond existing papers on salinization in bringing together various adaptation measures by thoroughly reviewing the measures through a triple P (People, Planet, Profit) lens. Five main salinity adaptation measures of the crop-soil-water continuum are 1) breeding and selection of salt tolerant varieties, 2) increased cultivation of halophytes, 3) soil management interventions, 4) use of biostimulants, and 5) irrigation techniques. These adaptation measures are described, discussed and analysed for their compliance to the sustainable development elements People, Planet and Profit. All five adaptation measures have potential positive impact on livelihood, contribute to food security and generate revenue but on the other hand, these measures may contribute to unwarranted changes of the ecosystem. The paper ends with a concluding chapter in which the bottlenecks and knowledge gaps that need resolving are identified based on the critical, including triple P, assessment of the discussed adaptation measures. Three key knowledge gaps on breeding, agronomy, environmental sciences and socioeconomics are identified with several approaches that lead to insights elucidated. Thereby informing on future research and action plans to optimize implementation of salinity adaptation measures in the Netherlands., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: Virulence genes play important roles in pathogenesis of infections caused by S. aureus. The aim of this study was to determine the prevalence of PVL, eta and mecA genes in S. aureus isolated from patients in South-Western Nigeria., Materials and Methods: In this study, a total of 116 S. aureus isolates from the clinical specimens submitted to laboratories in tertiary hospitals in the South Western Nigeria were used. Antibiotic susceptibility test was carried out to determine the susceptibility pattern of the isolates using multiple antibiotics disc. Minimum inhibitory concentration (MIC) was also carried out to determine the degree of resistant of the isolates to methicillin. PCR was used to screen for the presence of PVL, eta, and mecAgenes., Results: mecA gene was detected in 48 (41.4%) of 116 strains of S. aureus. The MIC 50 and MIC 90 for mecA negative strains were 1 and 8 μg/ml, respectively while the MIC 50 and MIC 90 for mecA positive were >256 μg/ml. Twenty eight (24.1%) of 116 isolates were PVL gene positive with none of them mecA+. The prevalence of community acquired MRSA (CA-MRSA) was estimated to be 6.9% using molecular techniques. No localization of mecA gene and PVL gene on the genome of the entire S. aureus strains studied. Site of isolation of organism /specimen type was found to be associated with the prevalence of PVL+ and mecA+ S. aureus (P< 0.01)., Conclusion: This study concludes that the PVL+ MRSA is rare and the prevalence of CA-MRSA is low in South-Western, Nigeria.