Mycoplasma Pneumoniae infections in the Maltese Islands

Mycoplasma pneumoniae is a free living micro-organism which is classified in the family Mycoplasmataceae. It is primarily a human respiratory pathogen and the infection may vary from a mild pharyngitis to a pneumonia. M. pneumoniae infections are usually endemic in the community but periodic epidemics can also occur. These micro-organisms are sensitive to specific antibiotics such as tetracycline and erythromycin and a laboratory diagnosis using rapid methods is therefore important. Studies were carried out at the Virology Laboratory, St. Luke’s Hospital involving 1,022 cases during the period 1995 to 1998. These were examined for specific anti-mycoplasmal IgM antibodies using an enzyme immunoassay (EIA) technique. One hundred and forty samples or 13.7% were found to be reactive. Compared to the traditional cultural methods, EIA techniques are very rapid laboratory diagnostic methods, the result being communicated to the clinician within a few hours. The differential diagnosis of the particular case can thus be resolved quickly and appropriate antibiotic therapy instituted without much delay for the maximum benefit to the patient.peer-reviewe

Looking Into the Black Box: A Survey of the Matching Function

We survey the microfoundations, empirical evidence and estimation issues underlying the aggregate matching function. Several microeconomic matching mechanisms have been suggested in the literature with some successes but none is generally accepted as superior to all others. Instead, an aggregate matching function with hires as a function of vacancies and unemployment has been successfully estimated for several countries. The Cobb-Douglas restrictions with constant returns to scale perform well. Recent work has utilized disaggregated data to go beyond aggregate estimates, with many refinements and suggestions for future research.Matching function, search, mismatch, Beveridge curve, co-ordination failure, stock-flow matching, ranking, on-the-job search, space aggregation, time aggregation

Scale Effects in Markets with Search

Reduced-form tests of scale effects in markets with search, run when aggregate matching functions are estimated, may miss important scale effects at the micro level, because of the reactions of job searchers. A semi-structural model is developed and estimated on a British sample, testing for scale effects on the offer arrival rate and the wage offer distribution. When contrasting London with the rest of the country we find scale effects in wage offers. But the larger market delivers higher realized wages and not more matches, because the scale effects on matches are offset by the response of reservation wages.Job search, economies of scale, matching, aggregate matching functions, wage offer distribution, unemployment

The Ins and Outs of European Unemployment

In this paper we study the contribution of inflows and outflows to the dynamics of unemployment in three European countries, the United Kingdom, France and Spain. We compare performance in these three countries making use of both administrative and labor force survey data. We find that the impact of the 1980s reforms in Britain is evident in the contributions of the inflow and outflow rates. The inflow rate became a bigger contributor after the mid 1980s, although its significance subsided again in the late 1990s and 2000s. In France the dynamics of unemployment are driven virtually entirely by the outflow rate, which is consistent with a regime with strict employment protection legislation. In Spain, however, both rates contribute significantly to the dynamics, very likely as a consequence of the prominence of fixed-term contracts since the late 1980s.unemployment dynamics, job finding rates, job separation rates

The Ins and Outs of European Unemployment

In this paper we study the contribution of inflows and outflows to the dynamics of unemployment in three European countries, the United Kingdom, France and Spain. We compare performance in these three countries making use of both administrative and labor force survey data. We find that the impact of the 1980s reforms in Britain is evident in the contributions of the inflow and outflow rates. The inflow rate became a bigger contributor after the mid 1980s, although its significance subsided again in the late 1990s and 2000s. In France the dynamics of unemployment are driven virtually entirely by the outflow rate, which is consistent with a regime with strict employment protection legislation. In Spain, however, both rates contribute significantly to the dynamics, very likely as a consequence of the prominence of fixed-term contracts since the late 1980s.unemployment dynamics, job finding rates, job separation rates

Assessment of the utility of repeat stool testing for Clostridium difficile stool toxin using enzyme immunoassay

The poor performance of toxin enzyme immunoassay (EIA) for laboratory testing for Clostridium difficile (C. difficile) infection (CDI) is well acknowledged. Guidelines published in recent years state that testing solely with EIA for detecting toxins A and B is sub-optimal. As a consequence, clinicians may lose confidence in the test and submit multiple samples to offset the poor sensitivity of the toxin EIA. This leads to waste of laboratory resources and is discouraged by recent guidelines. 2,489 requests for toxin EIA submitted during one year at a state general hospital in Malta were reviewed to assess the utility of repeat stool testing for C. difficile toxin detection using toxin EIA and also to gather data on the extent of repeat samples within 28 days of a positive test. There were a total of 1,970 diarrhoeal episodes, from which a total of 302 cases (15.3%) submitted more than one sample for repeated testing. Only 2% of these repeats tested positive after having an initial negative result for the C. difficile toxin EIA test. Most recent published practice guidelines recommend a two-step or three-step testing algorithm in the diagnosis of C. difficile-associated diarrhoea, which offers a marked increase in sensitivity when compared to that of toxin A and B EIA alone. A three-step protocol is proposed which should enable the discernment of the role of C. difficile in a diarrhoeal patient.peer-reviewe

Drug Resistant Streptococcus pneumoniae (DRSP) in the Maltese Islands

The DRSP prevalence rate for the Maltese Islands was investigated. Consecutive samples were obtained, both from adults and children, from September 2000 through April 2002. Penicillin-intermediately-resistant isolates amounted to 27%, erythromycin-resistant isolates 31%, and clindamycin-resistant isolates 19%. The oxacillin disk was found to be an effective screening method for the detection of penicillin resistance. An association was found in patients who had DRSP, as well as diabetes and/ or cardiovascular disease. Finally, an investigation of the local antibiotic consumptions over the period 1997-2000, for the National Health Service was conducted. The highest consumption rates were obtained with co-amoxiclav, amoxicillin, erythromycin, cephalexin and ciprofloxacin. The results obtained here call for more judicious use of antibiotics. In addition, the setting up of a local DRSP surveillance unit is mandatory. Moreover, the use of molecular techniques to investigate specific genes, such as ermAM and mefE associated with macrolide-resistance, should be introduced as part of investigational laboratory work.peer-reviewe

Novel vaccines : what's in the pipeline?

Scientists worldwide are striving without heed in order to develop new vaccines which protect the human race against old and emerging diseases. However it is not only the menu of these vaccine preventable diseases which is being extended but the quality and efficacy of these vaccines are improving tremendously. Researchers are today studying vaccine adjuvants which improve the immunogenicity of the product, aiming to create a vaccine which provides lifelong immunity and which is well tolerated and free from side effects. The problem of the pin cushion effect with multiple injections during one and subsequent visits to the family doctor and pediatrician will soon be a thing of the past with the introduction of combination vaccines. Also in the twenty first century the use of edible vaccines, nasal sprays or skin lotions may eliminate the use of needles completely.peer-reviewe

The Small Stellated Dodecahedron Code and Friends

We explore a distance-3 homological CSS quantum code, namely the small stellated dodecahedron code, for dense storage of quantum information and we compare its performance with the distance-3 surface code. The data and ancilla qubits of the small stellated dodecahedron code can be located on the edges resp. vertices of a small stellated dodecahedron, making this code suitable for 3D connectivity. This code encodes 8 logical qubits into 30 physical qubits (plus 22 ancilla qubits for parity check measurements) as compared to 1 logical qubit into 9 physical qubits (plus 8 ancilla qubits) for the surface code. We develop fault-tolerant parity check circuits and a decoder for this code, allowing us to numerically assess the circuit-based pseudo-threshold.Comment: 19 pages, 14 figures, comments welcome! v2 includes updates which conforms with the journal versio