Ulcerated lesions as a risk factor for Henoch-Schonlein purpura nephritis

Objective: To determine the correlation between the severity of Henoch-Schonlein purpura skin manifestations and development of nephritis and to characterise the disease within the Maltese paediatric population. -- Design: A retrospective analysis of the 96 cases diagnosed with Henoch-Schonlein purpura at Mater Dei Hospital between January 2008 and January 2016. Clinical notes were reviewed and anonymised data regarding the presentation, progression and follow-up of these cases was entered into a database. -- Results: 96 cases met the inclusion criteria with a male to female ratio of 1.35:1 and with a mean age at presentation of 6.4 years (interquartile range 3.5 years). 99% had the typical rash at presentation with 75% having other associated clinical findings. Renal involvement was found in 36.5%: isolated proteinuria in 19.8%, isolated haematuria in 13.5%, haematuria, proteinuria and hypertension in 3.1% and nephrotic range proteinuria in 2% of cases. A severe rash at presentation was shown to be a prognostic indicator for renal involvement. -- Conclusion: Henoch-Schonlein purpura in the Maltese paediatric population is similar in incidence to that quoted in the literature. The majority of cases are uncomplicated and the outcome is frequently favourable. The presence of a severe rash at presentation significantly increases the risk of renal involvement and long term complications.peer-reviewe

Aerial remote sensing and spatial analysis of marine benthic habitats in St George’s Bay (Malta)

This study was financed by the Malta Tourism Authority (MTA) through contract dated 14th April 2004 and tender MTA/104/2004 dated 26th November 2004, both awarded to Ecoserv.The spatial distribution of marine benthic assemblages and habitats present in St George’s Bay (St Julians, Malta) was mapped using aerial photography and GIS techniques as part of an environmental monitoring programme to assess the potential impacts of beach replenishment works carried out in the bay. Maps showing the distribution of benthic habitats in the study area were produced in May 2004 (prior to initiation of the beach replenishment works), and in April 2005 (one year following the beach replenishment works). On both occasions, data from the maps was ground-truthed by SCUBA divers, who also collected data on the occurrence of characteristic plant and animal species from each habitat type. The results from the remote techniques and diving surveys indicated the presence of four main benthic assemblage types in the study area: (i) an assemblage of bare sand; (ii) an assemblage of photophilic algae on hard substrata; (iii) Posidonia oceanica meadows; and (iii) Cymodocea nodosa meadows. Comparison of the map produced in 2004 (pre-replenishment) with the one produced in 2005 (post-replenishment) indicated that, following the beach replenishment works, the main changes in the distribution of benthic assemblages and habitats in the study area consisted of: (i) a decrease in coverage of assemblages of bare sand; and (ii) a corresponding increase in coverage of supralittoral sand habitat. Overall, the results from the first year of environmental monitoring showed that the beach replenishment works did not have any adverse impacts on the marine benthic assemblages and habitats of the area. The results are discussed in the light of use of aerial photography and GIS techniques for the first time locally to monitor potential adverse impacts from coastal development works on marine benthic habitats.peer-reviewe

Nikteb...

Ġabra ta’ poeżiji u proża li tinkludi: L-iben il-ħali ta’ David Agius Muscat – Kaptan ta’ Kit Azzopardi – Il-lanterna ta’ Charles Bezzina – Li kelli mmur lura ta’ Ġorġ Borg – Firda ta’ Ġorġ Borg – Garden fairy ta’ Charles Briffa – Sejf jinfidlek ruħek ta’ Charles Briffa – Waqt ta’ Joseph Buttigieg – Vjaġġ ta’ John Caruana – Ċaqlembuta ta’ Antoine Cassar – Ħaġa tqila ta’ Carmel G. Cauchi – F’tarf il-blat ta’ Leanne Ellul – Int ta’ Victor Fenech – Pippin u l-bojja ta’ Charles Flores – L-arloġġ ta’ Joe Friggieri – Il-fjur tal-ġakaranda ta’ Joe Friggieri – Fjur tal-kaktus ta’ Joel Galea – Biss is-skiet ta’ Joel Galea – Għalissa ta’ Maria Grech Ganado – Ilsna ta’ Maria Grech Ganado – Is-sried ixoqqna fin fin ta’ Adrian Grima – Ħsieb ħalliel... ta’ Patrick Sammut – Lament lil ommi ta’ Salv Sammut – Hekk kif tinħass ġol-arja x-xitwa ta’ Lillian Sciberras – F’għajnejha, il-ħarsa siekta ta’ Clare Azzopardi – Għad jagħdab l-irdum ta’ Paul P. Borg – Forsi...xi darba ta’ Charles Casha – Faxxa ngħas ta’ Sergio Grech – Il-mejda tal-mogħdija ta’ Pierre J. Mejlak – Min jaf bi Stojan Kurepa? ta’ Immanuel Mifsud – L-eħrex jum tal-gwerra ta’ Maurice Mifsud Bonnici – Il-vażett tal-bewsiet ta’ Rita Saliba – Pjanu ta’ Trevor Żahra – Il-ħalliel ta’ Guy de Maupassant, traduzzjoni ta’ Toni Aquilina – Salvu tal-pasturi ta’ Francis Ebejer, traduzzjoni ta’ Steve Borg – Sunetti ta’ William Shakespeare, traduzzjoni ta’ Oliver Friggieri – Nikteb... ta’ Nizar Qabbani, traduzzjoni ta’ Kevin Saliba.peer-reviewe

Attitudes and Performance: An Analysis of Russian Workers

This paper investigates the relationship between locus of control and performance among Russian employees, using survey data collected at 28 workplaces in 2002 in Taganrog and at 47 workplaces in 2003 in Ekaterinburg. We develop a measure that allows us to categorize the Russian employees participating in our survey as exhibiting an internal or external locus of control. We then assess the extent to which there are significant differences between “internals” and “externals” in work-related attitudes that may affect performance. In particular, we focus on (1) attitudes about outcomes associated with hard work, (2) level of job satisfaction, (3) expectation of receiving a desired reward, and (4) loyalty to and involvement with one’s organization. In each case we identify where gender and generational differences emerge. Our main objective is to determine whether Russian employees who exhibit an internal locus of control perform better than employees with an external locus of control. Our performance measures include earnings, expected promotions, and assessments of the quantity and quality of work in comparison to others at the same organization doing a similar job. Controlling for a variety of worker characteristics, we find that (1) individuals who exhibit an internal locus of control perform better, but this result is not always statistically significant; (2) even among “internals,” women earn significantly less than men and have a much lower expectation of promotion; (3) even among “internals,” experience with unemployment has a negative influence on performance.http://deepblue.lib.umich.edu/bitstream/2027.42/40144/3/wp758.pd

Silta mill-"Antigone" ta’ Sofokle

Ġabra ta’ poeżiji u proża li tinkludi: Ħajki ta’ Josette Attard – Din l-għanja tiegħi ta’ Rena Balzan – Fl-irdum fejn jidwi ta’ Charles Bezzina – Naqa’ biss ta’ Ġorġ Borg – Gambrinu, 7.45 a.m. ta’ Norbert Bugeja – Għadam ta’ Joseph Buttigieg – Tħarisx biss fil-wiċċ ta’ John Caruana – Petra ta’ Priscilla Cassar – Mhux iżjed dan il-pajjiż tiegħi ta’ Victor Fenech – Twieqi magħluqa ta’ Maria Grech Ganado – Joseph quddiem ir-ritratt ta’ sieħbu jitfarrak ta’ Adrian Grima – Ta’ l-ilma l-fruntieri tiegħek ta’ Simone Inguanez – Għall-kaċċa tal-grejtwajt ta’ Daniel Massa – Ftit weraq mis-Slovenja ta’ Immanuel Mifsud – Dak li kien ta’ Achille Mizzi – Wassalni ta’ Anna Pullicino – Tamiet fiergħa ta’ Patrick Sammut – Fost l-isbaħ jiem ta’ Lillian Sciberras – Kelma ta’ Marcel Zammit Marmarà – Lill-Imdina żagħżugħa ta’ Joe Zammit Tabona – Sodda ta’ l-ilma ta’ Clare Azzopardi – Kurċifiss ta’ Paul P. Borg – Mera mkissra ta’ Lina Brockdorff – No(ra)vella ta’ Joe Friggieri – L-abbati ta’ Henry Holland – L-eħrex ġurnata tal-gwerra ta’ Maurice Mifsud Bonnici – Marija ta’ Lino Spiteri – Ikla ta’ Trevor Żahra – Il-mara midinba ta’ Albert Camus, traduzzjoni ta’ Toni Aquilina – Silta mill-"Antigone" ta’ Sofokle, traduzzjoni ta’ Victor Xuereb.peer-reviewe

The seventh national communication of Malta under the United Nations framework convention on climate change

This is the fourth time that Malta is submitting a National Communication under the United Nations Framework Convention on Climate Change (UNFCCC), following the submission of a First National Communication in 2004 and a Second National Communication in 2010. This is also the second time that Malta is submitting such a Communication since its accession to Annex I status under the Convention, the first two submissions having been made as a non-Annex I Party. Emission reduction or limitation commitments applicable to Malta Malta’s status under the Convention up to the time it applied for accession to Annex I, and with that accession being conditional to not taking on quantified emission limitation or reduction targets for the first commitment period of the Kyoto Protocol, meant that until 2012 Malta was not subject to an economy-wide greenhouse gas related obligation under the Protocol. This however did not mean that Malta had no obligations to limit or reduce emissions from anthropogenic activities taking place in the country. In line with, Malta will be contributing its fair share of the EU’s unconditional commitment under the Convention to reduce emissions by 20% below 1990 levels by 2020. This is in line with the target inscribed in the amendments to the Kyoto Protocol (the Doha Amendments), that will be jointly fulfilling the second commitment period with the other Union member states; therefore, emissions from the aforementioned power plants remain subject to compliance with EU Emissions Trading Scheme provisions, while the Effort-Sharing Decision target is the principal emissions mitigation obligation that the country has until 2020, for all other greenhouse gas emissions. The major point sources of greenhouse gas emissions in Malta, namely the electricity generation plants have been, since of 2005, subject to the EU Emissions Trading Scheme, whereby they are required to surrender allowances in respect of emissions of carbon dioxide. Emissions of greenhouse gases not covered by the EU Emissions Trading Scheme, are subject to an overall limit under the so-called Effort-Sharing Decision. Under this decision, Malta must limit such greenhouse gases to not more than 5% over emission levels in 2005, by 2020. The EU is already looking towards the longer-term future, with the 2030 climate and energy framework providing for a 40% domestic reduction target for 2030. Legislative implementation of this goal is currently under discussion at EU level.peer-reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

High-intensity exercise to promote accelerated improvements in cardiorespiratory fitness (HI-PACE): study protocol for a randomized controlled trial

Background: African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared with Caucasians. Recent evidence indicates that low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest that vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g., reduction of glucose/insulin levels, pulse wave velocity, and body fat) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the HI-PACE (High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans. Methods/Design: A randomized controlled trial will be performed on overweight and obese (body mass index of 25–45 kg/m2) African Americans (35–65 years) (n = 60). Participants will be randomly assigned to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45–55% and 70–80% of VO2 max in the MOD-INT and HIGH-INT groups, respectively, for an exercise dose of 600 metabolic equivalents of task (MET)-minutes per week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near-infrared spectroscopy), skeletal muscle measurements (i.e., citrate synthase, COX IV, GLUT-4, CPT-1, and PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment). Discussion: The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies