Reducing the expense of ear wax

Ear wax is one of the commonest presenting complaints both in Ear Nose and Throat surgery and in General Practice. The commonest treatment by far given for this condition is Arachis oil (Cerumol®). Results from various studies however show that this appears not to be the most effective treatment and that cheaper options exist which may drastically reduce the costs incurred by the Health Department in this respect. We hereby outline the advantages of the use of 0.9% saline drops in the treatment of ear wax.peer-reviewe

Meeting the US Military’s Manpower Challenges

Concerns raised over the impact of changing demographics, domestic polarization, and the return of near-peer competition on US military manpower challenges are overstated. Drawing on open-source materials and interviews, this article discusses factors often neglected in conversations on this topic and provides leadership and policymakers with a scholarly overview of an important yet understudied issue facing the US armed forces

A unique case of esophageal perforation caused by prickly pears

This is a report of a previously healthy 20-year-old male presenting with the sensation of a foreign object being stuck in the throat and difficulty speaking after the ingestion of 2 prickly pears. Tests were performed, confirming an esophageal perforation which was managed medically. The patient was discharged after 7 days in hospital with no complications.peer-reviewe

Prevalence and characteristics of community carriage of methicillin-resistant Staphylococcus aureus in Malta

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. Malta is one of the countries with the highest MRSA prevalence in Europe, as identified from hospital blood cultures [1]. However, community prevalence of MRSA has never previously been investigated. This study aimed at establishing the prevalence of community MRSA nasal colonization in Maltese individuals and identifying the clonal characteristics of the detected isolates. Nasal swabs were collected from 329 healthy individuals who were also asked to complete a brief questionnaire about risk factors commonly associated with MRSA carriage and infection. The swabs were transported and enriched in a nutrient broth supplemented with NaCl. The presence of MRSA was then determined by culturing on MRSA Select chromogenic agar and then confirming by several assays, including catalase, coagulase and PBP2a agglutination tests. The isolates were assayed for antibiotic susceptibilities and typed by micro-array analysis to determine the clonal characteristics of each strain. The prevalence of MRSA nasal colonization in the healthy Maltese population was found to be 8.81% (95% confidence interval [CI], 5.75–11.87%), much higher than that found in other studies carried out in several countries. No statistical association was found between MRSA carriage and demographics or risk factors; however, this was hindered by the small sample size. Almost all the isolates were fusidic-acid resistant. The majority were found to belong to a local endemic clone (CC5) which seems to be replacing the previously prevalent European clone UK-EMRSA-15 in the country. A new clone (CC50-MRSA-V) was also characterized. The presence of such a significant community reservoir of MRSA increases the burdens already faced by the local healthcare system to control the MRSA epidemic. Colonization of MRSA in otherwise healthy individuals may represent a risk for endogenous infection and transmission to hospitalized patients after admission to a healthcare facility, leading to longer hospital stays and, consequently, increased healthcare costs.peer-reviewe

Post-tonsillectomy bleeding in Malta

Patients presenting with post-tonsillectomy haemorrhage are frequently readmitted to hospital, usually for observation, but surgical intervention may sometimes be necessary. A 10 year retrospective analysis of 3553 patients who underwent tonsillectomy with or without adenoidectomy at the Mater Dei hospital was carried out. Clinical notes were used to determine the post-tonsillectomy haemorrhage rate and its relationship to the use of antibiotics.peer-reviewe

An investigation into the geometric parameters affecting field uniformity in four pole magnetisers

In recent years, the field-metric method for measuring the joule losses set up in an electrical steel laminate when subjected to a rotating field has gained popularity. The ideal geometry of the magnetiser required to set up such a field is still however the subject of much debate. The work presented in this paper aims at providing some useful guidelines which might be considered when undertaking the construction of the simplest of such magnetizing setups having four salient poles excited by a two phase system and using a square sample. A 3D model for this rotational power loss tester was simulated for different pole geometries with the induction uniformity being assessed for every alteration

Building capacity and identifying appropriate support: how can the EU contribute to securing resources for health systems?

European health systems face increasing challenges and demands, while striving to provide high-quality care. The European Union (‎EU)‎ offers support to complement national efforts, but accessing and utilising it can be challenging for Member States. Austria, Belgium, and Slovenia are collaborating on a multi-country project supported by the EU’s Technical Support Instrument, to create an EU Health Resources Hub. This advisory service aims to help Member States access EU funding instruments for their health needs. This article discusses the project’s goals and early learnings, offering insights that could inform future health funding opportunities and policies in Europe

Everyday Argumentative Explanations for Classification

In this paper we study everyday explanations for classification tasks with formal argumentation. Everyday explanations describe how humans explain in day-to-day life, which is important when explaining decisions of AI systems to lay users. We introduce EVAX, a model-agnostic explanation method for classifiers with which contrastive, selected and social explanations can be generated. The resulting explanations can be adjusted in their size and retain high fidelity scores (an average of 0.95

RIP3, a kinase promoting necroptotic cell death, mediates adverse remodelling after myocardial infarction

Aims Programmed necrosis (necroptosis) represents a newly identified mechanism of cell death combining features of both apoptosis and necrosis. Like apoptosis, necroptosis is tightly regulated by distinct signalling pathways. A key regulatory role in programmed necrosis has been attributed to interactions of the receptor-interacting protein kinases, RIP1 and RIP3. However, the specific functional role of RIP3-dependent signalling and necroptosis in the heart is unknown. The aims of this study were thus to assess the significance of necroptosis and RIP3 in the context of myocardial ischaemia. Methods and results Immunoblots revealed strong expression of RIP3 in murine hearts, indicating potential functional significance of this protein in the myocardium. Consistent with a role in promoting necroptosis, adenoviral overexpression of RIP3 in neonatal rat cardiomyocytes and stimulation with TNF-α induced the formation of a complex of RIP1 and RIP3. Moreover, RIP3 overexpression was sufficient to induce necroptosis of cardiomyocytes. In vivo, cardiac expression of RIP3 was up-regulated upon myocardial infarction (MI). Conversely, mice deficient for RIP3 (RIP3−/−) showed a significantly better ejection fraction (45 ± 3.6 vs. 32 ± 4.4%, P < 0.05) and less hypertrophy in magnetic resonance imaging studies 30 days after experimental infarction due to left anterior descending coronary artery ligation. This was accompanied by a diminished inflammatory response of infarcted hearts and decreased generation of reactive oxygen species. Conclusion Here, we show that RIP3-dependent necroptosis modulates post-ischaemic adverse remodelling in a mouse model of MI. This novel signalling pathway may thus be an attractive target for future therapies that aim to limit the adverse consequences of myocardial ischaemi