The social impact of the American University of Malta on the Cottonera region

The American University of Malta (AUM) is a private university in the South Eastern Region of Malta. This article aims to look at the social impact of the American University of Malta’s Cospicua site on the Cottonera and the surrounding localities.peer-reviewe

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Privatization in Western Europe: Stylized Facts, Outcomes, and Open Issues

Privatization has certainly been one of the main events of the economic and financial history of the 20th century. Between 1997 and 2004 more than 4,000 privatization operations were carried out in the world, bringing to governments revenues for over 1,350US$billion. Western Europe emerges as the most important region, having implemented the greatest number of privatizations and raised a half of global revenues. The relevance of Western Europe in the process can be ascribed to several factors. This paper investigates the causes of this process, summarizes the main trends of privatization activity at the country level, analyzes the main privatization drivers and provides an account of the main findings of the effects of privatization at the macro and microeconomic level

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

Tagging Atlantic bluefin tuna from a Mediterranean spawning ground using a purse seiner

Atlantic bluefin tuna, Thunnus thynnus, is as an emblematic and commercially valuable large pelagic species. In the past ten years, the purse seine fishery in the Mediterranean represents more than 50 % of the catch. Nowadays, purse seines target large fish and operate during the spawning season in the spawning grounds. Electronic tagging has shed a considerable amount of light on the ecology and behaviour of bluefin tuna over the past twenty years. However, such technique has rarely been applied on large bluefin tunas caught by the Mediterranean purse seine fishery despite its major importance. The logistical constraints related to this specific fishery, combined with the timing of migration of the fish and the requirements related to the handling of big fish have made adequate tagging from purse seines complex. Here we detail such an operation, designed to bridge the knowledge gap on the migratory behaviour of tunas targeted by the purse seine fishery. Three large bluefin tunas from the same school were tagged during the fishing operation of a French purse seine, resulting in a different migration pattern than previous deployments. The fish were tagged onboard in less than 2 min and efficiently, avoiding any subsequent mortality. These results contrast with those from tagging operations carried out in the Northwest Mediterranean, which underlies the importance of tagging operations from purse seines to obtain unbiased description of the movements of the eastern Atlantic bluefin tuna stock in the context of its management

Tagging Atlantic bluefin tuna from a farming cage: An attempt to reduce handling times for large scale deployments

Our knowledge on the biology and ecology of marine species have improved greatly through the use of archival tags by enabling the collection on information from individual in the wild. This is specifically true for large pelagic species such as the Atlantic Bluefin tuna (ABFT, Thunnus thynnus) where, for the first time, it has been possible to confirm through fisheries-independent data, migration patterns, reproductive and feeding behaviours and habitat use. However, large-scale tagging experiments that would enable researchers to tackle group behaviour are difficult to set up. On the one hand, the impact of the actual tagging operation should be as minimal as possible to avoid any change in behaviour of the fish which could influence tag data analyses. On the other hand, large scale tagging experiments require handling a large number of animals in a relatively short period of time. In the present manuscript, a methodology for tagging several large ABFT with satellite tags was tested with ABFT caught from a cage of a Maltese farm. The total time of the operation, from the moment fish were caught by handline to release back to the sea lasted an average of 10 min for the 3 fish tagged. The handling of the fish on the deck lasted less than 2 min. This methodology proved successful at tagging several large (158–182 cm) fishes in a very short time, while ensuring the best conditions for the fish during tagging and subsequent release. This procedure requires substantial logistical preparation and an experienced crew team but, by reducing the time required for the operation, opens up the possibility of large scale tagging activities of large fish held in cages or caught by purse seiners

Electronic tagging of Bluefin Tunas from the Maltese spawning ground suggests size-dependent migration dynamics

International audienceThe purse seine fishery in the Mediterranean represents about 60% of the international catch for Atlantic Bluefin Tuna (Thunnus thynnus). Yet, tagging operations from this segment of the fisheries remain rare and despite its potential importance for management, several aspects related to the migratory behavior of Atlantic Bluefin Tuna from these areas remain unaddressed. In the present manuscript, we report the results of two tagging operations carried out on a commercial purse seiner during two consecutive years in the spawning ground around the Maltese islands in the Central Mediterranean Sea. During these operations, eight individuals were tagged and the results showed that the larger fish (> 200 cm) undertook large-scale migrations outside the Mediterranean, whereas smaller individuals did not. This study suggests that size might affect the migratory behavior of Atlantic Bluefin Tuna, and underlines the potential of large-scale tagging operations from spawning grounds to address scientific questions having significant management implications

Parkinsonism and dementia are negative prognostic factors for the outcome of subdural hematoma

To determine, among a population with subdural hematoma (SH), whether patients affected by neurodegenerative disorders (parkinsonism and dementia) have a worse clinical outcome. We reviewed the data of patients diagnosed with fall-related SH discharged from the Departments of Neurology/Stroke unit, Neurosurgery, Intensive Care Unit at Brotzu General Hospital (Cagliari, Italy) between January 2010 and December 2013. Patients with severe traumatisms, evidence of spontaneous intracerebral bleeding or aged less than 50 were excluded. 332 patients were selected: 69 with a neurodegenerative parkinsonism or dementia (N-group), 217 with history of chronic non-neurological medical conditions with significant disability, previous falls and/or balance problems (NND-group) and 46 with a history of "minor" chronic non-neurological disorder. (NN-group). The clinical status at admission and discharge was assessed by modified Rankin Scale (mRS). The time-span between trauma and hospital admission was also calculated. At hospital admission we found a significantly longer delay in SH's diagnosis (χ (2) test p < 0.001) and a worse mRS score (Kruskal Wallis p < 0.001) in the N-group compared to both NN and NND-groups. During hospital stay we observed the lack of significant variation in mRS score in N-group (Wilcoxon test p = 0.86), in contrast with NN and NND-groups who significantly improved (Wilcoxon test p < 0.001). Our results demonstrate that the consequences of SH are more severe in the N-group compared to NN and NND-groups. The longer interval between trauma and hospital admittance plays a critical role in worsening the outcome of patients with parkinsonism and dementia compared to subjects without neurodegenerative disorder