Experience: A Summer Elective in Germany

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Case number 6 : mucinous cystadenocarcinoma of the appendix

GM, a 67-year-old female, was referred after an appendiceal mucocoele which had been noted and removed during a total abdominal hysterectomy with bilateral oophorectomy (TAH-BSO) was diagnosed on histopathology as being a mucinous cystadenocarcinoma. The patient presented with no signs or symptoms. The patient subsequently underwent a laparoscopic right hemicolectomy and is being followed up at surgical outpatients yearly to exclude recurrence of the malignancy.peer-reviewe

The value of multiple 2D ultrasound scanning views in the detection of Congenital Heart Disease in the second trimester (18 to 24 weeks)

Antenatal detection for Congenital Heart Disease (CHD) is poor, but may be improved by adding views to routine ultrasound scanning. From June 2014-July 2015, 600 randomly selected women between 18 to 24 weeks of pregnancy, had a routine 4-chamber ultrasound scan at Mater Dei Hospital view (Basic 4CV). In addition, they completed an Extended Cardiac Ultrasound Examination (ExCUSE) including the left outflow tract, right outflow tract, 5-chamber view and 3-vessel view. All views were timed. The results obtained from the 600 women who received Basic and the ExCUSE scanning were followed-up clinically after delivery of the infants. Validity testing of both 4CV and ExCUSE views was carried out, and the detection rate of CHD compared. During the 12-month period, 61 cases from a total of 4,200 children up to 1 year of age were diagnosed with CHD by Paediatric Echocardiography. 19 were included in the 600-study cohort, of which 12 were detected antenatally, 1 via the 4CV alone, 4 by both the 4CV plus at least 1 of the ExCUSE views and 7 by 1 or more of the ExCUSE views alone. On average, ExCUSE views took approximately 6 minutes longer, yet there was a significant difference between the detection rate of CHD by the 4CV compared with the ExCUSE views (χ2 = 0.031, p=0.05). Sensitivity and specificity of the 4CV were 31.6% and 100%, respectively, and 63.1% and 100%, respectively for ExCUSE views. Antenatal diagnosis of CHD is improved with additional ultrasound views, but this will necessitate staff training and adjustments in clinic schedules to accommodate increased scan time.peer-reviewe

The role of temperature in shaping Culex acharistus mosquitoes life history traits in its southern limit of distribution (Patagonia-Argentina)

There is substantial evidence showing that temperature have a great impact on insects behavior, phenology and life histories. Because of mosquito global importance as disease vectors, in temperate regions where climatic conditions could be only borderline suitable for mosquito development, there is a growing interest in understanding the effect of temperature shifts on vital statistics to more accurately define how such changes could impact distribution and abundance patterns, as well as disease transmission cycles. We determined the role of ambient temperature under fluctuating conditions in shaping Culex acharistus (Diptera: Culicidae) life history traits, and estimated its development threshold and physiological time, in its southern limit of distribution in the Argentine Patagonia region. Four horizontal life tables were conducted under natural fluctuating temperature range in Esquel city (42°S – 71°W; 563 m a.s.l.), during spring-summer (17°C), summer (15.4°C), summer-autumn (12.7°C) and autumn-winter (5.6°C) seasons. Larvae, pupae and adult traits were recorded. The mean duration of the experiments varied between 28 to ≅100 days for spring-summer and autumn-winter seasons. Only during the cold season experiment pupae experienced the most severe temperatures and freeze-thaw cycles, and failed to reach adult stage. We found that larva and pupa development time, adult emergence time and longevity significantly increased with decreasing temperatures, while larval survival was greatest at an intermediate temperature and decreased toward low and high values. Also, protandry was observed and males emerge 2 days before females across seasons. Temperature development threshold and physiological time estimated for larva + pupa were 5.98°C and 211.24°C-days. Our study contributes to a growing body of knowledge by examining the effect of seasonal changes in temperature on mosquito life history traits. Results obtained here can be applied as useful parameters in the development of population dynamic models, improving current mosquito control strategies in cold-temperate regions.Fil: Grech, Marta Gladys. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagónica. Universidad Nacional de la Patagonia "San Juan Bosco". Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Miserendino, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagónica. Universidad Nacional de la Patagonia "San Juan Bosco". Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Almiron, Walter Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto de Investigaciones Biológicas y Tecnológicas; Argentin

Regional differences in childhood BMI data : the Malta childhood national body mass index study

Introduction: Obesity is a problem of major public health concern all over the world and Malta has high obesity prevalence rates. With over a third of Maltese children being overweight or obese, the Malta Childhood National Body Mass Index study was devised to quantify the extent of the problem precisely. This paper looks at regional differences in the BMI data obtained. Methods: Training in measurement was provided to physical education teachers and identical stadiometers were used. Data was processed using World Health Organisation cut-offs for underweight, overweight and obesity. Results: A total of 41,343 students from 145 schools were measured. Age range from 4.7 to 17 years. Approximately 40% of school-aged children in Malta were overweight or obese, with higher percentages of obesity than overweight being observed. Results show significant differences in BMI between children living in Northern and Southern regions of Malta. Conclusion: Results from this study further confirm the high levels of overweight and obesity in Maltese children. The North-South differences should help better target public health resources and should be further evaluated in more focussed research.peer-reviewe

Disability and forced migration : critical intersectionalities

The vast majority of the world’s displaced people are hosted in the global South, in the poorest countries in the world. This is also a space with the highest numbers of disabled people, many of who live in extreme and chronic poverty. This poverty, alongside deprivation, wars, conflict, and environmental disasters is what drives people to flee, in search of security. This includes disabled people. In spite of this, this population (disabled forced migrants) continues to be cast in a shadow, of epistemological, ontological and practical invisibility. It is hardly theorised in forced migration studies and rarely contemplated in humanitarian intervention. The lives of disabled forced migrants are cast aside in a Eurocentric disability studies that remains global North-centric and focused, while Southern contexts and histories and the geopolitics that envelope them, are forgotten or never known. Migration theory grows without the disabled person, disability studies without the migrant, and practice without the disabled migrant. In this paper, we explore the disability/forced migration nexus with a view to understanding some of the critical intersectionalities that emerge, and their implications for theory and practice. We trace elements of the forced migration trajectory, from exodus, to crossing international borders, to life in protracted refugee camps, the use of networks and smugglers, to those related to national and human security. We argue that forced migration studies, as well as humanitarian practice continue to be premised on and adopting an ableist approach focused on heteronormative productive bodies, while disability studies, with a corpus of work premised on an assumption of citizenship, has failed to critically engage with issues of sovereignty, borders and bodies that lie beyond the protection of the Nation State. In this paper, we also question and contest dominant and hegemonic frames that are historically contextualized, alongside discourses and structures that not only produce forced migration, but also serve to perpetuate the global divide and inequalities. We conclude by calling for a critical interrogation of theoretical perspectives in both forced migration and disability studies, in policy and humanitarian action, and to work towards a praxis geared towards social justice for disabled forced migrants.peer-reviewe

Mercy in the Maltese educational system : education practices to foster respect for diversity towards the migrant population

The growing diversity of learners in Maltese schools presents new challenges to policy-makers and practitioners. Schools and teachers often find themselves at odds when trying to respond to the increasingly diverse needs of the student population within schools. Over the past decade Malta made the shift from a country of emigration to a country of immigration. This trend is represented in Maltese schools, as the student population becomes increasingly heterogeneous. While this new reality is more pronounced in certain areas, all colleges have a representation of non-Maltese students, with Maria Regina College having the highest representation with a total of 1,134 students (819 at primary level, 95 in middle school and 220 in secondary school) and Saint Nicholas College having the lowest number, with a total population of eighty one migrant students (fifty-nine in the primary, eleven in middle school and eleven in the secondary school).peer-reviewe

Playing with fire - negative perceptions towards COVID-19 vaccination

Living during a pandemic has a great impact on a person’s health and psychological functioning. While many took the vaccine, others were very sceptical about the intentions and motivations of political and health authorities and the safety of the vaccine. Vaccines may play a role in prevention of disease, however some are against vaccination. This paper will explore the reasons and arguments that people put forward to support their stance against vaccines and the COVID-19 vaccination. This will help in providing a deeper understanding of these participants’ points of view, along with their experiences during this challenging period in time. A mixed methods approach was used. Study one was a quantitative study using online survey methodology to determine the degree of vaccine hesitancy and associated reasons. The most frequently cited reason given for not taking the vaccine were about safety issues. Study two was qualitative and involved interviewing six participants recruited through purposive sampling. The transcripts were analysed by using Thematic Analysis. The three main emerging themes were reasons related to health, others to the socio-political context and the third was the perceived lack of scientific information on COVID-19 vaccine. The results concluded that the participants’ objections to take the COVID-19 vaccine emerged from personal health factors, and was manifested as a form of protest against authorities.peer-reviewe

Beetle mania: Understanding pond aquatic beetles diversity patterns through a multiple-facet approach

Ecological studies searching for drivers of biodiversity variation have frequently focused on taxonomic richness. However, more aspects of biodiversity, namely diversity facets can be considered to properly assess biotic-environment relationships. Here, we explore the environmental factors that could control the four biodiversity facets of aquatic Coleoptera from 93 regionally sampled Patagonian ponds. We also explore which are the ponds with high diversity values of all facets to prioritize them with a high conservation value. We fitted generalized additive models (GAM) to test relationships among environment (i.e., local and climatic variables) and aquatic beetles diversity facets (i.e., richness (SD), functional diversity (FD), phylogenetic diversity (PD), and local contribution to local beta diversity (LCBD). Climatic drivers were the most important predictors of beetle diversity facets, which exhibited linear and nonlinear responses. Thus, ponds from warmer Patagonia exhibited the highest values of SD and PD, whereas LCBD also peaked on colder sites suggesting that ponds under extreme temperatures sustain unique beetle assemblages. Moreover, ponds located in areas with higher precipitation variability exhibit the highest values of LCBD (i.e., unique assemblages). This result in addition to arid conditions in Patagonia prevailing since 16 m.y.a made us think that Patagonian beetle pond-dwellers are basally adapted to aridity. We calculated an index that summarizes the four facets patterns, to assign high conservation value to those ponds with higher index values. The relative importance of each facet varies from pond to pond. Hence, this multifaceteded approach not only allows us to identify priority areas for biodiversity conservation but also focuses on the importance of including multiple facets to understand biodiversity spatial patterns.Fil: Martínez Román, Nicolás Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Epele, Luis Beltran. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Manzo, Luz Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Grech, Marta Gladys. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Archangelsky, Miguel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; Argentin

Mosquito (Diptera: Culicidae) larval ecology in natural habitats in the cold temperate Patagonia region of Argentina

Knowledge of immature habitats is an important focus for investigations of mosquito community ecology, and may improve our understanding of how environmental variables increase risk of mosquito-borne diseases by influencing the distributions and abundances of species. In Patagonia region, where climatic and ecological factors could be only borderline suitable for mosquito development, relatively little is known about larval ecology. The present study focuses on associations of environmental conditions in natural aquatic habitats with abundances of mosquito species that have colonized such habitats in Patagonia. We described the mosquito community composition within 26 natural temporary pools, and assessed the general relationships between environmental variables (pH, water temperature, conductivity, salinity, dissolved oxygen, aquatic plant cover and main nutrients) and larval abundances using redundancy analysis (RDA). Additionally, we compiled monthly climate data and vegetation indices for each larval habitat, and estimated the probability of presence for two of the most abundant species, describing through generalized linear models (GLM) the environmental, climatic and landscape variables-probability of occurrence relationships. Seven species belonging to the genera Culex and Aedes were identified, with Culex apicinus, Cx. acharistus and Aedes albifasciatus being the most abundant. Mean larval densities were low (6.8 ± 2.8 larvae/dip), and the highestspecies richness and larval densities were recorded in northern and central areas. Aedes albifasciatus, a species of sanitary importance, was widely distributed, being the only one collected south of the 45th parallel of S latitude. RDA indicated that aquatic conductivity, pH, water depth, dissolved oxygen, ammonia and soluble reactive phosphorous accounted for the main part of the variation in the species composition. According to GLMs, wind speed was thevariable that best described the presence of Ae. albifasciatus, and the probability of finding this species was positively associated with high wind speed values. On the other hand, the EVI vegetation index was the only variable included in the Cx. apicinus model, whereby there was a great probability of presence in arid areas with lower EVI values. Our results enhance our knowledge of larval habitat ecology under the extreme environmental conditions of Patagonia and will guide future efforts to understand how multiple effects can affect mosquito ecology and public health at higher latitudes.Fil: Grech, Marta Gladys. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Manzo, Luz Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Epele, Luis Beltran. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Laurito, Magdalena. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; ArgentinaFil: Claverie, Alfredo Ñancuche. Universidad Nacional de la Patagonia "San Juan Bosco"; ArgentinaFil: Ludueña Almeida, Francisco. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto de Investigaciones Biológicas y Tecnológicas; ArgentinaFil: Miserendino, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Almiron, Walter Ricardo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto de Investigaciones Biológicas y Tecnológicas; Argentin