Case number 1 : familial adenomatous polyposi

OC, a 17-year-old female, was referred due to a strong family history of Familial Adenomatous Polyposis. Multiple relatives (mother, two uncles, several cousins and others) have had Familial Adenomatous Polyposis and had undergone proctocolectomy to prevent the benign polyps from undergoing malignant transformation. The patient presented with no signs and symptoms. On colonoscopy, multiple polyps were found at 10 cm, 15 cm, 40 cm, 80 cm, 110 cm and even in the caecum. The patient subsequently underwent elective Restorative Proctocolectomy with an Ileal Pouch Reservoir. No defunctioning ileostomy was created but the patient was instead managed on TPN (Total Parenteral Nutrition) post-operatively for 2 weeks until a gastrografin small bowel study confirmed the integrity of the pouch and the anastomosis. The patient will be followed up by means of yearly pouchoscopy to exclude the possibility of malignant change at the Transitional Zone between the anal canal and the pouch.peer-reviewe

Clinicopathological conference

In October 1969, professor V.G. Griffiths inaugurated monthly clinicopathological conferences at St. Luke's Hospital Malta. Two of the case studies presented at the April 1970 meeting are hereby published. A guest participant was professor Linell, of the University Institute for Pathology, associated with the Almanna Sjukhuset of Malmo, Sweden, who was then visiting the medical school. The main focus of the subject of the conference is on tumours of the kidneys and ureters, whereby an interesting discussion about the cases in question is presented, outlining the respective detailed medical examinations and evaluations processes.peer-reviewe

A critical debate of the cultural and social effects of Valletta 2018 European Capital of Culture

The paper considers the hosting of the European Capital of Culture in Malta in 2018 in the light of the cultural and social effects on Malta’s capital city, Valletta. Governance and impacts on Malta’s tourism are also debated. The cultural sector was positively impacted with a varied and innovative programme. The expectations for Valletta 2018 was that the cultural scene in Malta would be taken to a much higher level. This did not happen largely because politicisation undermined the overall governance of the event. In the last two decades, ECoC was one of many projects and initiatives that brought about a process of Valletta’s regeneration. There are concerns, however, that excessive commercialisation has reduced liveability.peer-reviewe

Assessing the nonequilibrium thermodynamics in a quenched quantum many-body system via single projective measurements

The authors are indebted to T. S. Batalhao, J. Goold, R. Serra, and Peter Talkner for invaluable discussions.We analyze the nature of the statistics of the work done on or by a quantum many-body system brought out of equilibrium. We show that, for the sudden quench and for an initial state that commutes with the initial Hamiltonian, it is possible to retrieve the whole nonequilibrium thermodynamics via single projective measurements of observables. We highlight, in a physically clear way, the qualitative implications for the statistics of work coming from considering processes described by operators that either commute or do not commute with the unperturbed Hamiltonian of a given system. We consider a quantum many-body system and derive an expression that allows us to give a physical interpretation, for a thermal initial state, to all of the cumulants of the work in the case of quenched operators commuting with the unperturbed Hamiltonian. In the commuting case, the observables that we need to measure have an intuitive physical meaning. Conversely, in the noncommuting case, we show that, although it is possible to operate fully within the single-measurement framework irrespectively of the size of the quench, some difficulties are faced in providing a clear-cut physical interpretation to the cumulants. This circumstance makes the study of the physics of the system nontrivial and highlights the nonintuitive phenomenology of the emergence of thermodynamics from the fully quantum microscopic description. We illustrate our ideas with the example of the Ising model in a transverse field showing the interesting behavior of the high-order statistical moments of the work distribution for a generic thermal state and linking them to the critical nature of the model itself.This work has been supported by a PERFEST grant (L. F.) from Universita degli Studi di Palermo, the Marie Curie Action, the UK EPSRC (EP/G004579/1 and EP/ L005026/1), the John Templeton Foundation (Grant ID 43467), the EU Collaborative Project TherMiQ (Grant Agreement No. 618074), and by a Marie Curie Intra European Fellowship within the 7th European Community Framework Programme through the project NeQuFlux Grant No. 623085 (M. C.). T. J. G. A. is supported by the European Commission, the European Social Fund, and the Region Calabria through the program POR Calabria FSE 2007-2013-Asse IV Capitale Umano-Obiettivo Operativo M2. A. X. acknowledges funding from the Royal Commission for the Exhibition of 1851. Part of this work was supported by the COST Action MP1209 “Thermodynamics in the Quantum Regime.”peer-reviewe

Neuropathological correlates of falling in the CC75C population-based sample of the older old.

BACKGROUND: Previous imaging studies have suggested links between brain pathologies and factors that are associated with falls such as gait, balance and daily function. Possible neuropathological correlates of older people's falls have been suggested based on brain imaging studies, but to date none have been examined in brain tissue. METHODS: Falls data collected from repeated surveys of a population-based cohort of individuals aged at least 75 years old at baseline were related to neuropathological data collected from post-mortem examination of the study's associated brain donor collection (n=212). RESULTS: Amongst people without dementia, most cerebrovascular neuropathological features examined, particularly white matter pallor, microinfarcts and microscopic atherosclerosis, were increasingly common across the subgroups categorised by no reports of falling, only one or at least two reports of falling. The overall burden of pathology was greater in those with dementia, but only microinfarcts showed a similar increase with respect to reported falling status. CONCLUSIONS: Subclinical pathologies sharing a common vascular origin are associated with increased falling amongst people with no dementia, as are microinfarcts in those with dementia. Although further research is needed to address the mechanisms of falls and their neuropathological correlates, the findings from the current study would suggest that if cerebrovascular disease prevention reduces vascular neuropathology changes this may have direct benefits in reducing falls amongst older people with or without dementia

Neuropathological correlates of dementia in over-80-year-old brain donors from the population-based Cambridge city over-75s cohort (CC75C) study.

Key neuropathological changes associated with late-onset dementia are not fully understood. Population-based longitudinal studies offer an opportunity to step back and examine which pathological indices best link to clinical state. CC75C is a longitudinal study of the population aged 75 and over at baseline in Cambridge, UK. We report on the first 213 participants coming to autopsy with sufficient information for an end of life dementia diagnosis. Clinical diagnosis was ascertained by examining retrospective informant interviews, survey responses, and death certificates according to DSM-IV criteria. The neuropathological protocol was based on the Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Clinical dementia was present in 113 participants (53%): 67% with Alzheimer's disease, 4% vascular dementia, 22% mixed dementia, and 1% dementia with Lewy bodies. As Alzheimer-type pathology was common, the mutually blinded clinical and neuropathological diagnoses were not strongly related. Multivariable analysis identified associations between dementia during life and entorhinal cortex neuritic plaques, hippocampal diffuse plaques, neocortical neurofibrillary tangles, white matter pallor, Lewy bodies, and hippocampal atrophy. These results were consistent in those with clinical Alzheimer's disease. Vascular pathologies, especially microinfarcts, were more common in those with clinical diagnoses including vascular dementia. Alzheimer-type and cerebrovascular pathology are both common in the very old. A greater burden of these pathologies, Lewy bodies, and hippocampal atrophy, are associated with a higher risk of, but do not define, clinical dementia in old age

Lewy Body Variant of Alzheimer's Disease: Selective Neocortical Loss of t-SNARE Proteins and Loss of MAP2 and α-Synuclein in Medial Temporal Lobe

Lewy bodies (LBs) appear in the brains of nondemented individuals and also occur in a range of neurodegenerative disorders, such as dementia with Lewy bodies (DLB) and Parkinson's disease. A number of people with a definite diagnosis of Alzheimer's disease (AD) also exhibit these intraneuronal inclusions in allo- and/or neocortical areas. The latter, referred to as Lewy body variant of AD (LBV), bears a clinical resemblance to AD in terms of age at onset, duration of illness, cognitive impairment, and illness severity. Since the presence of LBs is accompanied by neuronal cytoskeleton changes, it is possible that the latter may influence neuronal connectivity via alterations to the synaptic network. To address this, we examined the expression of synaptic proteins (synaptophysin, syntaxin, SNAP-25, and α-synuclein) and two cytoskeletal proteins (tau and MAP2) in the brain tissue of subjects enrolled in a population-based autopsy study (n = 47). They were divided into groups with no memory problems (control group, n = 15), LBV (n = 5), AD devoid of LBs (n = 17), cerebrovascular dementia (n = 3), and mixed dementia (n = 7). The LBV and AD groups had a similar degree of cognitive impairment and neuropathological staging in terms of Braak staging and CERAD score. In comparison with the control group and the dementia groups without LBs, the LBV group had significantly lower levels of syntaxin and SNAP-25 (23%) in the neocortex, and depletion of MAP2 (64%), SNAP-25 (34%), and α-synuclein (44%) proteins in the medial temporal lobes. These findings suggest that the t-SNARE complex deficit present in LBV may be associated with the presence of LB-related pathology and may explain the more profound cholinergic loss seen in these patients

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

Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry

Background: The COVID-19 pandemic had a considerable impact on the provision of structural heart intervention worldwide. Our objectives were: 1) to assess the impact of the COVID-19 pandemic on transcatheter aortic valve replacement (TAVR) activity globally; and 2) to determine the differences in the impact according to geographic region and the demographic, development, and economic status of diverse international health care systems. Methods: We developed a multinational registry of global TAVR activity and invited individual TAVR sites to submit TAVR implant data before and during the COVID-19 pandemic. Specifically, the number of TAVR procedures performed monthly from January 2019 to December 2021 was collected. The adaptive measures to maintain TAVR activity by each site were recorded, as was a variety of indices relating to type of health care system and national economic indices. The primary subject of interest was the impact on TAVR activity during each of the pandemic waves (2020 and 2021) compared with the same period pre–COVID-19 (2019). Results: Data were received from 130 centers from 61 countries, with 14 subcontinents and 5 continents participating in the study. Overall, TAVR activity increased by 16.7% (2,337 procedures) between 2018 and 2019 (ie, before the pandemic), but between 2019 and 2020 (ie, first year of the pandemic), there was no significant growth (–0.1%; –10 procedures). In contrast, activity again increased by 18.9% (3,085 procedures) between 2020 and 2021 (ie, second year of the pandemic). During the first pandemic wave, there was a reduction of 18.9% (945 procedures) in TAVR activity among participating sites, while during the second and third waves, there was an increase of 6.7% (489 procedures) and 15.9% (1,042 procedures), respectively. Further analysis and results of this study are ongoing and will be available at the time of the congress. Conclusion: The COVID-19 pandemic initially led to a reduction in the number of patients undergoing TAVR worldwide, although health care systems subsequently adapted, and the number of TAVR recipients continued to grow in subsequent COVID-19 pandemic waves. Categories: STRUCTURAL: Valvular Disease: Aorti

Terrestrial Very-Long-Baseline Atom Interferometry:Workshop Summary

This document presents a summary of the 2023 Terrestrial Very-Long-Baseline Atom Interferometry Workshop hosted by CERN. The workshop brought together experts from around the world to discuss the exciting developments in large-scale atom interferometer (AI) prototypes and their potential for detecting ultralight dark matter and gravitational waves. The primary objective of the workshop was to lay the groundwork for an international TVLBAI proto-collaboration. This collaboration aims to unite researchers from different institutions to strategize and secure funding for terrestrial large-scale AI projects. The ultimate goal is to create a roadmap detailing the design and technology choices for one or more km-scale detectors, which will be operational in the mid-2030s. The key sections of this report present the physics case and technical challenges, together with a comprehensive overview of the discussions at the workshop together with the main conclusions