Small European states in the hybrid warfare era : the cases of Cyprus, Malta, and Estonia

The increasing number and complexity of hybrid threat activities forces small states, especially those with limited access to material resources, to reassess their foreign and defence policies. While the variable of ‘smallness’ may be sufficient to justify their overall engagement in dealing with conventional security threats, in the hybrid arena this is not the case. Pressure is amplified in establishing or maintaining a status of a reliable mediator, partner, and strategic communicator vis-à-vis their multilateral relations with other states or organisations to which they belong. This paper focuses on how small European states, with specific reference to Cyprus, Malta, and Estonia, need to develop adjustable yet resilient policies in accommodating security needs vis-à-vis hybrid threats, that are not only pertinent to their security, but also to that of the EU bloc. As the line between war and peace becomes more blurred due to hybrid threats, the small states’ security shortcomings may also become a security problem for the EU bloc. We argue that the nature of hybrid threats is such that hybrid activities can be utilised to hurt bigger states in a bloc by exploiting the small states’ vulnerabilities. Both the defensive and foreign policy collaborations of small states with bigger states have been, and are constantly being, re-evaluated to tackle and prevent such problems. As such, two objectives are identified in this approach. The first is the small states’ quest to appear as reliable partners within the bloc. The second is to avoid being the weakest security link in the bloc’s defence against hybrid threats. This unfamiliar environment for small states prompts us to rethink security from their perspective against complex and hybrid threats, and in relation to their security role as members of large organisations such as the EU.peer-reviewe

Rhodotorula mucilaginosa associacted meningitis: A subacute entity with high mortality. Case report and review

A fatal case of meningitis due to Rhodotorula mucilaginosa in a 28 year-old HIV-negative male with a history of Hodgkin lymphoma who underwent salvage chemotherapy is presented. Reviewing the literature we identified 13 cases with central nervous system infection due Rhodotorula spp. The disease usually occurs in HIV negative immunosupressed middle-aged males. It takes the form of subacute or chronic meningitis accompanied by fever with an overall mortality of 46.2% despite antifungal therapy

Human Papillomavirus (HPV) Detection Using In Situ Hybridization in Histologic Samples Correlations With Cytologic Changes and Polymerase Chain Reaction HPV Detection

Although in situ hybridization (ISH) and polymerase chain reaction (PCR) have extensively been used on cytology specimens, there have been limited reports of the usefulness of these techniques in relation to confirmed histologic findings. In this study, we used PCR and ISH to detect human papillomavirus (HPV) in cytologic and histologic specimens, respectively. By using positive and negative likelihood ratios, we attempted to identify any predictive role of ISH testing alone or in combination with PCR for the development of high-grade histologic lesions (cervical intraepithelial neoplasia [CIN] 2+). In our study, ISH was a useful method for detection of HP V. even in a large fraction of samples with normal cytologic or biopsy findings. We suggest that when used together and evaluated in conjunction with histologic sections, ISH is a useful tool for ancillary molecular testing of HPV infection in cervical lesions, especially in CIN 2+ histological lesions where its analytic sensitivities and specificities were as good as those of PCR testing

Extensive testing and public health interventions for the control of covid-19 in the republic of cyprus between march and may 2020

Coronavirus disease 2019 (COVID-19) has significantly affected the well-being of individuals worldwide. We herein describe the epidemiology of COVID-19 in the Republic of Cyprus during the first epidemic wave (9 March–3 May 2020). We analyzed surveillance data from laboratory-confirmed cases, including targeted testing and population screening. Statistical analyses included logistic regression. During the surveillance period, 64,136 tests (7322.3 per 100,000) were performed, 873 COVID-19 cases were diagnosed, and 20 deaths were reported (2.3%). Health-care workers (HCWs) represented 21.4% of cases. Overall, 19.1% of cases received hospital care and 3.7% required admission to Intensive Care Units. Male sex (adjusted Odds Ratio (aOR): 3.04; 95% Confidence Interval (CI): 1.97–4.69), increasing age (aOR: 1.56; 95%CI: 1.36–1.79), symptoms at diagnosis (aOR: 6.05; 95%CI: 3.18–11.50), and underlying health conditions (aOR: 2.08; 95%CI: 1.31–3.31) were associated with hospitalization. For recovered cases, the median time from first to last second negative test was 21 days. Overall, 119 primary cases reported 616 close contacts, yielding a pooled secondary attack rate of 12% (95%CI: 9.6–14.8%). Three population-based screening projects, and two projects targeting employees and HCWs, involving 25,496 people, revealed 60 positive individuals (0.2%). Early implementation of interventions with targeted and expanded testing facilitated prompt outbreak control on the island