Coeliac crisis with severe hypokalaemia in an adult

Coeliac crisis is a rare life-threatening presentation of coeliac disease, in which acute dramatic metabolic derangements are present. It is observed mainly in children less than two years of age. In adults, coeliac disease usually has an indolent course and presents with mild gastrointestinal symptoms or may even be asymptomatic and present with long term complications including anaemia, osteoporosis and infertility. This case describes a 38 year old gentleman who presented with acute diarrhoea that led rapidly to severe metabolic disturbances including life threatening hypokalaemia. This case illustrates the heterogeneous clinical course of coeliac disease and the importance of considering it in the differential diagnosis of adult patients presenting with acute diarrhoea and metabolic disturbances.peer-reviewe

N=2N=2 chiral WZNW model in superspace

We study the Poisson bracket algebra of the $N=2$ supersymmetric chiral WZNW model in superspace. It involves two classical r-matrices, one of which comes from the geometrical constraints implied by $N=2$ supersymmetry. The phase space itself consists of superfields satisfying constraints involving this r-matrix. An attempt is made to relax these constraints. The symmetries of the model are investigated.Comment: 21 page

Factors related to fatigue in systemic lupus erythematosus : a cohort cross-sectional study

Background Fatigue is the most prevalent symptom in Systemic Lupus Erythematosus (SLE) as it is present in up to 90% of patients; it is considered to be the most disabling symptom in around half of the patients [1,2]. Its aetiology is multi-factorial and there is conflicting evidence on the relationship between fatigue and SLE disease activity, and between fatigue and vitamin D deficiency. The Ad Hoc Committee on Systemic Lupus Erythematosus Response Criteria for Fatigue recommended the Fatigue Severity Scale (FSS) for the measurement of fatigue in SLE [2,3].peer-reviewe

Translation and validation of the Fatigue Severity Scale, Pittsburgh Sleep Quality Index and Modified Health Assessment Questionnaire into the Maltese language, in a cohort of Maltese Systemic Lupus Erythematosus patients

PURPOSE: The assessment of fatigue, sleep quality and functional disability requires the use of validated instruments such as the Fatigue Severity Scale (FSS), the Pittsburgh Sleep Quality Index (PSQI) and the Modified Health Assessment Questionnaire (mHAQ) respectively. The aim of this study was to translate and validate these instruments into the Maltese Language. METHOD: Forward translation from the original English version into Maltese was carried out by two translators. The two versions were compiled to produce a preliminary initial Maltese translation. This was translated back into English by two other translators. This led to the development of the pre-final version of the Maltese translation, which was pilot-tested in 20 bilingual patients with systemic lupus erythematosus. RESULTS: Psychometric testing revealed good reliability of the Maltese translation of the three questionnaires. Cronbach’s alpha of the Maltese versions of the FSS, PSQI and mHAQ were 0.877, 0.859 and 0.897 respectively, showing good internal consistency. Validity of the Maltese version of the FSS was shown, since it had a significant positive correlation with visual analogue scale for fatigue (r=0.809, p<0.001). CONCLUSION: The Maltese translations were thus finalised, and could be used for clinical assessment or research purposes.peer-reviewe

Financing urban transport through value capture.

The Green Paper on Urban Transport highlights the importance of promoting public transport as a means of achieving better sustainable mobility. Unfortunately, budget resources are often constrained. On the other hand, literature points out that transport infrastructure induce economic impacts in the areas where they are placed. This effect is caused by the fact that people realize the positive effects of accessibility and want to live or work close to transport stations. Regarding this fact a question arises. Is it possible to capture the value induced by the construction of a new infrastructure facility as an additional financial source? The aim of this paper is to analyze different direct and indirect mechanisms of value capture to fund transport infrastructure

Subordinated Public Participation Loans for Financing Motorway concessions in Spain.

Budgetary constraints are prompting many governments to encourage private financing of transportation infrastructure through concession contracts. The length and complexity of such contracts often force governments to provide fiscal support in order to increase the attractiveness of concessions. This paper deals with a new public support mechanism for concession contracts, called Subordinated Public Participation Loans (SPPLs), which has been implemented in Spain during the last few years. SPPLs are subordinated loans that may be given by the government to the concessionaire if the latter requests them in the tender. SPPLs are defined in such a way that the increase in interest accrued will reflect the traffic level: the larger the traffic the larger will be the SPPL yield. SPPLs have a twofold goal. First, they increase the financial attractiveness, and hence the feasibility, of concessions contracts. And second, they set up a fairer risksharing approach between the public and the private sector. This paper analyzes the implications of SPPLs in motorway concessions by contrasting the theoretical analysis with the empirical results obtained form the tender of five motorway concessions in Spain. Overall we found that the implementation of this mechanism may be considered a success. In spite of that, we propose some measures that may contribute to improving the SPPL performance in the future