Endoscopic bronchial ultrasound in mediastinal staging of lung cancer

Lung cancer is a global healthcare concern with a low 5-year survival rate and a high proportion of advanced-stage cases at diagnosis. In the absence of distant metastasis, the most important prognostic marker is mediastinal lymph node involvement. Timely diagnosis and staging improves prognosis, making rapid, safe, and accurate investigation essential. Endoscopic bronchial ultrasound (EBUS) is a minimally invasive technique which allows for ultrasound-guided transbronchial needle aspiration (TBNA) during bronchoscopy, with cytological sampling of several intrathoracic groups of lymph nodes. EBUS reduces need for open surgical biopsy, with good sensitivity and specificity and excellent safety profile. This article reviews current evidence regarding use of EBUS in lung cancer staging, including its role in other intrathoracic malignancies.eviews current evidence regarding use of EBUS in lung cancer staging, including its role in other intrathoracic malignancies.peer-reviewe

Bioresorbable vascular scaffolds : the way forward?

With the sheer breadth of emerging evidence in the field, cardiology is remarkable in its ability to evolve and grow. The Malta Cardiac Society Conference in October 2015 discussed many advances in the specialty, but especially exciting was the announcement of the introduction of bioresorbable vascular scaffolds during percutaneous coronary interventions (PCI) carried out in Malta.peer-reviewe

Subtyping somatic tinnitus: a cross-sectional UK cohort study of demographic, clinical and audiological characteristics

Somatic tinnitus is the ability to modulate the psychoacoustic features of tinnitus by somatic manoeuvres. The condition is still not fully understood and further identification of this subtype is essential, particularly for the purpose of establishing protocols for both its diagnosis and treatment. This study aimed to investigate the characteristics of somatic tinnitus within a large UK cohort using a largely unselected sample. We believe this to be relatively unique in comparison to current literature on the topic. This was investigated by using a total of 608 participant assessments from a set of recognised tinnitus and audiology measures. Results from a set of chi-square tests of association found that amongst the individuals with somatic tinnitus, a higher proportion had pulsatile tinnitus (different from heartbeat), were under the age of 40, reported variation in the loudness of their tinnitus and reported temporomandibular joint (TMJ) disorder. The same pattern of results was confirmed using a multivariate analysis of the data based on logistic regression. These findings have strong implications towards the profiling of somatic tinnitus as a distinct subtype of general tinnitus

The corporate governance code and compliance by Maltese listed companies

Purpose: In this paper we lay out the evaluation of non-compliance with the Code of Principles of Good Corporate Governance and the analyses of the adequacy of the explanations provided thereof, including the overall effectiveness of the existing regulatory framework. Design/methodology/approach: To achieve the objectives of this study, a review of the non-compliance section of the corporate governance statements of each Maltese listed company was carried out for the years 2012, 2014 and 2016. Furthermore, 13 semi-structured interviews were held. Findings: The paper finds that a general insufficiency in the explanations provided for non-compliance exists. Some entities give only lip service to the provisions of the Code as they fail to realise the benefits an entity may reap from having good corporate governance structures in place. There is a lack of education and awareness in this regard, and not only on the part of companies but also on the part of shareholders who seem to make minimal use of the information provided in the corporate governance statements. Practical implications: The study raises awareness of the need of improving corporate governance practices, as well as education on corporate governance, across Maltese listed companies. It is hoped that the recommendations made may encourage entities to improve in their reporting and the regulator to provide further guidance to entities to do so. Originality/value: Prior to the amendment of existing rules, increased enforcement of the current regulatory framework and monitoring by the regulator is required. The study highlights the misconceptions on the auditor's role in corporate governance.peer-reviewe

Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is a heart disease that enlarges the heart muscle and reduces its function, leading to heart failure, arrhythmia, and sudden cardiac death. The causes of DCM are not always clear, but may include genetic mutations, viral infections, alcohol abuse, and certain medications. Common symptoms include shortness of breath, fatigue, swelling, and irregular heartbeats. Diagnosis involves physical exams, ECGs, echocardiograms, and additional tests to identify underlying causes. Treatment includes medication, such as ACE inhibitors and beta blockers, to improve heart function, diuretics to reduce fluid buildup, and anticoagulants to prevent blood clots. Surgery or implantable devices, like pacemakers or defibrillators, may be necessary. Early diagnosis and treatment are crucial for managing DCM, and many individuals with DCM can lead full and active lives with proper treatment and lifestyle changes.peer-reviewe

Sex-selective abortions and infant mortality in India: the role of parents’ stated son preference

In India, millions of female foetuses have been aborted since the 1980s alongside an abnormally high infant girl mortality rate; this has generated a vast literature exploring the root causes of son preference. The literature is sparse, however, on how the decisions to abort or neglect girls are made. This paper examines mothers’ and fathers’ respective roles behind those decisions. Using NFHS-3 data, we show that sex- selective abortions are most commonly used if both spouses or if only the fathers prefer sons, while sex-selective neglect is used if only the mothers prefer sons

The impact of patient and public involvement in the SlowMo study: reflections on peer innovation

Background The SlowMo study demonstrated the effects of SlowMo, an eight-session digitally supported reasoning intervention, on paranoia in a large-scale randomized-controlled trial with 362 participants with schizophrenia-spectrum psychosis. Aim The current evaluation aimed to investigate the impact of Patient and Public Involvement (PPI) in the SlowMo study. Method PPI members were six women and three men from Sussex, Oxford and London with experience of using mental health services for psychosis. They received training and met at least 3-monthly throughout the project. The impact of PPI was captured quantitatively and qualitatively through (i) a PPI log of recommendations and implementation; (ii) written subjective experiences of PPI members; (iii) meeting minutes; and (iv) outputs produced. Results The PPI log revealed 107 recommendations arising from PPI meetings, of which 87 (81%) were implemented. Implementation was greater for recruitment-, data collection- and organization-related actions than for dissemination and emergent innovations. Qualitative feedback revealed impacts on study recruitment, data collection, PPI participants' confidence, knowledge, career aspirations and society more widely. Outputs produced included a film about psychosis that aired on BBC primetime television, novel webpages and journal articles. Barriers to PPI impact included geography, travel, funding, co-ordination and well-being. Discussion A future challenge for PPI impact will be the extent to which peer innovation (innovative PPI-led ideas) can be supported within research study delivery. Patient and Public Contribution Planned Patient and Public Contribution in SlowMo comprised consultation and collaboration in (i) design, (ii) recruitment, (iii) qualitative interviews and analysis of service users' experiences of SlowMo therapy and (iv) dissemination