Hilar Cholangiocarcinoma - Klatskin’s Tumour : review of the literature and report of first successfully resected case in Malta

Hepatic duct confluence sclerosing cholangiocarcinoma (Klatskin’s Tumour) is described as a small tumour in an inaccessible position, high up in the hilum of the liver. In the past the position of the tumour made it difficult to diagnose at operation, but nowadays with intelligent use of ultrasonography, percutaneous transhepatic cholangiography and digital subtraction angiography, pre-operative identification and localisation of this tumour is possible in a high percentage of cases. In this article the first case successfully treated by curative resection in Malta is presented after reviewing in detail the present international state of surgery for these tumours.peer-reviewe

Hand and wrist configurations in patients with Carpal Tunnel Syndrome

The association between hand and wrist configurations was investigated in this study. The hand and wrist dimensions of sixty patients with carpal tunnel syndrome and sixty healthy control subjects were measured using specific anatomical landmarks. The palm width was significantly greater in the patient group. There was no significant difference in the hand length between the two groups. Both the wrist width and wrist depth were significantly greater in the patient group. The hand ratio and the wrist ratio were significantly smaller in the patient group indicating that the latter had squarer hands and wrists than the control group respectively. This suggests that the anatomy of the hand and wrist may predispose to carpal tunnel syndrome.peer-reviewe

Model of limestone weathering and damage in masonry : sedimentological and geotechnical controls in the Globigerina limestone formation (Miocene) of Malta

Five types and subtypes of stone used in construction in the Maltese Islands and three problematic stone types, mostly extracted from facies within the Oligo-Miocene Valletta Basin, are identified. Their nature and geotechnical behaviour is discussed in the context of specific use in masonry. These stone types represent end members of the variations in depositional and diagenetic environments in carbonates which control their level of physical heterogeneity, and ultimately affect the nature of damage seen in Globigerina limestone masonry. A model is presented linking the level of heterogeneity to the mode of salt weathering seen especially in ancient constructions.peer-reviewe

Syntectonic deposition of an oligo-miocene phosphorite conglomerate bed in Malta

A succession of Oligo-Miocene sediments at Sliema, Qawra and Migra Ferha includes a 1O-20cm phosphorite conglomerate bed capping the terminal hardground of the Lower Coralline Limestone Formation (Oligocene) which consists of carbonate platform sediments. The conglomerate bed always occurs in areas of significant thinning of the overlying Lower Globigerina Limestone. These palaeohighs have been linked to NNE-SSW trending lineaments. At Sliema, allochthonous phosphatised conglomerate infill NW-SE trending Neptunian dykes that dissect the platform sediments. These Oligo-Miocene syntectonic deposits were later cemented and vertically displaced by minor faulting trending NW-SE. Tectonic features at Sliema are linked to the regional N-S extensional regime and tentatively interpreted to have developed from stresses caused by displacement along the western margin of a NNE-SSW trending strike-slip fault. East of this fault, synclinal subsidence created the Valletta Basin and set conditions for current upwelling. Phosphatogenesis occurred along the basin margin swept by the prevailing westward currents. Phosphatised pebbles and ahermatypic corals were transported westward of palaeohigh margins in central and western Malta and deposited on the terminal hardground of the drowned Oligocene carbonate platform.peer-reviewe

CARBONATE FACIES, DEPOSITIONAL SEQUENCES AND TECTONOSTRATIGRAPHY OF THE PALAEOGENE MALTA PLATFORM

The break-up of Pangaea and the Late Mesozoic global sea-level rise drowned many Tethyan carbonate platforms although the resilient Malta Platform aggraded >4 km of carbonates along the North African passive margin where it was isolated from continental siliciclastics. Carbonate sedimentation was terminated by extensive Late Cretaceous to Early Paleogene depositional hiatuses, but renewed during the Oligocene, when basinward carbonate progradation began to drape over the >350 km long, cusp-shaped escarpment along the eastern margin of the isolated platform. This study sub-divides the Oligocene sediments of Malta into eight facies associations. The facies consist of carbonate grains of coral, coralline red algae and large benthic foraminifera which dominated sediments of the Late Rupelian to early Chattian, mid-Chattian and late Chattian, respectively. These successive carbonate factories produced the photozoan-heterozoan-photozoan triplet of carbonate grain associations which, when dated by benthic foraminiferal biozonation, correlates to the succession of carbonate grain associations in other Mediterranean carbonate platforms. The sedimentary triplet reflects abrupt changes in carbonate ecosystems that coincide with the last three of six surfaces that extend >80 km around Malta. The surfaces show evidence of the influence of meteoric water and pedogenic processes recognised by diagenetic features and isotopic excursions. These sequence boundaries sub-divide the succession into seven depositional sequences that reflect global third-order cyclic sea-level falls produced by glaciations with a periodicity of 1.2 Ma triggered by low-amplitude obliquity variations of the Earth’s axis combined with orbital eccentricity cycles. The periodic growth of the Antarctic ice-sheet during the Oligocene also affected Tethyan climate by shifting low latitude climate belts northwards. It is suggested that increased aridity over North Africa had reduced nutrient flux to the Tethys and favoured photozoan carbonate biota over the Malta Platform and other Tethyan carbonate platforms. The stepwise decrease in oxygen isotope ratio by the mid-Chattian reflects Antarctic deglaciation that increased both precipitation over North Africa and nutrient flux in the Tethys, favouring heterozoan ecosystems. The mid-Chattian transgressive heterozoan carbonates draped over structured bathymetry of an antecedent extensional regime that produced rotated fault-blocks. Highstand shedding of coralline red algae resulted in large clinoforms prograding into partly filled NNE trending half-graben (50 km-wide basin by lithospheric sagging over a failed Mesozoic rift. The late Chattian climatic optimum was reflected by a further decrease in the oxygen isotope ratio and aridity over North Africa and favoured a return to the photozoan association during the last phase of the Oligocene sedimentary triplet. Lepidocyclinids flourished in inner to mid-platform environments forming banks although the rate of accumulation of these hydrodynamic foraminifera did not keep up with sea-level rise. The shift to increased trophic resources by the end Oligocene terminated shallow marine carbonate sedimentation which resulted in the drowning of the Malta Platform

'What a Coronacoaster!' Navigating primary science education in primary schools during the ongoing COVID-19 pandemic: EYFS and primary school teacher perspectives on the affective and pedagogical impacts of the pandemic

This edition of JES was prepared in the midst of the COVID-19 pandemic, and includes a number of papers produced before the crisis. However, it also features two articles written about the response to the pandemic, one by Amanda McCrory on the impact on EYFS and primary science provision, and a second article, by Susan Marks, about the contributions made by scientific enquiry and school leadership to a whole school culture of good wellbeing. Other topics covered in this issue include a new resource for primary teachers using Defra's Air Quality Archive, an examination of creativity in Irish primary schools, and making environmental studies engaging for the primary sector