Maltese bats show phylogeographic affiliation with North-Africa : implications for conservation

In the Mediterranean region, cryptic diversity of bats is common. As distinct genetic lineages should be managed independently for conservation, insight into bat phylogeography is important. The Maltese islands are located in the centre of the Mediterranean between North Africa and Sicily and are densely populated. At present, it is thought that at least seven species of bats are native, but phylogeographic affiliations remain largely unexplored. Therefore, we sequenced a ca. 540 bp fragment of the mitochondrial 16S rRNA gene from 23 bats, which were captured during the citizen-science project Akustika. We found two morphologically cryptic lineages common in North Africa, Plecotus gaisleri and a mainly North-African lineage of Hypsugo savii (named Hypsugo cf. darwinii in some recent studies). We also recorded two Pipistrellus species. The P. kuhlii haplotype belonged to a lineage present in North-Africa and across the Mediterranean. Within P. pipistrellus we found two novel haplotypes that clustered within a North-African clade, well distinguished from the European haplotypes. Our results highlight the historic connection between the bat fauna of the Maltese Islands and North Africa. Malta is one of the few regions in the European Union where P. gaisleri and the North-African clades of P. pipistrellus and H. savii occur. Hence, Malta has an exceptionally high responsibility for the conservation of these taxa in Europe

Pediatric tuberculosis in Italian children: Epidemiological and clinical data from the Italian register of pediatric tuberculosis

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries

Mapping Diversity in Milan - Historical Approaches to Urban Immigration

An historical and spatial approach is crucial to the understanding of any city. Waves of immigration and population movements from different sources have constructed the cultural mix of this financial, industrial and market city over time. To focus just on the new foreign immigration into Milan over the last 25 years or so risks omitting the deep historical fissures created by previous (and bigger) waves of population movements the traces left by these populations in the urban fabric and their role in subjective experience. Moreover, the historical and spatial comparison of various types and moments of population movement can help us to understand the changes to this city at macro and micro-levels. This paper uses a mixture of approaches in order to understand and map diversity in Milan, its province and its region. It is intended as a discussion paper to be looked at in conjunction with the work and arguments laid out in other research projects and published work. Methodologies used in this paper range from straightforward historical research (using documents and archives) to photography, micro-history (the examination of one small area in this case one housing block) and oral historical interviews

Valleys : discovering Malta & Gozo's watercourses their value to society

Contents : 1/ Introduction -- 2/ LANFRANCO, S. & BELLIA, A. F. - Hotspot of vegetation diversity in the Maltese Islands -- 3/ FENECH, N. - The importance of Malta's valleys for birds -- 4/ BUHAGIAR, K. - Transformation of the cultural landscape in the valleys of northern Malta -- 5/ FELIX, I & PORTELLI, E. - Mapping valleys for sustainable planning and management -- 6/ DEIDUN, A., SCIBBERRAS, A. & SCIBERRAS, J. - The challenge of non-indigenous species -- 7/ GAMBIN, B. & PATISSIER, R. - Influence of environmental conditions on the Great Reed invasion -- 8/ CALLEJA, E., SAPIANO, M. & CUTAJAR, A. - Strengthening the climate resilience of Wied il-Fiddien through ecological restoration -- 9/ VELLA, S. - Rehabilitation and regeneration of Wied Għajn Żejtuna -- 10/ GlossaryAn interconnected labyrinth of valleys, referred to locally as ‘widien’, meander their way through the Maltese Islands. They vary from broad, gently sloping formations, born out of tectonic movements, to narrow, deep, and steep-sided ravines that largely result from erosion. The widien are essentially seasonal watercourses, fed by runoff during the wet season and lying dry for most of the summer. There are a few exceptions, such as Wied il-Baħrija, where spring-flow supports a trickle of freshwater all year round. These valleys provide a home for different species of fauna and communities of vegetation that are found only within watercourses and their immediate vicinity. These plant communities are known as riparian flora. There are two major types of riparian flora: hydrophytes, which are species that need to be fully or partially submerged in water, and non-submerged littoral flora, which grow mainly on the banks of the watercourses. Maltese valleys also host a number of other specialist plant species, such as those that thrive in rocky environments. Throughout history, water in valley beds has attracted human settlement and agricultural activity. Malta’s valleys have long been used as a source of irrigation and drinking water, as well as convenient waste disposal sites. Other common uses include transport routes, grazing and recreation. The publication of this book, co-financed through the LIFE IP Project Optimising the Implementation of the 2nd RBMP in the Malta River Basin District (LIFE 16 IPE MT 008)1, is intended to guide the reader to discover the Maltese islands’ watercourses and their value and contribution to society. The information provided is not only to create awareness of the rich diversity of flora and fauna but also on their vulnerability, and will hopefully raise awareness to reverse negative trends. Only through education and awareness to the greater public in hand with the authorities could such gems be preserved for future generations to enjoy.peer-reviewe

The second generation of HIV-1 vertically exposed infants: A case series from the Italian Register for paediatric HIV infection

Background: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.Methods: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.Results: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450 mu L (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 -3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection.Conclusions: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants

Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Background: Data on the efficacy of Peg-interferon/ribavirin therapy for chronic hepatitis C are mostly derived from treatment of selected patients enrolled in clinical trials. This study aimed to assess the effectiveness of Peg-interferon/ribavirin therapy in "real world" chronic hepatitis C patients in Italy. Methods: Independent observational multicentre study including consecutive patients receiving Peg-interferon/ribavirin in the 18 months before (retrospective phase) and after (prospective phase) the start of the study. Results: 4176 patients were eligible. The final study population consisted of 2051 patients in the retrospective and 2073 in the prospective phase.Sustained virological response was achieved by 1036 patients (50.5%) during the retrospective phase: 325 were genotypes 1/4 (34.1%) and 684 were genotypes 2/3 (67.2%) and by 800 patients (38.6%) during the prospective phase: 300 were genotypes 1/4 (28.4%) and 473 were genotypes 2/3 (51.5%).During multivariate analysis genotypes 2/3 were significantly associated with higher sustained virological response rates; cirrhosis and γ-glutamil-transpeptidase >2 times the normal limit were associated with poorer response. Conclusions: The response to Peg-interferon/ribavirin therapy in "real world" clinical practice is distinctly lower than in registration trials. The difference in response rates was more pronounced among easy-to-treat than among difficult-to-treat hepatitis C virus genotypes. © 2014 Editrice Gastroenterologica Italiana S.r.l

Children living with HIV in Europe: do migrants have worse treatment outcomes?

International audienceTo assess the effect of migrant status on treatment outcomes among children living with HIV in Europe