Article A Geological overview of the Maltese Archipelago with reference to the Area of Sliema Daniele Spatola, Jodie Agius1, Micole Miceli Abstract | View full article |
PDF Abstract: This study offers an overview and account of the geological and geographical characteristics of the Maltese islands, with a particular emphasis on the Sliema peninsula. The stratigraphic sequence of the geology on the islands, including the lithostratigraphy and sedimentary structure dating back to the Oligo-Miocene Epoch, is described starting from the oldest layer, the Lower Coralline Limestone, up to the most recent rock deposition in the newly discovered quaternary rock deposition. Additionally, the report delves into the general seismic activity on the island that has contributed to the unique geomorphology, hydrology, and hydrogeology that exist on Malta and Gozo. The interrelationship between these geological components is evident on the islands, particularly in the tectonic activity that has resulted in the formation of cliffs and bays throughout. After providing a general geological overview of the islands, the report focuses more specifically on the Sliema area, a town located in the east of the main island of Malta known for its numerous rocky beaches and heavy urbanization.
Article Clinical vaccine research in children in Malta David Pace Abstract | View full article |
PDF Abstract: Clinical vaccine trials in children are extremely important for the investigation of new vaccines as well as for studying different ways of scheduling vaccines that are currently in use. Data from such trials, in addition to epidemiological data on the infectious disease the vaccines are trying to prevent, can be used to introduce vaccines as well as to improve the current immunisation schedules. The purpose of this review is to showcase the clinical vaccine research on meningococcal C vaccines in children that was carried out in Malta in collaboration with the UK from 2010 to 2013, data from which have already been presented and published in peer reviewed journals. This review gives a synopsis of the immunogenicity of reduced dose meningococcal C vaccine schedules in infants as well as the immune kinetics of the antibodies induced following a booster dose at 12 months of age. The practicality of the study findings are discussed, including their relevance to the meningococcal vaccines that were recently introduced on the national immunisation schedule in Malta. Hopefully this research will encourage doctors to show interest in leading future research in children in Malta with appropriate support from our clinical and academic institutions.
Article Living in the era of multiple epidemics – A Malta perspective Sarah Cuschieri Abstract | View full article |
PDF Abstract: Non-communicable diseases (NCDs) have long been a global epidemic way before the onset of the COVID-19 pandemic. In 2016, it was estimated that 6.55% of the adult population in Malta suffered from at least one NCD, with type 2 diabetes, obesity and low back pain dominating the NCD scene. The onset of COVID-19 challenged the healthcare systems, as well as the wellbeing of the population. Restrictions instituted to control COVID-19 led to negative repercussions on those suffering from NCDs apart from bringing to the fore specific NCDs such as mental illness, obesity, and back pain. Furthermore COVID-19 increased the population burden through enhanced morbidity and mortality. However, the COVID-19 vaccination was observed to have helped dampen this burden. Yet, it is important that a syndemic approach is adopted to ensure that all epidemics are simultaneously given the appropriate attention and timely action is provided to safeguard the population health and wellbeing.
Article Research on Microgrids at the University of Malta Alexander Micallef Abstract | View full article |
PDF Abstract: This article presents some of the work done in recent years by the microgrids research team at the Department of Industrial Electrical Power Conversion (IEPC). Research activities are dedicated towards enabling secure, reliable, and carbon free electricity systems. To date, the main contributions by the department were made to the operation, control and management of microgrids in low voltage (LV) distribution networks, ship electrification (shipboard microgrids) and low voltage DC microgrids. The paper also presents a few of the significant results achieved by the department to date including a hierarchical control architecture for single phase microgrids, control algorithms of power electronic converters for AC and DC microgrids, energy and power management strategies, power quality improvement algorithms and technologies, demand response strategies and devices, and the effective integration of renewables and energy storage systems.
Article Quality education, social cohesion and active labour market policies: A comparative analysis of two European island states Camilleri Mark Anthony, Adriana Caterina Camilleri Abstract | View full article |
PDF Abstract: Societies benefit from the delivery of inclusive education, lifelong learning and from active labour market policies. Therefore, this research presents a critical review of the relevant literature. It features a comparative analysis on the latest socio-economic policies that are currently being implemented in the Mediterranean island states of Malta and Cyprus. The findings suggest that both countries need to attract more students to vocational and higher education in order to improve their employment prospects. The latest European reports indicate that their labour market policies are increasingly targeting vulnerable individuals, including women, single parents, older adults and migrant workers, among others, who are not in employment, education or training. In conclusion, this contribution implies that the pursuit of continuous improvements in quality education and social cohesion can create a virtuous cycle of productivity outcomes, including job creation and societal well-being.
Article Cannabinoids For Fibromyalgia: An Updated Systematic Review Jean Claude Scicluna, Giuseppe Di Giovanni Abstract | View full article |
PDF Abstract: Fibromyalgia is an increasingly prevalent condition resulting in high morbidity and economic burden for sufferers. Minimal to modest benefit has been achieved by pharmacotherapies, creating a strong rationale for novel therapies. Substantial evidence has implicated the endocannabinoid system in the modulation of fibromyalgia symptoms. However, the therapeutic potential and potential adverse effects of cannabis-based therapy in fibromyalgia are still under-reported, leading to clinicians’ hesitation to opt for such therapy. This systematic review examined the literature and provided a critical review of the safety and efficacy of cannabis-based therapy in fibromyalgia. It resulted that medical cannabis is a safe and effective treatment option for fibromyalgia, whilst further research in this area is needed.
Article Interferometric phase denoising and unwrapping: a literature review Gianluca Valentino, Johann Briffa, Reuben Farrugia, Asma Fejjari Abstract | View full article |
PDF Abstract: Interferometric SAR (InSAR) phase denoising and phase unwrapping are two key steps of the InSAR pipeline, leading to estimated deformation maps. The objective of this paper is to provide an overview of the recent literature in the field of InSAR phase denoising and unwrapping, and identify the most promising techniques, as well as benchmarks for performance comparison. Summaries of the performance metrics of the various methods are also provided. An example use case of InSAR techniques, including phase denoising and unwrapping, to estimate deformation following a volcanic eruption is provided.
Article AI and Games: The Remarkable Case of Malta Georgios N. Yannakakis Abstract | View full article |
PDF Abstract: We currently witness a technological revolution that is attributed primarily to artificial intelligence (AI) advancements. Even before this AI Spring, however, the plethora of machine learning, search and optimization breakthroughs have been made possible through the direct applications of AI algorithms in digital games. As AI advances, games also advance since AI can continuously test, improve, design and complexify the environments it is engaged in. This symbiotic relationship between AI and games is currently shaping the research frontier of AI and boosts the innovation potential of games across multiple domains.
This short paper has a dual purpose and corresponding parts. Throughout the first general part of the paper, I survey briefly the current state of the art in the AI and games field. Then I outline the critical role of games in AI research, the importance of AI for game development, and the impact their relationship has on current and future scientific breakthroughs. In the second specific part of this paper, I focus on the Institute of Digital Games of the University of Malta as a successful centre of excellence on AI and games research, education, and innovation. Specifically, I provide evidence suggesting that a national focus and targeted investment in AI and video game development has managed to place a small island country like Malta — in just under a decade — among the leading players of AI and games research, education and innovation globally.
Article Serum Prolactin Monitoring in Patients on Risperidone admitted to the acute wards at Mount Carmel Hospital Rachel Gambin, Sheriseane Diacono, Therese Ann Mizzi, Rachel Taylor East Abstract | View full article |
PDF Abstract: First-generation antipsychotics have been shown to increase prolactin levels in the body. Atypical antipsychotics have a lower tendency to produce hyperprolactinaemia due to a weaker and transient dopamine antagonistic effect. Despite being an atypical antipsychotic, Risperidone, tends to cause a higher increase in prolactin due to a stronger and more prolonged blockade on dopamine receptors.
The purpose of this audit is to assess current practices at Mount Carmel Hospital (MCH) with regards to serum prolactin monitoring in patients taking Risperidone when compared to Maudsley Prescribing Guidelines in Psychiatry, 14th Edition (2021). The audit was based on patients acutely admitted between June and December 2021. Focus was placed on prolactin levels checked during admission in patients previously on Risperidone, prolactin levels checked in the preceding six months if no prolactin level was checked during admission and the appropriate action taken in cases where the serum Prolactin was noted to be high.
From this audit it was concluded that there is inadequate monitoring of serum prolactin levels in patients prescribed Risperidone at MCH. Increased awareness of Risperidone-induced hyperprolactinemia and associated guidelines are required to improve clinical practice.
The recommendations suggested from this audit were to increase awareness of serum prolactin monitoring guidelines amongst all medical and nursing staff at MCH and to create a simple flow-chart outlining the appropriate serum prolactin monitoring guidelines and distribute this to MCH wards.
Article Assessing Current C-reactive Protein Sampling Practices within the Neonatal Intensive Care Unit for Neonates with Suspected Early Onset Sepsis Nadine Anne De Battista, Michelle Marie Boffa, Jamie Alexander Grech, Pharrah Debono Abstract | View full article |
PDF Abstract: Background C-reactive protein is synthesized in the liver as part of the acute phase response activated in reaction to acute injury. It has been well established that CRP levels can be used as an acute marker of inflammation making it a useful aid in the diagnosis and management of sepsis. However, its use within the immediate postnatal period presents unique challenges.
Aim This study aimed to elucidate and standardise CRP blood sampling intervals in neonates with suspected early onset sepsis, and to describe the relationship between CRP results and final blood culture results, with the aim of implementing NICE recommendations within the local setting.
Results 316 infants were included in the study. 26.2% of neonates had at least 1 positive CRP value (>10mg/dl) during the first 72 hours of life, with 12.7% resulting in a detectable bacterial growth on blood cultures. The largest percentage of positive CRP levels was obtained when blood was sampled within 18 to 24 hours post birth (30.3%). 40.7% of CRP samples were repeated between 24-48 hours of life. For 27.7% of neonates, a first positive CRP level of more than 10mg/dl was noted after 24 hours of life.
Conclusion The results show the importance of maintaining adequate timing intervals between serial CRP levels, which should be taken as a baseline on admission and then repeated not before 12 hours of age, to achieve optimal sensitivity. Our current sampling practice might lead to falsely reassuring negative CRP values, affecting outcomes in sepsis management.
Article Ranking of rural localities in Malta and Gozo according to their degree of exposure to traditional locally produced fare George Attard, Francesco Luca Alexander, Tony Meli Abstract | View full article |
PDF Abstract: Mediterranean fare originated from regional ethnic groups living in the region, and, other than from external cultural influences, the ingredients used mostly originated from local production. In evaluating the role of tradition in Maltese food culture, three factors, namely part-time farmers, kitchen gardens, and small livestock numbers, appear to have characterised food production within a Mediterranean island agricultural landscape that was dominated by small holdings. This study evaluates Malta's different rural localities, ranked according to evidenced agricultural activities in small farming holdings, which, by their self-sustenance, appear to have retained traditional Maltese rural features. This paper can serve as a guideline for selecting locations to evaluate production and consumption patterns of traditional Maltese food in rural areas.
Article Precision Medicine and Enrichment in Sepsis Brendon Scicluna Abstract | View full article |
PDF Abstract: Sepsis is defined as a dysregulated host response to infection leading to life-threatening organ dysfunction. While this recent iteration of the sepsis definition rightly centralizes organ dysfunction, it does not reflect on the extensive heterogeneity in the host response observed in sepsis patient populations. Heterogeneity in sepsis has hindered the identification of effective therapeutic targets, with current treatment consisting of antimicrobials and supportive care. In order to address the shortcomings in identifying specific therapeutics for sepsis, the focus of various research activities turned towards developing precision medicine approaches. In particular, efforts aimed at stratifying patients into more homogenous subgroups having common dominant pathophysiological features and outcome trajectories, in turn facilitating the delineation of specific therapies. Here, I review current initiatives in prognostic and predictive enrichment strategies in sepsis patient populations, which will be key to identify patients who would benefit, or be harmed, from specific therapeutic interventions.
Article Impacts of local and landscape habitat variables and honeybee visitation on wild bee diversity in the Maltese Islands Balzan Mario V , Leticia De Santis Abstract | View full article |
PDF Abstract: Bees are important pollinators in several ecosystems, and losses of bee diversity can impact on crop and wild plants pollination, and associated ecosystem services. Here, we explore how landscape and local habitat variables influence honeybee and wild bee functional group abundance and richness. Within the context of high hive densities in the Maltese Islands, we explore how high honeybee visitation impacts on wild bee functional richness and abundance using a dataset of plant-bee networks from 78 sites surveyed in spring 2019. Honeybees were strongly associated with agricultural habitats and used a wide range of floral resources that overlapped with those used by wild bees. While no significant impact of local habitat type on functional group richness was recorded, different functional groups were associated with different local habitat types, with agricultural, garden and roadside vegetation habitats being the most important habitats. We assessed the influence of landscape context on wild bees in two radii (250 and 500m). At these scales, the land cover that influenced wild bee abundance positively were arable, garrigue and grassland, orchard and urban, and the abundance of different bee groups was influenced differently by landscape parameters. High honeybee visitation rate had a negative impact on wild bee abundance but no significant impact on functional group richness was recorded in this study. These results are used to provide recommendations for habitat management for bee conservation, as we stress the need for a more holistic approach that considers the effect of local and landscape habitat characteristics, and interspecific interactions when planning measures for the conservation of bee diversity and pollination ecosystem services in the Maltese Islands.
Article Playing with Fire -- Perceptions against COVID 19 Vaccination Mary Anne Lauri, Maria Cordina, Maria Grech Abstract | View full article |
PDF Abstract: Living during a pandemic has a great impact on a person’s health and psychological functioning. While many took the vaccine, others were very skeptical about the intentions and motivations of political and health authorities and the safety of the vaccine. Vaccines may play a role in prevention of disease, however some are against vaccination. This paper will explore the reasons and arguments that people put forward to support their stance against vaccines and the COVID-19 vaccination. This will help in providing a deeper understanding of these participants’ points of view, along with their experiences during this challenging period in time. A mixed methods approach was used. Study one was a quantitative study using online survey methodology to determine the degree of vaccine hesitancy and associated reasons. The most frequently cited reason given for not taking the vaccine were about safety issues. Study two was qualitative and involved interviewing six participants recruited through purposive sampling. The transcripts were analysed by using Thematic Analysis. The three main emerging themes were reasons related to health, others to the socio-political context and the third was the perceived lack of scientific information on COVID-19 vaccine. The results concluded that the participants’ objections to take the COVID-19 vaccine emerged from personal health factors, and was manifested as a form of protest against authorities.
Article An earthquake swarm on the Malta Graben, Central Mediterranean, September – November 2020 Pauline Galea, Matthew Agius, Daniela Farrugia, Sebastiano D'Amico Abstract | View full article |
PDF Abstract: The seafloor of the Sicily Channel is characteristized by an extensional regime, governed by a network of normal and strike-slip fault systems. These faults generate a background level of seismicity that rarely exceeds magnitude 5.0. A number of these faults pass close to the Maltese islands. In particular the Malta graben lies less than 15 km to the south of Malta at its closest point, and the islands have been shaken a number of times by earthquakes originating on this, and other fault systems. In this study we describe the occurrence of a seismic sequence, that started in September 2020 and lasted for several weeks, the largest event having a local magnitude of 4.5 and being strongly felt throughout the archipelago. The sequence was located at a distance of around 23km south of the eastern tip of Malta. We have used single-station polarization analysis at seismic station WDD to estimate epicentral location for all events, down to magnitude 1.2. For the largest events, we have also used conventional network location, utilising phase picks at stations of the Malta Seismic Network and in Southern Sicily. We describe the time evolution of the sequence, felt effects, the public response and the implications for seismic hazard.
Article Immature High Grade Teratoma in A 17-Year-Old Lady - a case report John Thake, Christine Zerafa, Sheriseane Diacono Abstract | View full article |
PDF Abstract: Introduction
Immature teratomas are uncommon, malignant ovarian neoplasms that make up less than 1% of ovarian germ cell tumours. Immature teratomas are often larger and occur in younger women (in the first three decades of life).
A 17-year-old lady was admitted to the emergency department in view of dyspnea, severe abdominal pain, abdominal distension and loss of appetite. On CTPA she had a large pelvic mass, and was referred to gynaecology. She underwent an elective right salpingo oophorectomy and cystectomy. Histology report indicated ovarian immature teratoma (high grade, grade 3) showing extensive neuroectodermal differentiation.
The incidence of immature teratoma is highest in young adults. Most patients present with early-stage disease, are managed with fertility sparing surgery and chemotherapy with an excellent prognosis. Diagnosis requires a combination of clinical, radiological and laboratory findings.
Article The 2022 COPCA Conference in Valletta Duncan Mifsud, Rebekah Attard-Trevisan, Nigel Mason View full article |