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Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention. Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.

This commentary addresses issues related to the scarcity of water in the Maltese Islands and its main causes. Some basic metrics related to the abstraction of freshwater, contamination of groundwater by nitrate and the limitations and challenges of the water sources in the Maltese Islands are highlighted. Hereafter, the relation between water scarcity, rainfall and population density, as well as the resultant effects on the sustainability of the freshwater sources of the Maltese Islands are presented. The current focus is on the production of good quality water based on a number of Reverse Osmosis (RO) plants that are found around the Maltese Islands. The significant energy requirements of this technology are compared with those for groundwater and wastewater treatment production. Current practices in the Maltese Islands regarding the treatment and use of sewage effluent by Sewage Treatment Plants (STPs) are described. The use of treated sewage effluent as an alternative source of water to RO water and of groundwater for second class uses is discussed. This paper concludes that the technology needed to employ treated effluents for unrestricted agricultural use and also for aquifer recharge is now in existence., peer-reviewed

Allozyme electrophoresis was carried out over 7 loci that were selected from a maximum of fourteen enzymes. These 7 loci showed an average polymorphism, over the entire population, of 23%. Genetic index and distance showed that a genetic variation is present in the sub-populations surveyed, with a significant difference within the sub-populations of Delimara and Anchor Bay. 54% of the specimens sampled show that they are coming from the same population. Another 12%, mainly specimens collected from Anchor Bay, show that they are genetically different. In both these sites, different sub-populations may have been in contact with different environmental conditions allowing for changes to occur. Differences in allelic frequencies between Holothuria polii from different sites were also detected., peer-reviewed

Randomly amplified polymorphic DNA (RAPD) analysis was used to assess the genetic variation of the sea cucumber Holothuria polii population. A total of 33 loci were chosen from the 7 primers used. The study revealed that there is divergence between sub-populations found on the east coast and the west coast of Malta, especially at the Anchor Bay site (I = 0.7; D = 0.3). On the other hand, Delimara’s sub-population showed a high homozygozity and less effective alleles (H = 0.214, N = 1.295), possibly due to a decline in numbers, as a result to new selection pressures. The UPGMA dendrogram obtained of the entire Maltese population shows that H. polii is sub-divided into two distinct populations, the north-westerly sub-populations and the south-eastern sub-populations., peer-reviewed

Miniaturisation of parts is emerging as an important approach to satisfy modern industrial and customer needs. Micro milling is one of the basic micromachining technologies used toproduce miniaturised components. It differs from conventional machining in that the handling and machining of very small features generates various problems. As a consequence, designers need to consider such problems during design to make micromilling more feasible. More emphasis thus needs to be placed on deriving design know-how from the other product life-phases. This paper reports the work undertaken by the Department of Manufacturing within the University of Malta to generate a set of Design for Micromilling (DFμM) guidelines that can contribute to the development to intelligent CAD for this domain., peer-reviewed

The association of liver damage and Halothane, a divisive issue hotly debated in the '60's and 70's, is now an accepted finding following the accumulation of clinical and experimental evidence. However Halothane is too often blamed when a clinician is confronted with a patient with unexplained jaundice after anaesthesia. This prejudiced attitude has been inherited from the days of (Qhloroform anaesthesia. It is an understandable human weakness to try and find a scape goat for whatever goes wrong - in this case an idiosyncratic reaction to an otherwise safe drug., non peer-reviewed

A survey of the attitudes of Maltese medical students to anaesthesia, their experiences during their anaesthetic training and their current tentative choice as regards post graduate work is compared to past surveys in Malta, in 3rd. World and in developed countries., non peer-reviewed

T en critically-ill patients with prolonged hypotension or unrecordable systolic blood-pressure, impaired mental status and respiratory depression (n this study. Naloxone, 0.8 - 1.2 mg was injected intravenously in all patients. in six hypotensive patients, systolic blood-pressure rose in range of 26-35%, within 5-15 minutes following the naloxone injection. lnfour patients systolic blood-pressure was unrecordable .and after naloxone injection rose to a value of 100-120 mm Hg. Naloxone was effective in three patients in which dopamine could not maintain the systolic blood-pressure at optimal renal perfusion level. lt seems that naloxone had a lesser effect in three patients treated with high doses of corticosteroids. The therapeutic effect of naloxone is suggested on the assumption that endorphins are mainly responsible for the hypotension and respiratory depression in critically-ill patients., non peer-reviewed

In 1965 Chen et al. and McCarthy et al. first reported on a new drug Ketamine which had been developed at PARKE-DAVIS laboratories in the USA. Domino, Chodoff and Corssen introduced the drug into clinical practice in 1965 at Ann Arbor. The possibilities of Ketamine were further explored in a symposium in 1968. Commercial launching took place in the USA in 1970. Ketamine was developed from phencyclidine (now marketed as Sernyl for veterenary practice), cyclohexamine and two other experimental compounds, which had been under study since the late 50's. Ketamine is the first parenteral agent for clinical use with a potent analgesic as well as a hypnotic effect. In 1966 Corssen described its effects as "dissociative anaesthesia" characterised by intense analgesia, light sleep, amnesia and hypertonus, which in many ways resembled the effects of neuroleptic drugs., non peer-reviewed