OAR@UM Collection:

Measuring the population attributable fraction and the potential impact fraction of dementia risk factors in Malta : a population based secondary data analysis

2026-01-15T14:55:54Z

Title: Measuring the population attributable fraction and the potential impact fraction of dementia risk factors in Malta : a population based secondary data analysis Authors: Scerri, Anthony; Scerri, Charles Abstract: Background: The 2024 Lancet Commission report estimated that up to 45% of global dementia cases could be prevented by addressing modifiable risk factors. However, these estimates are based on international data and may not reflect national differences in risk factor prevalence or intervention feasibility. This study uses a population-based secondary data analysis to estimate both the population attributable fraction (PAF) and the potential impact fraction (PIF) for 14 dementia risk factors specific to the Maltese population.; Design and methods: Secondary data were used to estimate the prevalence of each risk factor from Maltese peer-reviewed studies or reputable international datasets where national data were unavailable. Unweighted PAFs were calculated using Levin’s formula and adjusted for overlap between risk factors. PIFs were derived by applying evidence-based relative risk reductions from published intervention studies for each weighted PAF, representing more realistic outcomes of targeted interventions.; Results: The weighted PAF for Malta was 40.47%, indicating the theoretical maximum proportion of preventable dementia cases if all risk factors were eliminated. The total PIF was 33.82%, reflecting the estimated reduction in dementia incidence if feasible interventions were implemented. The risk factors contributing most to preventable cases were high LDL cholesterol (6.15%), loneliness (4.29%), and untreated vision loss (4.25%).; Conclusions: Up to one-third of dementia cases in Malta could be reduced through population-level strategies targeting modifiable risk factors. These PIF estimates provide realistic, evidence-informed guidance for national dementia prevention planning and prioritisation.

Genomic locus tagged by lung function GWAS SNV rs12477314 (2q37. 3) acts as a regulatory region for a systemic inflammatory phenotype

2026-01-15T13:38:37Z

Title: Genomic locus tagged by lung function GWAS SNV rs12477314 (2q37. 3) acts as a regulatory region for a systemic inflammatory phenotype Authors: Grech, Godwin M.; Fawcett, Katherine A.; Hall, Robert J.; Grech, Godfrey; Ellul-Micallef, Roger; Hall, Ian P.; Fenech, Anthony G. Abstract: SNV rs12477314 (C>T; 1000G MAF = 0.14), which maps to an intergenic region on 2q37.3, is a genome-wide significant association signal for pulmonary function in genome-wide association study meta-analyses. Bioinformatic analysis revealed that the intergenic region in proximity to the sentinel SNV is enriched for histone methylation markers suggestive of active enhancer regions modifiable by DNA methylation. The aim of this study was to investigate the functionality of putative enhancer/s and their potential interaction with CpG islands in the genomic region tagged by rs12477314 and their relevance to lung disease, in particular COPD. Two independent CRISPR/Cas9n-targeted deletions of the putative enhancer/s were performed in an airway epithelial cell line (NCI-H460). Deletion clones were subjected to RNA-Seq, and differential expression gene (DEG) datasets were generated using the Cufflinks version 2.2.1 pipeline (p-FDR < 0.05). Biological pathway analysis was performed using Qiagen's Ingenuity Pathway Analysis. Associations with the blood proteome were explored in UK Biobank. Our results suggest that the deleted regions are co-acting enhancers regulating overlapping gene expression patterns. The DEG datasets from the two genomic deletions are enriched for similar canonical pathways, which may contribute to a pro-inflammatory phenotype. Pathway-based regulatory effects analysis of the two DEG datasets resulted in identifying potential downstream biological processes. There was overlap between the pathways identified in protein association datasets and the DEG datasets. Our results suggest that the genomic region tagged by SNV rs12477314 constitutes a regulatory region responsible for regulating biological pathways conducive to a systemic inflammatory phenotype.

The prevalence of tunnelled line-associated MRSA and MSSA bacteraemias in a Maltese haemodialysis patient cohort between 2017 and 2024

2025-11-19T15:04:36Z

Title: The prevalence of tunnelled line-associated MRSA and MSSA bacteraemias in a Maltese haemodialysis patient cohort between 2017 and 2024 Authors: Farrugia, Elena; Sultana, George; De Silva, Peththawadu Thihan Daksitha; Azzopardi, Abigail; Lal, Athira; Farrugia, Emanuel; Borg, Michael Angelo; Scicluna, Elizabeth; Farrugia, Claire; Vassallo, Diana Abstract: Background and Aims: Sepsis is the second most common cause of death in haemodialysis patients and patients dialysing through tunnelled dialysis lines have a 2 to 3-fold increased risk of hospitalization for infection and death compared to patients dialysing through an arteriovenous fistula or graft. This is the first audit looking at the prevalence of catheter-related blood stream infections (CRBSI) in patients receiving haemodialysis via a tunnelled line in Malta. Our aims are to benchmark local data to UK renal registry data and to assess clinical outcomes.

A time series analysis approach to quantify change in antibiotic resistance and antibiotic consumption during COVID-19 epidemics : a multicentre cross-national ecological study on behalf of QUantifying change in antibiotic resistance, ANTibiotic use, and INfection control during COVID-19 epidemics study project

2025-11-19T14:11:31Z

Title: A time series analysis approach to quantify change in antibiotic resistance and antibiotic consumption during COVID-19 epidemics : a multicentre cross-national ecological study on behalf of QUantifying change in antibiotic resistance, ANTibiotic use, and INfection control during COVID-19 epidemics study project Authors: Meschiari, Marianna; López-Lozano, José María; Medioli, Filippo; Bacca, Erica; Sarti, Mario; Cancian, Laura; Bertrand, Xavier; Sauget, Marlène; Rosolen, Béatrice; Conlon-Bingham, Geraldine Mary; McKeating, Cara; Donnelly, Claire; Warnock, Gary; Paul, Mical; Dishon-Benattar, Yael; Abram, Maja; Rubinić, Igor; Palčevsi, Dora; Belančić, Andrej; Skočibušić, Nataša; Vlahović-Palčevski, Vera V.; Yahav, Dafna; Daitch, Vered; Borg, Michael Angelo; Zarb, Peter; Scott, Michael; Farren, David; Magee, Fidelma; Pirš, Mateja; Gregorčič, Sergeja; Beović, Bojana; Mussini, Cristina Abstract: Objectives: We aimed to assess the impact of COVID-19 on antibiotic consumption (AMC) and antimicrobial resistance (AMR) in the new epidemiological scenario from a cross-national perspective.; Methods: A quasi-experimental retrospective multicentre ecological study was conducted to explore the impact of COVID-19 on AMC and AMR using routinely generated retrospective time series data. This study included nine Healthcare University Hospitals from Europe and Israel on behalf QUantifying change in Antibiotic Resistance, ANTibiotic use, and INfection control during COVID-19 Epidemics project. Total effects were defined as the difference between the pre-COVID-19 period (ranging from January 2015 or January 2016 to February 2020) and during the COVID-19 pandemic period (March 2020 to July 2021 or December 2021). The outcomes were incidence density (ID) of carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Escherichia coli, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa and Clostridioides difficile, as monthly isolates per 1000 patient days and the monthly AMC ranked according to the Access, Watch, and Reserve WHO classification system.; Results: We assessed 15.9 million total hospital bed days, 315 736 COVID-19 bed days, 52 557 monthly bacterial isolates, and 461 739 monthly antimicrobial defined daily doses. The COVID-19 pandemic had a significant impact on the consumption of overall hospital antibiotics combined in all centres except two. Prescriptions for piperacillin/tazobactam, glycopeptides, and ceftazidime/avibactam increased, whereas third-generation cephalosporins, macrolides, and fluoroquinolones returned to pre-pandemic levels after an initial surge, in all centres. A positive relationship between the pandemic intensity and VRE ID was observed in 6 of 9 (66%) centres followed by methicillin-resistant S. aureus-ID and carbapenem-resistant P. aeruginosa-ID 3 of 4 (44%) for both. A negative relationship was found for extended-spectrum beta-lactamase-producing E. coli ID.; Discussion: The COVID-19 pandemic was associated with higher usage of broad-spectrum antibiotics and higher incidence of multidrug-resistant bacteria, with great variability by countries. These results could support international action plans that embed AMR as a priority in the post-COVID-19 era.