A commentary on of the new mental health act for the Maltese Islands

Legal notice 276, published in September 2013, has set out the time windows for the implementation of the Mental Health Act, which was approved by parliament in 2012. The changes are expected to be rolled out over a period of one year, with the totality of the Act being in force by 10th October 2014. The first set of changes, implemented last November, brings in effect the first half of the provisions of the Mental Health Act. Overall the proposed Mental Health Act is much improved on the previous Act; it reads well and brings the law up to date with modern psychiatry practice. At first glance the Maltese Mental Health Act seems to stem from the basis of the UK 1983 Mental Health Act as amended in 2007, although the authors are not familiar with other EU Mental Health Acts, therefore they could not comment on whether there are resemblances to other Acts. In this article, the authors will discuss and make comments on some of the seminal parts of the new Mental Health Act.peer-reviewe

Alzheimer's disease research group (ADRG)

In these last few years, there has been a growing consensus in Europe and beyond on the need of increasing research on neurodegenerative diseases including Alzheimer's disease and other related dementias. The societal impact and financial consequences of these diseases are already being felt and will continue to grow with the projected rise in the elderly population. Currently, there are over 35 million individuals with dementia worldwide, a figure that will treble by the year 2050. It has been estimated that formal and informal dementia care costs a total of €445 billion (2009 data),' equivalent to 1 % of the global gross domestic product. It is therefore not surprising that the European Union supports various funding programmes in the hope of enhancing diagnosis, provide better treatment and improve care pathways and support for individuals with dementia, their caregivers and relatives.peer-reviewe

Pediatric Bipolar disorder, in Malta is it under-diagnosed?

The objective of this retrospective study was to determine the frequency of Bipolar Disorder in children and adolescents referred to the Child Guidance Clinic (CGC), St. Luke’s Hospital, Malta, over a year. Diagnostic criteria were analyzed and compared to current literature. Of 141 children, none were diagnosed with Bipolar Disorder. Further awareness of clinicians is advised, to identify Bipolar Disorder, thus limiting its long term morbidity and mortality.peer-reviewe

Nickel(II) Complex with a Flexidentate Ligand Derived from Acetohydrazide: Synthesis, Structural Characterization and Hirshfeld Surface Analysis

The mononuclear Ni(II) complex [Ni(Lp)2(CH3OH)2]Cl2 has been synthesized by reacting 1-(5-hydroxy-3-methyl-5-phenyl-4,5-dihydro-1H-pyrazol-1-yl)ethan-1-one ligand (HL) with NiCl2.6H2O in methanol solution. In the reaction, the tridentate ligand, HL, was converted in situ into 4-hydroxy-4-phenylbut-3-en-2-ylidene)acetohydrazid ligand, (pyrazole, Lp). The pyrazole ligand acts as bidentate neutral ligand and the hydroxyl group is left uncoordinated. The structure of the Ni(II) complex has been established by X-ray crystallography. The Ni(II) is six-coordinate and has a distorted octahedral geometry. It is bonded by two nitrogen and by two oxygen atoms of the two pyrazole ligands and two oxygen atoms of methanol molecules. The Hirshfeld surface analysis and the 2D the fingerprint plot are used to analyses all of the intermolecular contacts in the crystal structures. The main intermolecular contacts are H/H and Cl/H interactions

The effect of age and clinical circumstances on the outcome of red blood cell transfusion in critically ill patients

Introduction: Whether red blood cell (RBC) transfusion is beneficial remains controversial. In both retrospective and prospective evaluations, transfusion has been associated with adverse, neutral, or protective effects. These varying results likely stem from a complex interplay between transfusion, patient characteristics, and clinical context. The objective was to test whether age, comorbidities, and clinical context modulate the effect of transfusion on survival. Methods: By using the multiparameter intelligent monitoring in intensive care II database (v. 2.6), a retrospective analysis of 9,809 critically ill patients, we evaluated the effect of RBC transfusion on 30-day and 1-year mortality. Propensity score modeling and logistic regression adjusted for known confounding and assessed the independent effect of transfusion on 30-day and 1-year mortality. Sensitivity analysis was performed by using 3,164 transfused and non-transfused pairs, matched according the previously validated propensity model for RBC transfusion. Results: RBC transfusion did not affect 30-day or 1-year mortality in the overall cohort. Patients younger than 55 years had increased odds of mortality (OR, 1.71; P < 0.01) with transfusion. Patients older than 75 years had lower odds of 30-day and 1-year mortality (OR, 0.70; P < 0.01) with transfusion. Transfusion was associated with worse outcome among patients undergoing cardiac surgery (OR, 2.1; P < 0.01). The propensity-matched population corroborated findings identified by regression adjustment. Conclusion: A complex relation exists between RBC transfusion and clinical outcome. Our results show that transfusion is associated with improved outcomes in some cohorts and worse outcome in others, depending on comorbidities and patient characteristics. As such, future investigations and clinical decisions evaluating the value of transfusion should account for variations in baseline characteristics and clinical context. Electronic supplementary material The online version of this article (doi:10.1186/s13054-014-0487-z) contains supplementary material, which is available to authorized users

Victimization, Urbanicity, and the Relevance of Context: School Routines, Race and Ethnicity, and Adolescent Violence

The United States is undergoing a historical racial and ethnic demographic shift. There is limited criminological research exploring if and how these changes influence variation in the relationship between routine activity theory and adolescent violence. Although the link between routine activities and victimization has been tested and well established, criminologists have questioned if routine activities can explain adolescent violence across different social contexts. Prior research demonstrates that there are potential nuances in the theoretical connections between routine activities and victimization, particularly when considering race and ethnicity. This study builds on previous research by questioning if the elements of routine activities predict victimization across predominately urban, rural, and suburban schools. The implications of the relevance of school context in the relationships between routine activities and adolescent victimization will also be discussed more generally

Methylation in mycobacterium tuberculosis is lineage specific with associated mutations present globally

DNA methylation is an epigenetic modification of the genome involved in regulating crucial cellular processes, including transcription and chromosome stability. Advances in PacBio sequencing technologies can be used to robustly reveal methylation sites. The methylome of the Mycobacterium tuberculosis complex is poorly understood but may be involved in virulence, hypoxic survival and the emergence of drug resistance. In the most extensive study to date, we characterise the methylome across the 4 major lineages of M. tuberculosis and 2 lineages of M. africanum, the leading causes of tuberculosis disease in humans. We reveal lineage-specific methylated motifs and strain-specific mutations that are abundant globally and likely to explain loss of function in the respective methyltransferases. Our work provides a set of sixteen new complete reference genomes for the Mycobacterium tuberculosis complex, including complete lineage 5 genomes. Insights into lineage-specific methylomes will further elucidate underlying biological mechanisms and other important phenotypes of the epi-genom

Utility of pharmacogenetic testing to optimise antidepressant pharmacotherapy in youth: a narrative literature review

Pharmacogenetics (PGx) is the study and application of how interindividual differences in our genomes can influence drug responses. By evaluating individuals’ genetic variability in genes related to drug metabolism, PGx testing has the capabilities to individualise primary care and build a safer drug prescription model than the current “one-size-fits-all” approach. In particular, the use of PGx testing in psychiatry has shown promising evidence in improving drug efficacy as well as reducing toxicity and adverse drug reactions. Despite randomised controlled trials demonstrating an evidence base for its use, there are still numerous barriers impeding its implementation. This review paper will discuss the management of mental health conditions with PGx-guided treatment with a strong focus on youth mental illness. PGx testing in clinical practice, the concerns for its implementation in youth psychiatry, and some of the barriers inhibiting its integration in clinical healthcare will also be discussed. Overall, this paper provides a comprehensive review of the current state of knowledge and application for PGx in psychiatry and summarises the capabilities of genetic information to personalising medicine for the treatment of mental ill-health in youth

Hand2 delineates mesothelium progenitors and is reactivated in mesothelioma.

The mesothelium lines body cavities and surrounds internal organs, widely contributing to homeostasis and regeneration. Mesothelium disruptions cause visceral anomalies and mesothelioma tumors. Nonetheless, the embryonic emergence of mesothelia remains incompletely understood. Here, we track mesothelial origins in the lateral plate mesoderm (LPM) using zebrafish. Single-cell transcriptomics uncovers a post-gastrulation gene expression signature centered on hand2 in distinct LPM progenitor cells. We map mesothelial progenitors to lateral-most, hand2-expressing LPM and confirm conservation in mouse. Time-lapse imaging of zebrafish hand2 reporter embryos captures mesothelium formation including pericardium, visceral, and parietal peritoneum. We find primordial germ cells migrate with the forming mesothelium as ventral migration boundary. Functionally, hand2 loss disrupts mesothelium formation with reduced progenitor cells and perturbed migration. In mouse and human mesothelioma, we document expression of LPM-associated transcription factors including Hand2, suggesting re-initiation of a developmental program. Our data connects mesothelium development to Hand2, expanding our understanding of mesothelial pathologies

Hand2 delineates mesothelium progenitors and is reactivated in mesothelioma

The mesothelium lines body cavities and surrounds internal organs, widely contributing to homeostasis and regeneration. Mesothelium disruptions cause visceral anomalies and mesothelioma tumors. Nonetheless, the embryonic emergence of mesothelia remains incompletely understood. Here, we track mesothelial origins in the lateral plate mesoderm (LPM) using zebrafish. Single-cell transcriptomics uncovers a post-gastrulation gene expression signature centered on hand2 in distinct LPM progenitor cells. We map mesothelial progenitors to lateral-most, hand2-expressing LPM and confirm conservation in mouse. Time-lapse imaging of zebrafish hand2 reporter embryos captures mesothelium formation including pericardium, visceral, and parietal peritoneum. We find primordial germ cells migrate with the forming mesothelium as ventral migration boundary. Functionally, hand2 loss disrupts mesothelium formation with reduced progenitor cells and perturbed migration. In mouse and human mesothelioma, we document expression of LPM-associated transcription factors including Hand2, suggesting re-initiation of a developmental program. Our data connects mesothelium development to Hand2, expanding our understanding of mesothelial pathologies