Off-label prescription of psychotropic medications in a sample of Italian psychiatrists working in private practice: a cross sectional study

Background Off-label prescription refers to the use of a drug outside the terms of its Marketing Authorization. According to the literature, this practice is particularly common in clinical psychiatry. Objective To describe patterns of off-label prescription in a sample of Italian psychiatrists working in private practice. Methods An ad hoc questionnaire was developed and sent by e-mail to a sample of Italian psychiatrists working in private practice in the Region Emilia-Romagna. The questionnaire assessed frequency of off-label prescription, reasons associated with it, diagnostic categories more often associated with such practice, main sources of information used to support off-label prescription, and psychotropic agents most commonly prescribed off-label, as well as medical-legal implications. Data were analysed by means of univariate and multivariate ordered logistic regressions. Results Fifty psychiatrists (female: 44%) out of 129 who received the e-mail invitation responded (response rate: 39%). Off-label prescription was found to be inversely proportional to clinicians’ age (OR = 10.53 [95% CI 2.13-52.13]). Most commonly, second-generation antipsychotics (SGAs) were prescribed to patients diagnosed with personality disorders (PDs) (OR = 0.08 [95% CI 0.02-0.36]). A higher rate of off-label prescription was also associated to relying more on pharmaceutical sales representatives (OR = 0.58 [95%CI 0.01-0.30]) or personal professionals’ clinical experience (OR = 0.05 [95% CI 0.01-0.36]) and less on other colleagues’ experience (OR = 11.80 [95% CI 4.16-33.50]) as source of information. Conclusions Off-label prescription is common, especially among young psychiatrists, who frequently rely on previous personal clinical experience, especially when prescribing SGAs for treating patients with PDs. Respondents pointed to the need for further research and training on the topic addressed by the present study

First Sample of Hα\alpha+[O III] λ\lambda5007 Line Emitters at z>6z > 6 through JWST/NIRCam Slitless Spectroscopy: Physical Properties and Line Luminosity Functions

We present a sample of four emission-line galaxies at $z=6.11-6.35$ that were serendipitously discovered using the commissioning data for the JWST/NIRCam wide-field slitless spectroscopy (WFSS) mode. One of them (at $z=6.11$) has been reported previously while the others are new discoveries. These sources are selected by the secure detections of both [O III] $\lambda$5007 and H$\alpha$ lines with other fainter lines tentatively detected in some cases (e.g., [O II] $\lambda$3727, [O III] $\lambda$4959 and [N II] $\lambda$6583). In the [O III]/H$\beta$ - [N II]/H$\alpha$ Baldwin-Phillips-Terlevich diagram, these galaxies occupy the same parameter space as that of $z\sim2$ star-forming galaxies, indicating that they have been enriched rapidly to sub-solar metallicities ($\sim$0.6 $Z_{\odot}$), similar to galaxies with comparable stellar masses at much lower redshifts. The detection of strong H$\alpha$ lines suggests a higher ionizing photon production efficiency within galaxies in the early Universe. We find brightening of the [O III] $\lambda$5007 line luminosity function (LF) from $z=3$ to 6, and no or weak redshift evolution of the H$\alpha$ line LF from $z=2$ to 6. Both LFs are under-predicted at $z\sim6$ by a factor of $\sim$10 in certain cosmological simulations. This further indicates a global Ly$\alpha$ photon escape fraction of 5-7% at $z\sim6$, much lower than previous estimates through the comparison of the UV-derived star-formation rate density and Ly$\alpha$ luminosity density. Our sample recovers $88^{+164}_{-57}$% of $z=6.0-6.6$ galaxies in the survey volume with stellar masses greater than $5\times10^8$ $M_{\odot}$, suggesting the ubiquity of strong H$\alpha$ and [O III] line emitters in the Epoch of Reionization, which will be further uncovered in the era of JWST.Comment: 25 pages, 11 figures, submitted to Ap

JADES: Detecting [OIII]λ4363λ4363 Emitters and Testing Strong Line Calibrations in the High-zz Universe with Ultra-deep JWST/NIRSpec Spectroscopy up to z∼9.5z \sim 9.5

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We present ten novel [OIII]λ4363 auroral line detections up to z ∼ 9.5 measured from ultra-deep JWST/NIRSpec MSA spectroscopy from the JWST Advanced Deep Extragalactic Survey (JADES). We leverage the deepest spectroscopic observations taken thus far with NIRSpec to determine electron temperatures and oxygen abundances using the direct Te method. We directly compare these results against a suite of locally calibrated strong-line diagnostics and recent high-z calibrations. We find the calibrations fail to simultaneously match our JADES sample, thus warranting a self-consistent revision of these calibrations for the high-z Universe. We find a weak dependence between R2 and O3O2 with metallicity, thus suggesting these line ratios are inefficient in the high-z Universe as metallicity diagnostics and degeneracy breakers. We find R3 and R23 are still correlated with metallicity, but we find a tentative flattening of these diagnostics, thus suggesting future difficulties when applying these strong line ratios as metallicity indicators in the high-z Universe. We also propose and test an alternative diagnostic based on a different combination of R3 and R2 with a higher dynamic range. We find a reasonably good agreement (median offset of 0.002 dex, median absolute offset of 0.13 dex) with the JWST sample at low metallicity, but future investigations are required on larger samples to probe past the turnover point. At a given metallicity, our sample demonstrates higher ionization and excitation ratios than local galaxies with rest-frame EWs(Hβ) ≈200 − 300 Å. However, we find the median rest-frame EWs(Hβ) of our sample to be ∼2× less than the galaxies used for the local calibrations. This EW discrepancy combined with the high ionization of our galaxies does not offer a clear description of [OIII]λ4363 production in the high-z Universe, thus warranting a much deeper examination into the factors influencing these processes.Peer reviewe

Inside the bubble: exploring the environments of reionisation-era Lyman-α emitting galaxies with JADES and FRESCO⋆

© 2024 The Author(s). Published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We present a study of the environments of 17 Lyman-α emitting galaxies (LAEs) in the reionisation-era (5.8 5%) observed in our sample of LAEs, suggesting the presence of ionised hydrogen along the line of sight towards at least eight out of 17 LAEs. We find minimum physical 'bubble'sizes of the order of R ion ∼ 0.1- 1pMpc are required in a patchy reionisation scenario where ionised bubbles containing the LAEs are embedded in a fully neutral IGM. Around half of the LAEs in our sample are found to coincide with large-scale galaxy overdensities seen in FRESCO at z ∼ 5.8- 5.9 and z ∼ 7.3, suggesting Lyman-α transmission is strongly enhanced in such overdense regions, and underlining the importance of LAEs as tracers of the first large-scale ionised bubbles. Considering only spectroscopically confirmed galaxies, we find our sample of UV-faint LAEs (M UV ≳ -20mag) and their direct neighbours are generally not able to produce the required ionised regions based on the Lyman-α transmission properties, suggesting lower-luminosity sources likely play an important role in carving out these bubbles. These observations demonstrate the combined power of JWST multi-object and slitless spectroscopy in acquiring a unique view of the early Universe during cosmic reionisation via the most distant LAEs.Peer reviewe

JADES: Insights into the low-mass end of the mass–metallicity–SFR relation at 3 < z < 10 from deep JWST/NIRSpec spectroscopy⋆

© 2024 The Author(s). Published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We analysed the gas-phase metallicity properties of a sample of low-stellar-mass (log M⋆/M⊙ ≲ 9) galaxies at 3  6, with galaxies significantly less enriched than predicted given their M⋆ and SFR (with a median offset in log(O/H) of ∼0.5 dex, significant at ∼5σ). These observations are consistent with an enhanced stochasticity in the gas accretion and star-formation history of high-redshift systems, prompting us to reconsider the nature of the relationship between M⋆, O/H, and SFR in the early Universe.Peer reviewe

The Cosmos in its Infancy: JADES Galaxy Candidates at z > 8 in GOODS-S and GOODS-N

We present a catalog of 717 candidate galaxies at $z > 8$ selected from 125 square arcminutes of NIRCam imaging as part of the JWST Advanced Deep Extragalactic Survey (JADES). We combine the full JADES imaging dataset with data from the JEMS and FRESCO JWST surveys along with extremely deep existing observations from HST/ACS for a final filter set that includes fifteen JWST/NIRCam filters and five HST/ACS filters. The high-redshift galaxy candidates were selected from their estimated photometric redshifts calculated using a template fitting approach, followed by visual inspection from seven independent reviewers. We explore these candidates in detail, highlighting interesting resolved or extended sources, sources with very red long-wavelength slopes, and our highest redshift candidates, which extend to $z_{phot} = 18$. We also investigate potential contamination by stellar objects, and do not find strong evidence from SED fitting that these faint high-redshift galaxy candidates are low-mass stars. Over 93\% of the sources are newly identified from our deep JADES imaging, including 31 new galaxy candidates at $z_{phot} > 12$. Using 42 sources in our sample with measured spectroscopic redshifts from NIRSpec and FRESCO, we find excellent agreement to our photometric redshift estimates, with no catastrophic outliers and an average difference of $\langle \Delta z = z_{phot}- z_{spec} \rangle= 0.26$. These sources comprise one of the most robust samples for probing the early buildup of galaxies within the first few hundred million years of the Universe's history.Comment: v2: 40 pages, 18 figures, submitted to AAS Journals, online data catalog (JADES Deep only) found at https://doi.org/10.5281/zenodo.809252

The Cosmos in its Infancy: JADES Galaxy Candidates at z > 8 in GOODS-S and GOODS-N

© 2024. The Author(s). Published by the American Astronomical Society. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/We present a catalog of 717 candidate galaxies at z > 8 selected from 125 square arcmin of NIRCam imaging as part of the JWST Advanced Deep Extragalactic Survey (JADES). We combine the full JADES imaging data set with data from the JWST Extragalactic Medium Survey and First Reionization Epoch Spectroscopic COmplete Survey (FRESCO) along with extremely deep existing observations from Hubble Space Telescope (HST)/Advanced Camera for Surveys (ACS) for a final filter set that includes 15 JWST/NIRCam filters and five HST/ACS filters. The high-redshift galaxy candidates were selected from their estimated photometric redshifts calculated using a template-fitting approach, followed by visual inspection from seven independent reviewers. We explore these candidates in detail, highlighting interesting resolved or extended sources, sources with very red long-wavelength slopes, and our highest-redshift candidates, which extend to z phot ∼ 18. Over 93% of the sources are newly identified from our deep JADES imaging, including 31 new galaxy candidates at z phot > 12. We also investigate potential contamination by stellar objects, and do not find strong evidence from spectral energy distribution fitting that these faint high-redshift galaxy candidates are low-mass stars. Using 42 sources in our sample with measured spectroscopic redshifts from NIRSpec and FRESCO, we find excellent agreement to our photometric redshift estimates, with no catastrophic outliers and an average difference of 〈Δz = z phot − z spec〉 = 0.26. These sources comprise one of the most robust samples for probing the early buildup of galaxies within the first few hundred million years of the Universe’s history.Peer reviewe

A recently quenched galaxy 700 million years after the Big Bang

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Local and low-redshift ($z$10^{10}~M_{\odot}$) and relatively old. Here we report a (mini-)quenched galaxy at z$=$7.3, when the Universe was only 700~Myr old. The JWST/NIRSpec spectrum is very blue ($U$-$V$$=$0.16$\pm0.03$~mag), but exhibits a Balmer break and no nebular emission lines. The galaxy experienced a short starburst followed by rapid quenching; its stellar mass (4-6$\times 10^8~M_\odot$) falls in a range that is sensitive to various feedback mechanisms, which can result in perhaps only temporary quenching.Peer reviewe