Rates of psychotropic medicine prescribing in paediatric populations in Australian general practice from 2000-2016

General practitioner (GP) prescribing of psychotropic medicines to paediatric patients is increasing across countries, sparking the need for additional research into this field. We examined prescribing rates, GP and patient characteristics and indications associated with prescribing psychotropic medicines to paediatric patients in Australian general practice, using data from the Bettering the Evaluation and Care of Health (BEACH) program. We extracted all encounters with children aged 3 to 17 from 2000 to 2016. Psychotropic medicines were defined as those in the ATC codes N05 (Psycholeptics) and N06 (Psychoanaleptics). Of the 144,397 encounters, GPs prescribed 1829 psychotropic medicines to paediatric patients at an average rate of 1.16 prescriptions per 100 encounters (95% confidence interval 1.09–1.23). We found that the rate of psychotropic medicines prescribed to paediatric patients in Australian general practice increased. Patients who were adolescent, female, socio-economically disadvantaged or from an English-speaking background were significantly more likely to be prescribed a psychotropic medicine. GP practices in remote or regional areas and Australian graduate GPs were more likely to prescribe psychotropic medicines to paediatric patients. Depression, attention deficit hyperactivity disorder, anxiety and autism were the most common psychiatric indications managed with psychotropic medicines. Antidepressants, psychostimulants, benzodiazepines, antipsychotics and other psychotropic medicines were prescribed, signifying a high rate of off-label use. Sertraline was the most common psychotropic medicine prescribed, followed by fluoxetine and methylphenidate. Future studies involving data from other prescribers, e.g. paediatricians and psychiatrists, and studies linking prescribed medicines to their indications may widen our understanding of psychotropic medicine prescribing in Australian paediatric patients

Rates of psychotropic medicine prescribing in paediatric populations in Australian general practice from 2000-2016

General practitioner (GP) prescribing of psychotropic medicines to paediatric patients is increasing across countries, sparking the need for additional research into this field. We examined prescribing rates, GP and patient characteristics and indications associated with prescribing psychotropic medicines to paediatric patients in Australian general practice, using data from the Bettering the Evaluation and Care of Health (BEACH) program. We extracted all encounters with children aged 3 to 17 from 2000 to 2016. Psychotropic medicines were defined as those in the ATC codes N05 (Psycholeptics) and N06 (Psychoanaleptics). Of the 144,397 encounters, GPs prescribed 1829 psychotropic medicines to paediatric patients at an average rate of 1.16 prescriptions per 100 encounters (95% confidence interval 1.09–1.23). We found that the rate of psychotropic medicines prescribed to paediatric patients in Australian general practice increased. Patients who were adolescent, female, socio-economically disadvantaged or from an English-speaking background were significantly more likely to be prescribed a psychotropic medicine. GP practices in remote or regional areas and Australian graduate GPs were more likely to prescribe psychotropic medicines to paediatric patients. Depression, attention deficit hyperactivity disorder, anxiety and autism were the most common psychiatric indications managed with psychotropic medicines. Antidepressants, psychostimulants, benzodiazepines, antipsychotics and other psychotropic medicines were prescribed, signifying a high rate of off-label use. Sertraline was the most common psychotropic medicine prescribed, followed by fluoxetine and methylphenidate. Future studies involving data from other prescribers, e.g. paediatricians and psychiatrists, and studies linking prescribed medicines to their indications may widen our understanding of psychotropic medicine prescribing in Australian paediatric patients

Tribimaximal Neutrino Mixing from A_4 Replication

Motivated by dimensional deconstruction, we propose a model of tribimaximal neutrino mixing based on A_4 x A_4 symmetry. In this model, the two triplet symmetry-breaking fields of conventional A_4 models are taken to transform under different A_4 group factors, but are not distinguished by any other quantum numbers. An additional bi-triplet flavon field breaks A_4 x A_4 to its diagonal subgroup. If the bi-triplet transforms under an additional Z_3 symmetry, we show that one can construct a general, renormalizable superpotential that yields the desired pattern of symmetry breaking. We identify the features that this model has in common with a deconstructed 5D theory in which A_4 is a subgroup of a continuous gauged flavor symmetry in the bulk.Comment: 13 pages LaTeX (v2: discussion added

Comparative Direct Analysis of Type Ia Supernova Spectra. IV. Postmaximum

A comparative study of optical spectra of Type Ia supernovae (SNe Ia) obtained near 1 week, 3 weeks, and 3 months after maximum light is presented. Most members of the four groups that were defined on the basis of maximum light spectra in Paper II (core normal, broad line, cool, and shallow silicon) develop highly homogeneous postmaximum spectra, although there are interesting exceptions. Comparisons with SYNOW synthetic spectra show that most of the spectral features can be accounted for in a plausible way. The fits show that 3 months after maximum light, when SN Ia spectra are often said to be in the nebular phase and to consist of forbidden emission lines, the spectra actually remain dominated by resonance scattering features of permitted lines, primarily those of Fe II. Even in SN 1991bg, which is said to have made a very early transition to the nebular phase, there is no need to appeal to forbidden lines at 3 weeks postmaximum, and at 3 months postmaximum the only clear identification of a forbidden line is [Ca II] 7291, 7324. Recent studies of SN Ia rates indicate that most of the SNe Ia that have ever occurred have been "prompt" SNe Ia, produced by young (100,000,000 yr) stellar populations, while most of the SNe Ia that occur at low redshift today are "tardy", produced by an older (several Gyrs) population. We suggest that the shallow silicon SNe Ia tend to be the prompt ones.Comment: Accepted by PAS

Spatio-temporal expression patterns of Arabidopsis thaliana and Medicago truncatula defensin-like genes

Plant genomes contain several hundred defensin-like (DEFL) genes that encode short cysteine-rich proteins resembling defensins, which are well known antimicrobial polypeptides. Little is known about the expression patterns or functions of many DEFLs because most were discovered recently and hence are not well represented on standard microarrays. We designed a custom Affymetrix chip consisting of probe sets for 317 and 684 DEFLs from Arabidopsis thaliana and Medicago truncatula, respectively for cataloging DEFL expression in a variety of plant organs at different developmental stages and during symbiotic and pathogenic associations. The microarray analysis provided evidence for the transcription of 71% and 90% of the DEFLs identified in Arabidopsis and Medicago, respectively, including many of the recently annotated DEFL genes that previously lacked expression information. Both model plants contain a subset of DEFLs specifically expressed in seeds or fruits. A few DEFLs, including some plant defensins, were significantly up-regulated in Arabidopsis leaves inoculated with Alternaria brassicicola or Pseudomonas syringae pathogens. Among these, some were dependent on jasmonic acid signaling or were associated with specific types of immune responses. There were notable differences in DEFL gene expression patterns between Arabidopsis and Medicago, as the majority of Arabidopsis DEFLs were expressed in inflorescences, while only a few exhibited root-enhanced expression. By contrast, Medicago DEFLs were most prominently expressed in nitrogen-fixing root nodules. Thus, our data document salient differences in DEFL temporal and spatial expression between Arabidopsis and Medicago, suggesting distinct signaling routes and distinct roles for these proteins in the two plant species

Satellite Observations of Stratospheric Hydrogen Flouride and Comparisons with SLIMCAT Calculations

The vast majority of emissions of fluorine-containing molecules are anthropogenic in nature, e.g. chlorofluorocarbons (CFCs), hydrochlorofluorocarbons (HCFCs), and hydrofluorocarbons (HFCs). Many of these fluorine-containing species deplete stratospheric ozone and are regulated by the Montreal Protocol. Once in the atmosphere they slowly degrade, ultimately leading to the formation of hydrogen fluoride (HF), the dominant reservoir of stratospheric fluorine due to its extreme stability. Monitoring the growth of stratospheric HF is therefore an important marker for the success of the Montreal Protocol. We report the comparison of global distributions and trends of HF measured in the Earth\u27s atmosphere by the satellite remote-sensing instruments ACE-FTS (Atmospheric Chemistry Experiment Fourier transform spectrometer), which has been recording atmospheric spectra since 2004, and HALOE (HALogen Occultation Experiment), which recorded atmospheric spectra between 1991 and 2005, with the output of SLIMCAT, a state-of-the-art three-dimensional chemical transport model. In general the agreement between observation and model is good, although the ACE-FTS measurements are biased high by  ∼  10 % relative to HALOE. The observed global HF trends reveal a substantial slowing down in the rate of increase of HF since the 1990s: 4.97 ± 0.12 % year−1 (1991–1997; HALOE), 1.12 ± 0.08 % year−1 (1998–2005; HALOE), and 0.52 ± 0.03 % year−1 (2004–2012; ACE-FTS). In comparison, SLIMCAT calculates trends of 4.01, 1.10, and 0.48 % year−1, respectively, for the same periods; the agreement is very good for all but the earlier of the two HALOE periods. Furthermore, the observations reveal variations in the HF trends with latitude and altitude; for example, between 2004 and 2012 HF actually decreased in the Southern Hemisphere below  ∼  35 km. An additional SLIMCAT simulation with repeating meteorology for the year 2000 produces much cleaner trends in HF with minimal variations with latitude and altitude. Therefore, the variations with latitude and altitude in the observed HF trends are due to variability in stratospheric dynamics on the timescale of a few years. Overall, the agreement between observation and model points towards the ongoing success of the Montreal Protocol and the usefulness of HF as a metric for stratospheric fluorine

First Remote Sensing Observations of Trifluoromethane (HFC-23) in the Upper Troposphere and Lower Stratosphere

This work reports the first remote sensing measurements of atmospheric HFC-23 (CHF3) using solar occultation measurements made by the Atmospheric Chemistry Experiment Fourier transform spectrometer (ACE-FTS) and the Jet Propulsion Laboratory Mark IV (MkIV) balloon interferometer. A total of 8809 ACE occultations measured between 2004 and 2010 have been processed, along with 24 MkIV occultations measured between 1989 and 2007. ACE data (yearly averages over the 10-25 km altitude range) in the tropics/subtropics (40°S-40°N) reveal a trend of 4.0 ± 1.6% per year in the growth of HFC-23 for 2004-2009 (or 3.9 ± 1.2% per year for 2004-2010), slightly smaller than surface measurements from Cape Grim air archive samples over the same time period (4.7 ± 0.3% per year). The northern midlatitude and high-latitude MkIV data (averaged over the 10-25 km altitude range) indicate a growth rate of 5.8 ± 0.3% per year over the period 1989-2007 (5.3 ± 0.4% per year for just the midlatitude data), similar to the Cape Grim surface trend of 5.7 ± 0.1% per year over the same period. The absolute HFC-23 volume mixing ratios measured by ACE and MkIV in the upper troposphere/lower stratosphere are in good agreement (\u3c5% bias) with each other but are ∼30% larger than ground-based measurements. The source of this bias has not been definitively ascertained; however, spectroscopic errors are the most likely cause. Copyright 2012 by the American Geophysical Union

5-ethyl-2'-deoxyuridine fragilizes Klebsiella pneumoniae outer wall and facilitates intracellular killing by phagocytic cells

Klebsiella pneumoniae is the causative agent of a variety of severe infections. Many K. pneumoniae strains are resistant to multiple antibiotics, and this situation creates a need for new antibacterial molecules. K. pneumoniae pathogenicity relies largely on its ability to escape phagocytosis and intracellular killing by phagocytic cells. Interfering with these escape mechanisms may allow to decrease bacterial virulence and to combat infections. In this study, we used Dictyostelium discoideum as a model phagocyte to screen a collection of 1,099 chemical compounds. Phg1A KO D. discoideum cells cannot feed upon K. pneumoniae bacteria, unless bacteria bear mutations decreasing their virulence. We identified 3 non-antibiotic compounds that restored growth of phg1A KO cells on K. pneumoniae, and we characterized the mode of action of one of them, 5-ethyl-2'-deoxyuridine (K2). K2-treated bacteria were more rapidly killed in D. discoideum phagosomes than non-treated bacteria. They were more sensitive to polymyxin and their outer membrane was more accessible to a hydrophobic fluorescent probe. These results suggest that K2 acts by rendering the membrane of K. pneumoniae accessible to antibacterial effectors. K2 was effective on three different K. pneumoniae strains, and acted at concentrations as low as 3 μM. K2 has previously been used to treat viral infections but its precise molecular mechanism of action in K. pneumoniae remains to be determined

Search for top quark decays t → qH, with H → γγ, in s=13 TeV pp collisions using the ATLAS detector

This article presents a search for flavour-changing neutral currents in the decay of a top quark into an up-type (q = c, u) quark and a Higgs boson, where the Higgs boson decays into two photons. The proton-proton collision data set analysed amounts to 36.1 fb−1 at s=13 TeV collected by the ATLAS experiment at the LHC. Top quark pair events are searched for, where one top quark decays into qH and the other decays into bW . Both the hadronic and leptonic decay modes of the W boson are used. No significant excess is observed and an upper limit is set on the t → cH branching ratio of 2.2 × 10−3 at the 95% confidence level, while the expected limit in the absence of signal is 1.6 × 10−3. The corresponding limit on the tcH coupling is 0.090 at the 95% confidence level. The observed upper limit on the t → uH branching ratio is 2.4 × 10−3