Sedation for Gastrointestinal Endoscopic Procedures in the Elderly: Getting Safer but Still Not Nearly Safe Enough

Previously published UK reports showed that excessively large doses of benzodiazepines and opiates were being commonly used to sedate elderly patients for gastrointestinal (GI) endoscopy. This unsafe practice has lead to avoidable morbidity and mortality. We have taken the opportunity provided by recent reports to examine whether GI endoscopy sedation practice in the elderly has improved in the light of this evidence and the publication of guidelines in which specific recommendations on sedation dosage are given

Adult Manifestation of Milder Forms of Autism Spectrum Disorder; Autistic and Non-autistic Psychopathology

We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger's Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher on a dimensional ASD self- and other-report measure than clinical controls, the majority did not exceed the ASD cutoff according to the Autism Diagnostic Observation Schedule. Part of the individuals with an ASD diagnosis in their youth no longer show behaviors that underscribe a clinical ASD diagnosis in adulthood, but have subtle difficulties in social functioning and a vulnerability for a range of other psychiatric disorders

The volume densities of giant molecular clouds in M83

Using observed GALEX far-ultraviolet (FUV) fluxes and VLA images of the 21-cm HI column densities, along with estimates of the local dust abundances, we measure the volume densities of a sample of actively star-forming giant molecular clouds (GMCs) in the nearby spiral galaxy M83 on a typical resolution scale of 170 pc. Our approach is based on an equilibrium model for the cycle of molecular hydrogen formation on dust grains and photodissociation under the influence of the FUV radiation on the cloud surfaces of GMCs. We find a range of total volume densities on the surface of GMCs in M83, namely 0.1 - 400 cm-3 inside R25, 0.5 - 50 cm-3 outside R25 . Our data include a number of GMCs in the HI ring surrounding this galaxy. Finally, we discuss the effects of observational selection, which may bias our results.Comment: 9 pages, 11 figure

Evaluation of the ADOS Revised Algorithm: The Applicability in 558 Dutch Children and Adolescents

The revised ADOS algorithms, proposed by Gotham et al. (J Autism Dev Disord 37:613–627, 2007), were investigated in an independent sample of 558 Dutch children (modules 1, 2 and 3). The revised algorithms lead to better balanced sensitivity and specificity for modules 2 and 3, without losing efficiency of the classification. Including the restricted repetitive behaviour domain in the algorithm contributes to a clinical ASD classification in modules 2 and 3. For module 1, the results indicate less improvement, probably due to the low-functioning population. In most groups, the advantages of the revised algorithms are achieved without losing the strength of the original algorithm

Variational approach to a class of nonlinear oscillators with several limit cycles

We study limit cycles of nonlinear oscillators described by the equation $\ddot x + \nu F(\dot x) + x =0$. Depending on the nonlinearity this equation may exhibit different number of limit cycles. We show that limit cycles correspond to relative extrema of a certain functional. Analytical results in the limits $\nu ->0$ and $\nu -> \infty$ are in agreement with previously known criteria. For intermediate $\nu$ numerical determination of the limit cycles can be obtained.Comment: 12 pages, 3 figure

Cobalt complexes modulate plasmid conjugation in <i>Escherichia coli</i> and <i style="">Klebsiella pneumoniae</i>

Antimicrobial resistance genes (ARG), such as extended-spectrum β-lactamase (ESBL) and carbapenemase genes, are commonly carried on plasmids. Plasmids can transmit between bacteria, disseminate globally, and cause clinically important resistance. Therefore, targeting plasmids could reduce ARG prevalence, and restore the efficacy of existing antibiotics. Cobalt complexes possess diverse biological activities, including antimicrobial and anticancer properties. However, their effect on plasmid conjugation has not been explored yet. Here, we assessed the effect of four previously characterised bis(N-picolinamido)cobalt(II) complexes lacking antibacterial activity on plasmid conjugation in Escherichia coli and Klebsiella pneumoniae. Antimicrobial susceptibility testing of these cobalt complexes confirmed the lack of antibacterial activity in E. coli and K. pneumoniae. Liquid broth and solid agar conjugation assays were used to screen the activity of the complexes on four archetypical plasmids in E. coli J53. The cobalt complexes significantly reduced the conjugation of RP4, R6K, and R388 plasmids, but not pKM101, on solid agar in E. coli J53. Owing to their promising activity, the impact of cobalt complexes was tested on the conjugation of fluorescently tagged extended-spectrum β-lactamase encoding pCTgfp plasmid in E. coli and carbapenemase encoding pKpQILgfp plasmid in K. pneumoniae, using flow cytometry. The complexes significantly reduced the conjugation of pKpQILgfp in K. pneumoniae but had no impact on pCTgfp conjugation in E. coli. The cobalt complexes did not have plasmid-curing activity, suggesting that they target conjugation rather than plasmid stability. To our knowledge, this is the first study to report reduced conjugation of clinically relevant plasmids with cobalt complexes. These cobalt complexes are not cytotoxic towards mammalian cells and are not antibacterial, therefore they could be optimised and employed as inhibitors of plasmid conjugation.</p

Excitation of the molecular gas in the nuclear region of M82

We present high resolution HIFI spectroscopy of the nucleus of the archetypical starburst galaxy M82. Six 12CO lines, 2 13CO lines and 4 fine-structure lines are detected. Besides showing the effects of the overall velocity structure of the nuclear region, the line profiles also indicate the presence of multiple components with different optical depths, temperatures and densities in the observing beam. The data have been interpreted using a grid of PDR models. It is found that the majority of the molecular gas is in low density (n=10^3.5 cm^-3) clouds, with column densities of N_H=10^21.5 cm^-2 and a relatively low UV radiation field (GO = 10^2). The remaining gas is predominantly found in clouds with higher densities (n=10^5 cm^-3) and radiation fields (GO = 10^2.75), but somewhat lower column densities (N_H=10^21.2 cm^-2). The highest J CO lines are dominated by a small (1% relative surface filling) component, with an even higher density (n=10^6 cm^-3) and UV field (GO = 10^3.25). These results show the strength of multi-component modeling for the interpretation of the integrated properties of galaxies.Comment: Accepted for publication in A&A Letter

Crystalline Assemblies and Densest Packings of a Family of Truncated Tetrahedra and the Role of Directional Entropic Forces

Polyhedra and their arrangements have intrigued humankind since the ancient Greeks and are today important motifs in condensed matter, with application to many classes of liquids and solids. Yet, little is known about the thermodynamically stable phases of polyhedrally-shaped building blocks, such as faceted nanoparticles and colloids. Although hard particles are known to organize due to entropy alone, and some unusual phases are reported in the literature, the role of entropic forces in connection with polyhedral shape is not well understood. Here, we study thermodynamic self-assembly of a family of truncated tetrahedra and report several atomic crystal isostructures, including diamond, {\beta}-tin, and high- pressure lithium, as the polyhedron shape varies from tetrahedral to octahedral. We compare our findings with the densest packings of the truncated tetrahedron family obtained by numerical compression and report a new space filling polyhedron, which has been overlooked in previous searches. Interestingly, the self-assembled structures differ from the densest packings. We show that the self-assembled crystal structures can be understood as a tendency for polyhedra to maximize face-to-face alignment, which can be generalized as directional entropic forces.Comment: Article + supplementary information. 23 pages, 10 figures, 2 table