A Dense Packing of Regular Tetrahedra

We construct a dense packing of regular tetrahedra, with packing density $D > >.7786157$.Comment: full color versio

Emergency preparedness and long-distance leisure catamaran sailing

Introduction : La présente étude prospective avait pour objectif d’identifier les incidents médicaux survenus en mer et de présenter la préparation médicale des membres de l’équipage. Synthèse des faits : Le traitement médical de 24 incidents a été rapporté. Les blessures (4,5/1000 heures) ont été occasionnées en majeure partie par des trébuchements. Parmi les maladies (5,8/1000 heures) figurent avant tout le mal de mer et les coups de soleil. Ces incidents dépendaient des conditions de navigation. Conclusion : L’objectif de la phase préparatoire est de mettre en place des mesures de sécurité visant à réduire au mieux le risque médical pour les membres de l’équipage. Mots clés : Navigation ; Blessures ; Maladies ; Préparation médicale ; Atlantique

Off-label prescription of psychiatric drugs by non-psychiatrist physicians in three general hospitals in Germany

Abstract Background Off-label prescribing of psychoactive drugs is a common practice in psychiatry. Here, we sought to investigate the frequency of off-label prescribing in a population of hospitalized patients with a somatic illness who were also suffering from a psychiatric pathology. Methods Using a prospective, observational design, we collected data from 982 hospitalized patients with a somatic illness for whom a psychiatric consultation was requested because of the presence of additional psychiatric symptoms. Data were collected at three hospitals in Germany. Demographic and clinical data, including the previous psychoactive medications and an assessment of the suitability of the previous medications, were recorded and analyzed. Results Data on the previous psychiatric medications were available for 972 patients. In 16.6% of patients, at least one psychoactive drug had been prescribed off-label, 20.2% had received on-label medication, and 63.2% had not received any psychiatric medication. Among all patients receiving psychiatric medication, 45.1% had received off-label medication. The logistic regression analysis showed a significant influence of age on the likelihood of receiving off-label medication (p = 0.018). Benzodiazepines were the most frequent off-label prescription (25.8% of off-label prescriptions), followed by atypical antipsychotics (18.2%) and low-potency antipsychotics (17.2%). Notably, 57.1% of off-label prescriptions were judged to be ‘not indicated’ by experienced psychiatrists. Conclusions Our data show a high frequency of the off-label prescription of psychoactive drugs by physicians treating patients with somatic illnesses in general hospitals. Because more than half of these cases were judged to be “not indicated”, these prescriptions indicate a potential risk to patients. Furthermore, the classes of drugs that were most frequently prescribed off-label, benzodiazepines and antipsychotics, both show a substantial risk profile, particularly for elderly patients