Association between proton pump inhibitor use and neurological or psychiatric disorders: a systematic review protocol.

OBJECTIVE: The objective of this review is to examine the association between proton pump inhibitors (PPIs) and neurological and/or psychiatric disorders in adults. INTRODUCTION: The association between PPIs and neurological and/or psychiatric disorders remains unclear, despite the widespread use of the medications. A systematic review is required to investigate the risk of developing neurological and/or psychiatric disorders following the use of PPIs. INCLUSION CRITERIA: Studies including participants aged ≥18 years and using any PPIs, including participants with comorbid conditions or using other medications, will be considered for inclusion. Randomized controlled trials, quasi-experimental studies, and observational studies examining the association of neurological and/or psychiatric disorders with the use of PPIs among adults will be included. METHODS: MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases will be searched from inception until the present. Two authors will independently screen and review the titles, abstracts, and full texts. The methodological quality of included studies will be assessed using the JBI critical appraisal checklists. Study characteristics, populations, type and duration of PPI usage, status of existing neurological and/or psychiatric disorders, comorbidity conditions, use of other medications, identification of neurological and/or psychiatric disorders (International Classification of Diseases codes vs others), and estimation of the associated neurological and/or psychiatric disorders will be extracted. Studies will be pooled using statistical meta-analysis where available; otherwise, the findings will be presented in narrative format. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach for grading the certainty of evidence will be followed. REVIEW REGISTRATION: PROSPERO CRD42022355543.

Forensic Death Investigations of Dog Bite Injuries in 31 Cats.

Animal bite injuries are common in free-ranging cats in Taiwan, and most fatal animal bite events are presumed to be caused by dogs. However, speculation regarding animal abuse may occur when carcasses with prominent injuries are found by members of the general public. Local animal protection offices and veterinary clinicians sometimes face difficulties in convincing these individuals by identifying specific features of dog bite injuries in cat carcasses. Therefore, the present study analyzed injury patterns and distribution in 31 necropsied cats with animal bite injuries, and applied deoxyribonucleic acid (DNA) analysis for canine DNA identification in 13 cats. The main necropsy findings included puncture wounds (26 (83.9%)), linear or small, round contusions/abrasions (20 (64.5%)), lacerations/avulsions (17 (54.8%)), abdominal wall rupture/laceration (19 (61.3%)), herniation (16 (51.6%)), fractures (21 (67.7%)), broken claws (16 (51.6%)), and hair tufts on the body surface (28 (90.3%)). The most-commonly injured regions were the ventral thorax and axilla (23 (74.2%)), hind limbs (22 (71.0%)), shoulder-to-dorsal thorax (21 (67.7%)), back and flank (20 (64.5%)), abdomen (19 (61.3%)), neck (19 (61.3%)), and hip/tail/perineum (17 (54.8%)). Canine mitochondrial DNA was identified in 3 out of 11 cases (27.3%) that were sampled using wound swabs and in 4 out of 5 cases that had hair entrapped in broken claws. In conclusion, this study determined the distribution and features of dog bite injuries in cats and developed an elemental method using trace evidence for DNA identification in animal bites.

Mortality rate, risk factors, and causes of death in people with epilepsy and intellectual disability.

PURPOSE: The extent to which co-occurring intellectual disability influences mortality in people with epilepsy is largely unknown. This study compares mortality rates in people with epilepsy with and without intellectual disability and investigates causes of death and risk factors for mortality. METHOD: This retrospective cohort study used linked population-based administrative datasets to derive a cohort of people with epilepsy admitted to hospital from 2005-2015 in New South Wales, Australia. We calculated mortality rates for those with and without intellectual disability and compared them by estimating relative mortality risks with modified Poisson regression. Leading causes of death were summarised. We investigated risk factors for death in people with intellectual disability by fitting Poisson regression. RESULTS: Of 28500 people hospitalised with an epilepsy diagnosis, 6029 had intellectual disability, 863 (14.3%) of whom died during follow-up. Sex and age-adjusted relative mortality risks showed that people with intellectual disability had higher mortality than those without, with the highest risk in females and peaking at age 5 (males: 1.88, 95%CI 1.28-2.48; females: 2.73, 95%CI 1.84-3.62), then decreasing with age. Neurological, respiratory, and endocrine, nutritional, and metabolic disorders were overrepresented causes of death in people with intellectual disability. The risk factors for death were older age, disability service use and several specific comorbidities. CONCLUSION: Children and young adults with epilepsy and intellectual disability are at greater risk of dying than those with epilepsy alone. Our data highlight the potential to reduce the excess risk by improved management of epilepsy and comorbid conditions.

Readmission and emergency department presentation after hospitalisation for epilepsy in people with intellectual disability: A data linkage study.

BACKGROUND: Despite the high prevalence of epilepsy and multiple barriers to care in people with intellectual disability, the risk of returning to hospital after an admission for epilepsy is largely unknown. In this study, we sought to quantify and compare readmission and emergency department (ED) presentations after hospitalisation for epilepsy in people with and without intellectual disability. METHODS AND FINDINGS: Using linked administrative datasets, we conducted a retrospective cohort study of people aged 5-64 years with an acute hospitalisation for epilepsy from 2005-2014 in New South Wales, Australia. Acute readmission and ED presentation rates within 30, 90, and 365 days of the index hospitalisation were estimated and compared between people with and without intellectual disability using modified Poisson regression. Of 13537 individuals with an index hospitalisation, 712 children and 1862 adults had intellectual disability. Readmission and ED presentation after the index hospitalisation were common in people with intellectual disability. Within 30 days, 11% of children and 15.6% of adults had an all-cause readmission and 18% of children and 23.5% of adults had an ED presentation. Over 60% of both children and adults presented to an ED within a year. Neurological, respiratory, and infectious conditions were overrepresented reasons for readmission in people with intellectual disability. Age-adjusted relative risks (RRs) within each period showed a higher risk of readmission and ED presentation in children and adults with intellectual disability than without. Most RRs remained statistically significant after controlling for covariates. The largest adjusted RRs were observed for readmission for epilepsy (RR 1.70, 95% CI: 1.42 to 2.04) and non-epilepsy related conditions (RR 1.73, 95%: CI 1.43 to 2.10) in children. Study limitations include lack of clinical data. CONCLUSIONS: Increased risk of returning to acute care after epilepsy hospitalisation suggests there is a need to improve epilepsy care for people with intellectual disability. We recommend research into strategies to improve management of both seizures and comorbidity.

Features of ophthalmic, magnetic resonance imaging, and histopathology of a feline case of idiopathic sclerosing orbital pseudotumor.

In the present report, we describe a case of sclerosing orbital pseudotumor in an 11-year-old castrated male American Shorthair cat. Ophthalmic exam showed lagophthalmos, retracted right upper eyelid, and resistant to retropulsion in his right eye. Under magnetic resonance imaging (MRI) scans, increased volume of the extraocular muscles (EOMs) of the right eye was prominent. Immunosuppressive dosage of prednisolone partially ameliorated the clinical signs, but some clinical signs were still gradually progressive or persistent. In the second MRI scan, decreased diameter of the thickened right extraocular muscles was found. After the third MRI scan, enucleation of the right eye was performed due to substantial adverse effects of systemic steroid therapy. Histopathological examination revealed no evidence of neoplastic transformation nor infection. Feline restrictive orbital myofibroblastic sarcoma (FROMS) was therefore excluded, suggesting unknown causes of extensive fibrotic changes in the right orbit of the affected cat.

Orthodontic force regulates metalloproteinase-3 promoter in osteoblasts and transgenic mouse models.

BACKGROUND/PURPOSE: Previously we demonstrated up-regulation of matrix metalloproteinase-3 (MMP-3) in human osteoblasts under compression and in bony specimens of experimental orthodontic tooth movement (OTM). Here, we studied the temporal characteristics of compression stimulation in human and mouse osteoblast cell lines, and generated a transgenic mouse model for assessing the MMP-3 expression during OTM. MATERIALS AND METHODS: We investigated MMP-3 expressions in human and murine osteoblasts through RT-PCR and luciferase assay, after compressive force loading. Inhibitors were added to identify the possible mechanisms for signal transduction. A human MMP-3 promoter was isolated, cloned and transfected to generate a transgenic mouse with a green fluorescent protein reporter. OTM was then initiated to observe the location and time course of transcriptional regulation of MMP-3 signals. RESULTS: We found changes in the transcription of MMP-3 in response to mechanical force applied to both human and mouse osteoblast cell lines, suggesting that the response is positive across species. Cloned human MMP-3 promoter may cause the response of luciferase to 1% compression. Moreover, p38 inhibitor exerted a down-regulatory effect on MMP-3 promoter expression, although the inhibitory effect didn't reach a significant level. In the transgenic mouse OTM model, we again found increased expression of MMP-3 in response to mechanical force loading around the periodontal ligament. CONCLUSION: Mechanical force can stimulate MMP-3 expression, possibly through the p38 MAPK pathway, with its strongest signal occurring at 24 h. The mechanical responsiveness in MMP-3 promoter regions can be observed in both humans and rodents in vitro and in vivo.

Prevalence and incidence of physical health conditions in people with intellectual disability - a systematic review.

OBJECTIVE: To synthesize evidence on the prevalence and incidence of physical health conditions in people with intellectual disability (ID). METHODS: We searched Medline, PsycInfo, and Embase for eligible studies and extracted the prevalence, incidence, and risk of physical health conditions in people with ID. RESULTS: Of 131 eligible studies, we synthesized results from 77 moderate- to high-quality studies, which was mainly limited to high-income countries. The highest prevalence estimates were observed for epilepsy, ear and eye disorders, cerebral palsy, obesity, osteoporosis, congenital heart defects, and thyroid disorders. Some conditions were more common in people with a genetic syndrome. Compared with the general population, many health conditions occur more frequently among people with ID, including asthma and diabetes, while some conditions such as non-congenital circulatory diseases and solid cancers occur at the same or lower rate. The latter associations may reflect under-detection. CONCLUSIONS: People with ID have a health profile more complex than previously known. There is a pressing need for targeted, evidence-informed population health initiatives including preventative programs for this population.

Diagnosis of meningeal melanomatosis in a dog using magnetic resonance imaging and cerebrospinal fluid findings.

A 13-year-old spayed female Labrador Retriever was presented with severe progressive tetraparesis. The neuroanatomic localization was the C1-C5 spinal cord segments with brainstem or cranial nerve involvement. Magnetic resonance imaging revealed diffuse T1-weighted and T2-weighted hyperintense lesions with strong contrast enhancement spreading through meninges of the cervical spinal cord and the brain. Few small round areas showing T1-weighted hyperintensity and T2-weighted hypointensity were scattered within the lesions. Cerebrospinal fluid analysis revealed neoplastic round cells and possible melanocytes. Malignant melanoma was suspected. At necropsy, the brain and the entire spinal cord were covered with thick, dark membranous tissue. Based on histopathologic findings, a positive response against Melan-A, and no melanoma identified outside the central nervous system, primary meningeal melanomatosis was diagnosed.

Qualification for upper secondary education in individuals with autism without intellectual disability: Total population study, Stockholm, Sweden.

LAY ABSTRACT: Obtaining a quality education is important for any individual's chances of leading a healthy and thriving life. Currently, educational policies in many countries underscore the rights of students with autism to be educated in mainstream schools. While there is some knowledge on school outcomes among students with autism from older studies, little is known about rates of qualification for upper secondary education among children with autism in mainstream schools today. This lack of knowledge is problematic since autism is diagnosed more widely, and prior evidence may not be relevant for individuals with autism and their families today. Using Swedish registers, we therefore examined this in a study including all children and young people in Stockholm County in 2001 through 2011. We found that about two thirds of children with autism without intellectual disability qualified for upper secondary education at the expected age, in comparison with about nine in ten among typically developing peers. We also found that girls with autism had further difficulties obtaining such qualification than boys and that those who were additionally diagnosed with attention-deficit hyperactivity disorder were particularly at risk of non-qualification. Finally, students with autism without intellectual disability had a greater chance of completing compulsory education if given an extended period to graduate. These findings underline the need for supportive interventions for children with autism during compulsory school. They may also challenge the inclusive education policy adopted by majority of western countries, at least in the wake of addressing special needs in mainstream schooling.

Silver Nanoplates for Colorimetric Determination of Xanthine in Human Plasma and in Fish Meat via Etching/Aggregation/Fusion Steps.

Silver nanoplates (AgP) were prepared and used in a colorimetric method for the evaluation of Xanthine (Xan) in blood plasma and fish meat. The detection mechanism for Xan was observed to occur via etching of AgP particles/aggregation/fusion steps, resulting in a color change from blue to grey. First, the basic Xan solution is adsorbed through partial substitution of capping molecules around the AgP with Xan, and then intermolecular hydrogen bonds form between AgP and AgP. Subsequently, the titrant Xan solution further etches the AgP and finally fuses particles together. Owing to the step by step mechanism, the response range towards Xan has two linear regression ranges: 0.15-0.60 µM and 0.61-3.00 µM, respectively. The detection limit in the range of 0.15-0.60 µM is 0.011 µM (S/N = 3). AgP exhibits good selectivity for Xan over other potential interferents such as amino acids and blood proteins. AgP achieves rapid detection of Xan and can be applied to the satisfactory determination of Xan in blood plasma and fish meat. This colorimetric sensor is easy to use, cost effective, fast, selective and user friendly.

The relationship between human leukocyte antigen-DP/DQ gene polymorphisms and the outcomes of HCV infection in a Chinese population.

BACKGROUND: Recently, human leukocyte antigen (HLA) class-II gene polymorphisms have been reported to be related to Hepatitis C virus (HCV) infection and chronicity. The objective of this study was to explore the relationship of HLA-DP rs9277535 and HLA-DQ rs7453920 with the outcomes of HCV infection. METHODS: The rs9277535 and rs7453920 were genotyped in 370 subjects with chronic HCV infection, 194 subjects with spontaneous HCV clearance, and 973 subjects with non-HCV infection from the Chinese population using the ABI TaqMan allelic discrimination assay. RESULTS: Logistic regression analyses showed that the minor allele A of rs7453920 significantly increased the susceptibility of HCV infection in dominant model (adjusted OR = 1.33, 95% CI: 1.04-1.71, P = 0.026) and additive models (adjusted OR = 1.30, 95% CI: 1.06-1.60, P = 0.012). Rs9277535 A allele significantly increased the risk of chronic HCV infection in dominant model (adjusted OR = 1.52, 95% CI: 1.01-2.28, P = 0.046). Haplotype AA showed a higher risk of HCV infection than the most frequent haplotype GG (adjusted OR = 1.37, 95% CI: 1.05-1.78, P = 0.018). CONCLUSION: The HLA-DQ rs7453920 and -DP rs9277535 mutations were significantly associated with HCV infection susceptibility and chronicity, respectively.

The immediate effect of muscle release intervention on muscle activity and shoulder kinematics in patients with frozen shoulder: a cross-sectional, exploratory study.

BACKGROUND: Contractile tissue plays an important role in mobility deficits in frozen shoulder (FS). However, no study has assessed the effect of the muscle release technique on the muscle activation and kinematics in individuals with FS. The purposes of this study were to assess the differences in shoulder muscle activity and kinematics between the FS and asymptomatic groups; and to determine the immediate effects of muscle release intervention in the FS group. METHODS: Twenty patients with FS and 20 asymptomatic controls were recruited. The outcome measures included muscle activity of the upper and lower trapezius (UT and LT), infraspinatus (ISp), pectoralis major (PM), and teres major (TM), shoulder kinematics (humeral elevation, scapular posterior tilt (PT) and upward rotation (UR), shoulder mobility, and pain. Participants in the FS group received one-session of heat and manual muscle release. Measurements were obtained at baseline, and immediately after intervention. Multivariate analysis of variance was used for data analysis. The level of significance was set at α=0.05. RESULTS: Compared to the controls, the FS group revealed significantly decreased LT (difference =55.89%, P=0.001) and ISp muscle activity (difference =26.32%, P =0.043) during the scaption task, and increased PM activity (difference =6.31%, P =0.014) during the thumb to waist task. The FS group showed decreased humeral elevation, scapular PT, and UR (difference = 35.36°, 10.18°, 6.73° respectively, P <0.05). Muscle release intervention immediately decreased pain (VAS drop 1.7, P <0.001); improved muscle activity during scaption (UT: 12.68% increase, LT: 35.46% increase, P <0.05) and hand to neck (UT: 12.14% increase, LT: 34.04% increase, P <0.05) task; and increased peak humeral elevation and scapular PT during scaption (95.18°±15.83° to 98.24°±15.57°, P=0.034; 11.06°±3.94° to 14.36°±4.65°, P=0.002), and increased scapular PT during the hand to neck (9.47°±3.86° to 12.80°±8.33°, P=0.025) task. No statistical significance was found for other group comparisons or intervention effect. CONCLUSION: Patients with FS presented with altered shoulder muscle activity and kinematics, and one-session of heat and manual muscle release showed beneficial effects on shoulder muscle performance, kinematics, mobility, and pain. TRIAL REGISTRATION: Retrospectively registered on Jan 18, 2016 (ACTRN 12616000031460 ).

Characterization and in vitro biocompatibility of catanionic assemblies formed with oppositely charged dicetyl amphiphiles.

In this study, cationic dicetyldimethylammonium bromide (DCB) and anionic dicetyl phosphate (DCP) were mixed to form catanionic assemblies in water, and their colloidal morphology, size, charge characteristics, phase behavior, membrane fluidity, and in vitro biocompatibility are comprehensively investigated for the first time. Our results show that the catanionic DCB and DCP mixtures in water are capable of forming circular vesicles and this binary mixed system expresses the miscibility with deviation from the ideal mixing. Compared to the nanoscale DCB-rich vesicles, the DCP-rich vesicles have smaller size, higher negative zeta potential, higher main transition temperature, and better storage stability. The temperature and molecular cooperativity of the main transition phase for the DCP vesicles can be reduced by an addition of DCB. This work demonstrates that the head groups and the relative composition of the two considered dicetyl amphiphiles remarkably affect the phase behavior, membrane rigidity, encapsulation ability and in vitro biocompatibility of DCB/DCP vesicles. The iso-stoichiometric mixed DCB/DCP vesicle, showing low cytotoxicity, long storage time, and high drug loading, is a potential candidate for the drug delivery system.

Development and Initial Validation of the Multicultural Personality Inventory (MPI).

Two studies summarize the development and initial validation of the Multicultural Personality Inventory (MPI). In Study 1, the 115-item prototype MPI was administered to 415 university students where exploratory factor analysis resulted in a 70-item, 7-factor model. In Study 2, the 70-item MPI and theoretically related companion instruments were administered to a multisite sample of 576 university students. Confirmatory factory analysis found the 7-factor structure to be a relatively good fit to the data (Comparative Fit Index =.954; root mean square error of approximation =.057), and MPI factors predicted variance in criterion variables above and beyond the variance accounted for by broad personality traits (i.e., Big Five). Study limitations and directions for further validation research are specified.