Management of psychotropic medications in adults with intellectual disability: a scoping review protocol

Introduction: Psychotropic medications are commonly prescribed among adults with intellectual disability (ID), often in the absence of a psychiatric diagnosis. As such, there is great disparity between the estimated prevalence of mental illness and the rates of psychotropic medication use amongst people with ID. ‘Off-label’ use of these medications may account for much of this discrepancy, in particular their use in the management of challenging behaviour. This has come under scrutiny due to the myriad of side effects and the deficiency of high-quality data supporting their use for this indication. Understanding the causes and justifications for such disparity is essential in discerning the efficacy of current prescription practice. Objective: To explore the existing evidence base regarding the prescription and management of psychotropic medications in adults with ID. The aim will be achieved through identifying the psychotropic medications commonly prescribed, the underlying rationale(s) for their prescription and the evidence available that demonstrates their appropriateness and effectiveness. Additionally, the paper will seek to evaluate the availability of any existing guidance that informs the management of these medications, and the evidence and outcomes of psychotropic medication dose reduction and/or cessation interventions. Inclusion criteria: This review will consider studies that focus on the use of psychotropic medications amongst patients with ID. Methods: Research studies (qualitative, quantitative and mixed design) and Grey Literature (English) will be included. The search will be conducted without time restrictions. Databases will include: Ovid MEDLINE, Embase, CINAHL, JBI Evidence Synthesis, Cochrane Central Register of Controlled Trials, Cochrane Databased of Systematic Reviews, PsycINFO and Scopus. A three-step search strategy will be followed, with results screened by two independent reviewers. Data will be extracted independently by two reviewers using a data extraction tool with results mapped and presented using a narrative form supported by tables and diagrams.

The Association Between COVID-19 and Thyroxine Levels: A Meta-Analysis

ObjectivesRecently, a number of reports have described the potential relationship between COVID-19 and thyroid hormones, but the results were conflicting. We performed a meta-analysis to evaluate the effect of the severity of COVID-19 on thyroid-related hormones and the effect of thyroid-related hormones on the outcome of COVID-19 in order to try to confirm the association between the serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) and the severity or mortality of coronavirus-19 patients.MethodsThe methodology was already registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, and the protocol number is CRD42021269246. Systematic searches were carried out on the Cochrane Library, Embase, PubMed and Web of Science databases on November 15, 2021. We set up the literature search strategy based on the following keywords: [(T3 OR FT3 OR triiodothyronine) or (T4 OR FT4 OR thyroxine) or (TSH or thyrotropin)] and (COVID-19 OR SARS-CoV-2), without time restrictions.ResultsTwenty studies satisfied the inclusion/exclusion criteria and were included in the meta-analysis. A total of 3609 patients were enrolled in the study. From the analysis of the included studies, the incidence of thyroid-related hormone abnormalities was higher in patients with severe COVID-19, and the serum levels of FT3 and TSH were lower than those of patients with nonsevere COVID-19. However, the difference in the FT4 levels was not significant. Similar characteristics were shown between survivors and nonsurvivors. In addition, the outcomes of the meta-analysis showed that patients with abnormal thyroid-related hormones had greater mortality.ConclusionsLow FT3 serum levels, low FT4 serum levels and low TSH serum levels may increase the mortality of COVID-19 patients during admission. On the other hand, the higher the severity level of COVID-19, the higher the probability of decreases in the FT3, FT4, TSH levels.

Constitutional Principle of Social Solidarity as a Basis for the Consolidation of the Russian Society and States

The current circumstances related to the Covid-19 pandemic, which the entire world community had to face, raised sharply the question of mutual responsibility of the society and the state. At the same time, restrictions imposed at the state level are most often assessed by citizens as excessive. As a result, the number of studies devoted to establishing the legitimacy of restricting human rights and freedoms in the conditions of the epidemic is growing, however, such a phenomenon as social solidarity remains practically ignored. It is social solidarity, understood as the cohesion of the society (not only in the face of common threats and challenges), that can become the basis for constructive interaction between the society and the state. The aim of the study was the legal understanding of social solidarity as a new constitutional principle of the Russian state, which presupposes the possibility of establishing permissible restrictions on individual rights and freedoms in the conditions of protecting the foundations of the constitutional state from the modern threats. The absence of a normative definition of social solidarity in the current legislation of Russia, despite the constitutional reform carried out in 2020, entails difficulties in the correct interpretation of this phenomenon. The use of both general scientific and special methods of cognition of socio-legal phenomena — the formal legal method and the method of legal modeling — made it possible to see in social solidarity not only the legal structure, but also the leading moral and ethical principle of interaction between the society and the state. The analysis of the domestic legal acts made it possible to conclude that the constitutional principle of social cohesion of the society and the state in the face of various threats with the observance of such elements as the rule of law, the constitutional provision of individual rights and freedoms and the conditions for their permissible restriction is the basis for the inviolability of the state and its constitutional system.

Efficacy and safety of escitalopram and agomelatine in the treatment of major depressive disorder-A meta-analysis

Review question / Objective: The aim of this meta-analysis of randomized controlled trials is to evaluate the efficacy and safety of escitalopram and agomelatine in the major depressive disorder. Condition being studied: Major depressive disorder (MDD), is one of the most common, costly, and disabling mental health conditions worldwide, with an estimated 246 million sufferers globally in 2020.At present, there is a great demand for effective antidepressant treatment in medicine. Information sources: We will search, with no time restrictions, the following databases for relevant English language literature: PubMed, the Cochrane Central Register of Controlled Trials and Web of Science. The search string will be built as follows: (escitalopram) AND (agomelatine) AND (major depressed disorder).

The Informal Sector Facing COVID-19: The Case of Cameroon

This study aims to analyze the effects of COVID-19 on actors in the informal economy in Cameroon. To analyze the effects of the COVID-19 crisis on actors in the informal economy, we use secondary data from the National Institute of Statistics (NIS). These data come from a survey of 1310 households. We performed data analysis using comparative methods and a labor market participation model that considers changes in people’s behavior towards health risks in order to explore and compare empirical results with earlier studies. From this analysis, it was revealed that job losses are more important in the informal sector (and, in particular, among men). We note that the absence of wearing a mask decreases the chances of having an informal job and of being suspended from one’s job during the crisis. Likewise, time restrictions that are not appreciated by workers will push actors more towards the informal sector. These results lead to recommendations that contribute towards providing support or direct support to informal workers in the sector.

Increasing Animal Cognition Research in Zoos

Animal cognition covers various mental processes including perception, learning, decision-making and memory, and animal behavior is often used as a proxy for measuring cognition. Animal cognition/behavior research has multiple benefits; it provides fundamental knowledge on animal biology and evolution but can also have applied conservation and welfare applications. Zoos provide an excellent yet relatively untapped resource for animal cognition research, because they house a wide variety of species - many of which are under threat - and allow close observation and relatively high experimental control compared to the wild. Multi-zoo collaboration leads to increased sample size and species representation, which in turn leads to more robust science. However, there are salient challenges associated with zoo-based cognitive research, which are subject-based (e.g., small sample sizes at single zoos, untrained/unhabituated subjects, site effects) and human-based (e.g., time restrictions, safety concerns, and perceptions of animals interacting with unnatural technology or apparatus). We aim to increase the understanding and subsequent uptake of animal cognition research in zoos, by transparently outlining the main benefits and challenges. Importantly, we use our own research (1) a study on novelty responses in hornbills, and (2) a multi-zoo collaboration called the ManyBirds project to demonstrate how challenges may be overcome. These potential options include using drop and go apparatuses that require no training, close human contact or animal separation. This article is aimed at zoo animal care and research staff, as well as external researchers interested in zoo-based studies.

Rancang Bangun E-Learning System Pada SMK Pratiwi Prabumulih Menggunakan PHP & MySQL

Along with the development of internet technology, e-learning began to be developed. Thus encouraging the authors to maintain the quality of education by applying e-learning at Pratiwi Prabumulih Vocational High School. E-learning is one of the tools to improve the efficiency and effectiveness of performance in the teaching and learning process. E-learning is a web-based system developed using the PHP programming language, HTML document types and MySQL to manage databases. The research method used is the system development method, namely the waterfall method. The system design method with a functional approach is described using UML (Unified Modeling Language). With the web-based e-learning system, the teaching and learning process can be accessed in all places anytime and anywhere without time restrictions. E-learning supports functions/features (upload and download) of data in the form of document content. E-learning is also able to display online questions or exams and score results so that it helps in the learning process

Diagnostic value of YKL-40 for patients with asthma: A meta-analysis

Objective: YKL-40 is a highly conserved and chitin-bound human glycoprotein in mammals that is associated with airway inflammation and has no enzyme activity. We aimed to conduct a meta-analysis to assess the use of YKL-40 levels as a diagnosis of asthma. Methods: A meta-analysis was conducted based on the data from medical literature data base searches with time restrictions of January 2007 to January 2021. We searched and extracted relevant information from a total of 15 studies that reported YKL-40 levels in patients with asthma and in healthy controls, and obtained a sample of 1647 patients with asthma and 1259 healthy controls. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated for this study by using statistical software packages. Results: Serum YKL-40 levels were higher in the patients with asthma than in the healthy controls (SMD 1.36 ng/ml [95% CI, 0.82‐1.89 ng/ml]). YKL-40 levels are elevated in pediatric patients with asthma (SMD 2.26 ng/ml [95% CI, 1.33‐3.18 ng/ml]) and in adult patients with asthma (SMD 0.96 ng/ml [95% CI, 0.26‐1.66 ng/ml]). In addition, a subgroup analysis of asthma disease status showed that YKL-40 levels were significantly increased in the patients with stable asthma (SMD 1.69 ng/ml [95% CI, 0.81‐2.56 ng/ml]) and in those with acute exacerbation asthma (SMD 3.31 ng/ml [95% CI, 2.04‐4.58 ng/ml]), and serum YKL-40 levels were significantly higher in patients with acute exacerbation asthma than in patients with stable asthma (SMD 1.49 ng/ml [95% CI, 0.50‐2.48 ng/ml]). Conclusion: Results of this meta-analysis suggested that increased serum levels of YKL-40 in patients with asthma could be used as an emerging indicator for distinguishing individuals with asthma from healthy individuals.

Potential Targets Other than PSMA for Prostate Cancer Theranostics: A Systematic Review

Background: Prostate-specific membrane antigen (PSMA) is not sufficiently overexpressed in a small proportion of prostate cancer (PCa) patients, who require other strategies for imaging and/or treatment. We reviewed potential targets other than PSMA for PCa theranostics in nuclear medicine that have already been tested in humans. Methods: We performed a systematic web search in the PubMed and Cochrane databases, with no time restrictions by pooling terms (“prostate cancer”, “prostatic neoplasms”) and (“radioligand”, “radiotracer”). Included articles were clinical studies. The results were synthetized by the target type. Results: We included 38 studies on six different targets: gastrin-releasing peptide receptors (GRPRs) (n = 23), androgen receptor (n = 11), somatostatin receptors (n = 6), urokinase plasminogen activator surface receptor (n = 4), fibroblast activation protein (n = 2 studies) and integrin receptors (n = 1). GRPRs, the most studied target, has a lower expression in high-grade PCa, CRPC and bone metastases. Its use might be of higher interest in treating earlier stages of PCa or low-grade PCa. Radiolabeled fibroblast activation protein inhibitors were the most recent and promising molecules, but specific studies reporting their interest in PCa are needed. Conclusion: Theranostics in nuclear medicine will continue to develop in the future, especially for PCa patients. Targets other than PSMA exist and deserve to be promoted.

Profile of adverse events in toxoplasmosis drug therapy: a review

This study aims to analyze the profile of adverse events (AEs) of drugs for the treatment of Toxoplasmosis. This is a review carried out through a bibliographic search in the electronic databases PubMed, SciELO, Cochrane Digital Library and LILACS. The keywords “Toxoplasmosis” AND “Drug Therapy” AND “Drug-Related Side Effects and Adverse Reactions” were used. The selection was performed by two independent reviewers and the articles were included considering the presence of retrospective studies and case reports published in the literature in Portuguese and English and without time restrictions. In total, 40 articles were found, of which 14 met the inclusion criteria. Cases of cerebral, ocular, gestational and congenital Toxoplasmosis were identified. Among these, we observed a total of 85 patients with reports of AEs due to the use of Pyrimethamine, Sulfadiazine, Spiramycin, Clindamycin, Atovaquone, Trimethoprim and Sulfamethoxazole and Sulfadoxine. Clinical reactions were in the form of skin rash (57.1%), hematological alterations (28.5%), Lyell syndromes (7.1%), Stevens-Johnson (21.4%) and DRESS (21 .4%). The prevalence of AEs related to hematological alterations was seen mainly in treatments based on Pyrimethamine + Sulfadiazine, Trimethoprim and Sulfamethoxazole; on the other hand, those associated with severe syndromes are often related to the use of Pyrimethamine + Sulfadiazine. It is important to establish a standard protocol for drug therapy for Toxoplasmosis, which does not yet exist. In addition, the need to monitor patients after drug administration is highlighted, given the possibility of the occurrence of adverse events that can represent a threat to life.