Non-systematic Review Research Articles

Emerging Pharmacological Approaches for Psychosis and Agitation in Alzheimer's Disease.

Psychosis and agitation are among the most distressing neuropsychiatric symptoms (NPSs) of Alzheimer's disease (AD), linked to faster disease progression and earlier admission to nursing homes. While nonpharmacological treatments may alleviate mild behavioral symptoms, more severe syndromes often require pharmacological intervention. Brexpiprazole is the only medication approved for agitation in AD, although its limited clinical efficacy has raised criticism. No drugs have been approved for treating psychosis in AD, highlighting the critical need for new, effective, and safe treatments. Recent studies have elucidated part of the neurobiological basis of NPSs in the AD brain, offering insights for testing repurposed and novel drugs. We conducted a comprehensive nonsystematic literature review, aiming to provide a critical overview of both current treatments and emerging pharmacological interventions under clinical development for treating psychosis and agitation in AD. Additionally, we present strategies to optimize the clinical development of new drug candidates. We identify three promising compounds that are currently in phase 3 trials: xanomeline-trospium for AD psychosis, and dextromethorphan-bupropion and dexmedetomidine for agitation in AD. We propose that biomarkers linked to the neuropsychiatric traits of AD patients should be identified in dedicated studies and then included in phase 2 dose-range-finding studies with novel compounds to establish biological engagement. Furthermore, phase 3 placebo-controlled studies should be carried out in AD biomarker-confirmed subjects with narrower cognitive impairment ranges and precise NPS severity at screening. Alternative study designs, such as sequential phase approaches, may also be adopted.

Decision support systems in the diagnosis of urological diseases

The need to process large amounts of data has led to the creation of software that can improve and facilitate the work of medical staff. Decision support systems (DSS) are now used in many branches of medicine both at the outpatient and inpatient stages of medical care, helping clinicians to choose the tactics of treatment and management of each individual patient. These systems to a certain extent can improve treatment results and diagnostic process. The introduction of DSS in clinical practice has shown many advantages in reducing the frequency of misdiagnosis and, consequently, the risk of medical errors. At the same time, DSS can have a number of disadvantages. For example, physicians may view them as a threat to their “clinical autonomy”, and the implementation and subsequent maintenance of DSS can be quite costly. Artificial intelligence, which is increasingly being used not only for diagnosis, but also for treatment and prediction of outcomes in various diseases, should be considered as a prerequisite for the creation of DSS. Active development of artificial intelligence has been noted in almost all branches of medicine. A non-systematic review of the available literature published in the period between 2012 and 2022 has shown that the application of AI in prostate cancer diagnosis has great potential in clinical practice, as it helps both in the choice of treatment method and in planning the course of further surgery.

Colostrum: The Golden Elixir of Health – Unveiling Its Multifaceted Benefits in Modern Medicine

Introduction: Colostrum is uniquely rich in immunoglobulins, growth factors, antibacterial peptides, probiotics, prebiotics, and essential vitamins and minerals. Available as a supplement, BC is used to prevent gastrointestinal infections, boost immune support, and aid in managing chronic inflammation, autoimmune diseases, and even athletic recovery. Aim: The aim of this article is to assess the potential benefits of colostrum across various health areas, including gastrointestinal health, immune system support, respiratory diseases, dermatology, autoimmune conditions and the development of preterm infants. The article will also present a critical analysis of current scientific data and examine future research directions and therapeutic advancements. Review methods: This article is based on a comprehensive, non-systematic review of the scientific literature. A thorough search of the PubMed database was conducted, and 45 sources published up to 2024 were analyzed to ensure that the information presented is current and relevant. Abbreviated description of the state of knowledge: Analysis of the literature suggests that colostrum may provide passive protection, reduce inflammation and support gut integrity in preterm infants. Inflammatory bowel disease may benefit from colostrum, though results for IBS are mixed. It aids wound healing, has anti-aging effects, and shows potential in autoimmune disease management. It also boosts respiratory immunity and aids athletes' recovery and performance. Conclusions: Colostrum contains bioactive components like immunoglobulins, lactoferrin, and growth factors. While current studies highlight its benefits in enhancing immunity, supporting gut health, and managing inflammatory conditions, more comprehensive clinical trials are required to confirm its efficacy and safety across various populations and health conditions.

Current role of focal therapy in prostate cancer.

Thanks to the improved accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) to detect and localize the dominant index lesion on prostate cancer (PCa), the concept of minimally invasive focal treatments (FT) has gained popularity. Nevertheless, although high-quality evidence that FT has favorable functional outcomes, definitive proof of its oncological effectiveness compared to standard treatments remains underreported. This study aims to explore the efficacy, safety, oncologic and functional outcomes of different type of FT for PCa. A non-systematic literature review was conducted by searching on PubMed "prostate cancer" AND "focal treatment" OR "HIFU" OR "irreversible electroporation" OR "cryoablation" OR "focal laser ablation." Overall, 22 articles published in English literature from 2018 to 2023 describing FT techniques for PCa were included. Related to the field ablated, focal therapies include hemiablation (half gland), focal ablation (zonal-base) or targeted therapy (lesion-based). FT modalities can be categorized in thermal and non-thermal energy: thermal energy techniques include high-intensity focused ultrasound (HIFU), cryotherapy, radiofrequency ablation (RFA), and focal laser ablation (FLA). Focal brachytherapy, irreversible electroporation (IRE), and vascular-targeted photodynamic therapy (VTP) are classified as non-thermal ablation. Each focal ablative treatments could be promising alternative to conventional radical therapies to treat PCa in term of mid-term oncologic and functional outcomes, however, limited data are available in comparison with standardized radical treatments. HIFU and Cryo are the most studied techniques and seem to be superior to radical treatments in term of functional outcomes despite associated with higher recurrence and retreatment rate. Current evidences of oncologic and functional outcomes of FT are based mainly on retrospective, non-comparative and single center studies. Thus, none of the focal therapies available should be considered safe alternative to standardized treatments in routine practice and should be offered only for well selected PCa patients with low or at least favorable-intermediate risk disease, unfit for radical options.

Treatment of hypothalamic obesity with GLP-1 analogs

Abstract Introduction Congenital and acquired damage to hypothalamic nuclei or neuronal circuits controlling satiety and energy expenditure results in hypothalamic obesity (HO). To date, successful weight loss and satiety has only been achieved in a limited number of affected patients across multiple drug trials. Glucagon-like peptide-1 (GLP-1) acts via central pathways that are independent from the hypothalamus to induce satiety. GLP-1 receptor agonists (GLP-1RAs) may provide an alternative approach to treating HO. Methods We performed a comprehensive search in Medline, google scholar, and clinical trials registries (ClinicalTrials.gov; clinicaltrialsregister.eur). This non-systematic literature review was conducted to identify scientific papers published from January 2005 to February 2024, using the Pubmed and Embase databases. Key words used were GLP-1, GLP-1 receptor agonist, hypothalamic obesity, suprasellar tumor, and craniopharyngioma. Results Our search identified 7 case studies, 5 case series and 2 published clinical trials relating to the use of GLP-1RAs in HO. All case studies demonstrated weight loss and improved metabolic function. In contrast, results from case series were variable, with some showing no weight loss, and others demonstrating moderate to significant weight loss and improved metabolic parameters. In the “ECHO” clinical trial, nearly half the subjects randomized to weekly exenatide showed reduced BMI. Paradoxically, BMI reduction was greater in patients with more extensive hypothalamic injuries. Conclusion GLP-1RAs potentially offer a new approach to treating HO. There is a need to stratify patients who are more likely to respond. Further RCTs are required to determine their efficacy either in isolation or combined with other therapies.

Hemadsorption with CytoSorb in Infants with Sepsis: Non-Systematic Review of Cases.

Sepsis is a severe and potentially life-threatening condition that occurs when the body's response to an infection damages its own tissues and organs. It can lead to organ failure and death if not treated. Cytosorb is a promising medical device for hemadsorption in pediatric septic patients (under 18 years old). As many studies conclude, Cytosorb results in efficient hemodynamics stabilization. This paper is a nonsystematic review of cases. PubMed-, Google Scholar-, and Scopus-indexed journals were used to collect papers for the research. Overall, 11 pediatric cases (six journal articles) were collected. Reductions in interleukin (IL)-6 and IL-10 levels after hemoperfusion with CytoSorb suggest a potential benefit in modulating the inflammatory response in pediatric patients. Moreover, other septic shock indicators such as C-reactive protein, lactate, procalcitonin, ALT, and AST were also significantly reduced in surviving patients within the first few hours of hemadsorption with CytoSorb. The use of CytoSorb seems to be efficient in managing different sepsis-related conditions, even in neonatal and infant populations, as a valuable supplementary tool. However, overcoming the obstacles associated with the age and weight of pediatric patients might necessitate the creation of CytoSorb devices tailored specifically to their needs.

Forensic and legal medicine in Chile: Cinderella without a prince.

Forensic medicine is of enormous importance in the functioning of contemporary justice systems worldwide. Therefore, in order to characterize the current state of medicolegal and forensic activity in Chile, a non-systematic review of the biomedical and legal literature on the subject was carried out. An analysis of open sources of information was also incorporated, including the National Registry of Individual Health Care Providers, the latest public accounts of the Forensic Medical Service, relevant background information available on the active transparency portal of that institution, exempt resolutions included in the "Chile Law" database (of the Department of Legislative and Documentary Services of the Library of the National Congress) and the lists of judicial experts appointed by the Courts of Appeals of the country for the biennium 2024 to 2025. We note that Chile maintains an unacceptable historical debt in terms of academic development and training of qualified professionals in forensic matters. Likewise, national scientific productivity in this field is practically null. Currently, forensic medicine is the medical specialty with the deepest shortage of professionals nationwide. Consequently, as in the early part of the last century, medical expert opinions are frequently performed by professionals untrained in forensic medicine. This scenario, taking into account the attitudes of certain lawyers and judges (detailed in the article), increases the risk of a miscarriage of justice. National public policies must take urgent action to address the deficits and provide solutions.

Artificial Intelligence in Breast Cancer Diagnosis and Treatment: Advances in Imaging, Pathology, and Personalized Care.

Breast cancer is the most prevalent cancer worldwide, affecting both low- and middle-income countries, with a growing number of cases. In 2024, about 310,720 women in the U.S. are projected to receive an invasive breast cancer diagnosis, alongside 56,500 cases of ductal carcinoma in situ (DCIS). Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life. About 65% of women with the BRCA1 and 45% with the BRCA2 gene variants develop breast cancer by age 70. While these genes account for 5% of breast cancers, their prevalence is higher in certain populations. Advances in early detection, personalised medicine, and AI-driven diagnostics are improving outcomes by enabling a more precise analysis, reducing recurrence, and minimising treatment side effects. Our paper aims to explore the vast applications of artificial intelligence within the diagnosis and treatment of breast cancer and how these advancements can contribute to elevating patient care as well as discussing the potential drawbacks of such integrations into modern medicine. We structured our paper as a non-systematic review and utilised Google Scholar and PubMed databases to review literature regarding the incorporation of AI in the diagnosis and treatment of non-palpable breast masses. AI is revolutionising breast cancer management by enhancing imaging, pathology, and personalised treatment. In imaging, AI can improve the detection of cancer in mammography, MRIs, and ultrasounds, rivalling expert radiologists in accuracy. In pathology, AI enhances biomarker detection, improving HER2 and Ki67 assessments. Personalised medicine benefits from AI's predictive power, aiding risk stratification and treatment response. AI also shows promise in triple-negative breast cancer management, offering better prognosis and subtype classification. However, challenges include data variability, ethical concerns, and real-world validation. Despite limitations, AI integration offers significant potential in improving breast cancer diagnosis, prognosis, and treatment outcomes.

New Approaches to Researching AI Crime: Institutionalization of Digital Criminology

Objective: the article deals with modern scientific approaches to the “digital society”, identifies new criminological perspectives, such as that of digital criminology in an ever-changing hybrid world, in the scientific study of the potential use of AI by criminals, including what is referred to here as AI crime.Methods: this article is an essay commonly used in humanities and social sciences, as the author aims to present provocative arguments to encourage readers to rethink AI issues in relation to criminality in the “hybrid world” based on a non-systematic literature review. The arguments should be supported by relevant references to “digital criminology” and its non-binary way of thinking in favour of a techno-social approach.Results: the era of divided perspectives is coming to an end, and it’s time for synergies, especially at the interdisciplinary level. The «mirror of artificial intelligence» can help identify flaws and solutions, ensuring the future of AI and human society is decided by the people. In a digital society, technology is integrated into people’s lives, including crime, victimization, and justice. Digital technologies blur the boundaries between online and offline realities, creating a human-technological hybrid world where crimes occur in virtual networks. AI has potential for social good and Sustainable Development Goals, but concerns about human rights violations need to be addressed. Multidisciplinary approaches are needed to ensure safe use, address education inequalities, enhance justice, and identify online behavior as deviant or criminal. In the context of emerging technoethics, the idea that this unofficial norm, derived from a popular belief, will be the ‘touchstone’ for characterising online mediated behaviour as deviant/ crimninal, is missing - or rather in the process of being formed.Scientific novelty: the author aims to provide some insightful thoughts on formulating the right questions and interesting reflections from a technoethical perspective on the phenomenon of the use of information and communication technologies for criminal purposes under the catalytic influence of AI, recognising the social challenges arising from technological disruption (e.g. prediction and prevention through the transformation of policing, increased surveillance and criminal justice practises) in “digital society”.Practical significance: some of the initial ideas of this theoretical material can be used in the elaboration of proposals for amendements and additions to the current crime legislation, as well as in pedagogical activity, especially in the implementation of educational courses or modules on crime in the context of the digital transformation of society.

Trace Lithium for Suicide Prevention and Dementia Prevention: A Qualitative Review.

Background: Anti-manic effects of lithium and the nature of trace element in lithium were first observed in 1949. In this review, we explore the potential effects of trace lithium in the prevention of suicide and dementia. Methods: This is a qualitative and non-systematic review. Results: While most studies to date have been cross-sectional, limiting the establishment of causal relationships, the potential benefits of trace lithium for suicide prevention and dementia prevention are notable, especially in the absence of radical treatments for suicide and dementia. Furthermore, trace lithium appears to lack many of the adverse effects associated with so-called therapeutic lithium levels. Conclusions: The present findings suggest that trace lithium may be associated with lower suicide rates and reduced dementia rates. Probably, trace lithium may inhibit testosterone and thereby mitigate aggression and impulsivity and decrease suicide. Also, trace lithium may inhibit GSK-3β and thereby lower amyloid β and tau hyperphosphorylation and inhibit pro-inflammatory cytokines such as IL 6 and IL 8 and thereby mitigate inflammation, whereas trace lithium may promote BDNF and neurogenesis in the general population.

A importância dos conceitos de “paisagem” para o ambientalismo brasileiro

This article intends to contribute to the debate on the importance of the concepts of “landscape” for national environmentalism, especially in the context of socio-environmental collapse we are currently experiencing, marked by the intensification of the negative consequences of climate change. The discussion starts with a characterization and critical analysis of the use of the concepts of “landscape” in three fields: Ecology, Environmental Education, and Law by means of a non-systematic bibliographic review and analysis of secondary data.

Artificial urinary sphincter: recent developments and the way forward.

The AMS 800 has dominated the treatment of postprostatectomy urinary incontinence (PPUI) due to intrinsic sphincter deficiency (ISD) for five decades. A narrative review from June 2022 to June 2024 was conducted using 'artificial urinary sphincter' (AUS) MeSH terms in Embase. We extracted information on innovative AUS, randomized controlled trials (RCTs) or prospective studies, and systematic reviews. We evaluated the latest guidelines and consensus and analyzed current trends to discuss options for advancing AUS practices. Of 465 papers identified, 320 were excluded (irrelevant, duplicates, non-AUS devices, non-English, veterinary), and 145 were reviewed, with 24 selected: seven on novel AUS in development, 7 with higher-level evidence (1 RCT, 1 prospective, 4 systematic reviews, 1 nonsystematic review), and 9 retrospective relevant studies [pressure regulating balloon (PRB), revision strategies, radiotherapy history, manual dexterity/cognition, transscrotal vs. transperineal approach]. The final paper summarized current guidelines from Asia & Pacific on AUS. In the past 2 years, six novel AUS have emerged, two female RCTs are ongoing, the SATURN study published its 1-year outcomes, and four systematic reviews on female AUS were conducted. These findings enhance evidence levels and position novel AUS to challenge the Gold Standard.

The role of feedback in the development of managers

The landscape in which modern organisations operate is rapidly changing and requires managerial agility. This necessitates a frequent review of how managers are developed. The aim of this article is to examine the role of workplace feedback in employee development. This will be achieved by developing a contemporary and comprehensive definition of feedback and specifying the elements of feedback that are associated with managerial development. Employing a qualitative, non-systematic literature review approach, journal articles and textbooks published after 2015, with feedback as their primary theme, were systematically selected and analysed for their content as well as the seminal works they referred to. The analysed literature suggests that feedback forms part of a dynamic communication and learning process. Development-driven feedback is information presented to recipients regarding their behaviour and/or performance in executing work tasks, as assessed by supervisors, subordinates, peers, coworkers, or the recipients themselves, with the intent to enhance work relationships and job performance. The elements central to structuring feedback were identified as purpose, content, source, frequency, timing, and delivery. These elements are customised to meet workplace performance requirements, also taking individual skill sets and personalised needs into account. A broad base of academic literature was captured and integrated to reach a comprehensive understanding of feedback as a development intervention. It was concluded that, although complex, literature on feedback can be consolidated to present both an inclusive definition of the concept and the elements associated with it.

Minimising Harm and Managing Pain: Deprescribing Opioids in Older Adults.

Approximately one in three older adults (aged 65 years and over) experience pain, negatively impacting their quality of life. Opioid analgesics are commonly prescribed to manage pain; however, balancing the benefits and harms of these high-risk analgesics can be challenging for both healthcare professionals and patients. This is particularly true for older adults, as factors such as polypharmacy, age-related physiological changes and cognitive decline may impact upon opioid safety and efficacy. Deprescribing is the patient-centred process of reducing or discontinuing a medication that is no longer appropriate, or where the risks of continuation are deemed to outweigh the anticipated benefits. Opioid deprescribing has been proposed as a mechanism to reduce individual and societal opioid-related harm; however, to date, research has predominantly focused on the general adult population, rather than older adults. This current opinion aims to summarise the existing opioid deprescribing literature, discussing its applicability for older adults. Drawing on a non-systematic review of the literature, it identifies unique challenges and considerations for this population, highlights international initiatives to enhance opioid deprescribing in clinical practice and proposes future directions to advance the field.

Developing a structured framework to address vaccination barriers for Newly Arrived Migrants in EU/EEA

Abstract Background Access to vaccination is a critical aspect of public health, particularly for newly arrived migrants (NAMs) in European Union/European Economic Area (EU/EEA) countries. Despite this, significant barriers exist, necessitating urgent attention. This study addresses the pressing need to improve vaccination coverage for NAMs by developing a General Conceptual Framework (GCF) to understand and overcome system barriers and analyzing possible strategies. Methods starting from a theoretical conceptualization, the study employed a mixed-method approach, incorporating literature review and qualitative research. The GCF was formulated based on key components of the vaccination process. Barriers and solutions were identified through a non-systematic literature review and qualitative investigation. The GCF served as a guide for study activities, facilitating data integration. Results The study outlines a structured GCF comprising five interconnected steps in the vaccination process: entitlement, reachability, adherence, achievement, and evaluation of vaccination. Barriers and solutions identified through literature review and qualitative research are presented. Strategies to enhance professional knowledge, accessibility, adherence, coverage, and intervention evaluation are proposed. Recommendations include proximity strategies, provider training, migrant-sensitive approaches, and robust data collection. Conclusions Equitable access to vaccination is paramount for public health, particularly for vulnerable populations like NAMs in EU/EEA countries. The development of the GCF represents a crucial step towards understanding and addressing barriers to vaccination access. Implementation of recommended strategies can significantly improve vaccination outcomes for NAMs, ultimately contributing to the overall health and well-being of these communities.

Conceptualising self-reflexive practice as transformational competence: Exploring relationships and relatedness in a fourth industrial revolution technological environment

In the author’s exploration of the literature, little seems to be known regarding the potential value of self-reflexive practice in exploring the fourth industrial revolution (4IR) and its related phenomena. The thesis is presented in narrative format and based on personal experience and insights, supported by a non-systematic review of the literature on self-reflexive practice and the 4IR. This perspective argues that one of the most impactful transformational competences in the context of the 4IR, is arguably what is known as self-reflexive practice (SRP). Through this practice we elucidate our conscious and unconscious assumptions and orientations towards the 4IR and associated phenomena. The aim of this article was to highlight the importance of self-reflexive practice as a critical skill for navigating the complexities and challenges presented by the Fourth Industrial Revolution. In this article SRP is conceptualised as the critically informed stance of reflexive dialogue with the self, regarding conscious and unconscious realities. It is argued that the value of SRP lies in its capacity to a) foster critical thinking, b) manage paradoxes, dilemmas and complexities that are characteristic of the 4IR, and c) create psychological “containing spaces” for complexity, ambivalence, and ambiguity. Thus, reflexivity as a way of being, could help us reshape and reorient how we relate to the 4IR and enable practitioners to learn from experience (through deep reflection) about themselves, their work and the way they relate.

Biomarkers for autism spectrum disorder: a short review

Background: Autism Spectrum Disorder (ASD) is characterized by social disabilities and stereotyped behaviors. There is a relevant social impact on autistic people’s lives and, therefore, biomarkers have become relevant for understanding neurobiological mechanisms. Objective: This study aims to review current knowledge about the role of biomarkers and their main scientific evidence in autism. Methods: We performed a non-systematic literature review through the PubMed database, using the keywords “biomarkers”, “autism” and “autism spectrum disorder”. The search was restricted to articles written in English, in the last 10 years. Results: Analyzing the articles found, it is possible to delimit the biomarkers according to the development of ASD, from the prenatal period with exposure to diseases or association of autism with other genetic diseases, through the immune and nutritional factors exposed during pregnancy, and for end those associated with diagnoses phase in which there is the presence of symptoms in which these markers can be used to aid in the diagnosis. Conclusion: Although preliminary, biomarkers may hold promise for prenatal and presymptomatic screening. It may also be used as predictors of treatment for autism spectrum disorder.

Features of refeeding syndrome in pediatric intensive care unit patients (literature review)

Introduction. Restoration of nutrition in patients with nutritional deficiency hospitalized in intensive care units is a complex process due to the high risk of the development of refeeding syndrome. Refeeding syndrome is insufficiently studied in children not only with regard to pathogenesis and intensive care, but also with regard to its influence on the further development of the child.Materials and methods. A non-systematic review of literature sources was performed. Domestic publications were searched in the database on the eLibrary website, foreign publications were searched in PubMed, Google Scholar, Cophrane Library, Cyberleninka, ResearchGate databases in the period 2017–2024. 73 full-text publications describing risk factors, peculiarities of mechanisms of refeeding syndrome development in children, clinical picture and methods of intensive therapy were analyzed.Results. The review analyzed and systematized the stratified risk factors, peculiarities of pathogenesis and clinical picture of refeeding syndrome in children depending on developing metabolic disorders. The connection of refeeding syndrome on the progression of nutritional deficiency is shown. The main methods of intensive therapy, including nutritional support for patients with high-risk and developed refeeding syndrome are determined.Conclusion. Currently, there is no unambiguous definition and diagnostic criteria for refeeding syndrome in children. Timely intensive therapy in cases of refeeding syndrome development allows to correct nutritional deficiency, to increase the survival rate of patients, can influence further growth and development of the child.

Touch: A Review of the Infant-Caregiver Relationship in the Neonatal Field

Touch is a domain of enormous importance with implications in development, from birth, and across the lifespan. This work aims to review touch implications within infant-caregiver interaction. A non-systematic review of the literature was performed to assess the relevance of touch in the neonatal period, on attachment, and in child development. The review was conducted on PubMed database, in May 2023 using the following keywords: “infant”, “child”, “baby”, “newborn”, “neonatal”, “touch”, “contact”, “tactile”, and “attachment”. In the neonatal period, close skin contact facilitates caregiver sensitivity and responsiveness, promotes parent-infant reciprocity, reduces psychological distress both in caregiver and infants, and regulates the infant’s physiological systems (circadian rhythm, autonomic regulation). Touch also plays a crucial role in attachment by contributing to synchrony and self-regulation abilities, since secure attachment promotes learning of emotional regulation, social skills, and behavioural organization. Early sensory experiences are critical to developmental dimensions such as cognitive, motor, and socio-emotional, and influence physical growth rate. Concluding, in neonatal care services, touch should be systematically addressed in routine appointments. Within the field of infant-caregiver interactions, there is an urgent need to create a reliable tool for tactile assessment, allowing clear interpretations and the development of target interventions.

Overcoming Graft Rejection in Induced Pluripotent Stem Cell-Derived Inhibitory Interneurons for Drug-Resistant Epilepsy.

Cell-based therapies for drug-resistant epilepsy using induced pluripotent stem cell-derived inhibitory interneurons are now in early-phase clinical trials, building on findings from trials in Parkinson's disease (PD) and Huntington's disease (HD). Graft rejection and the need for immunosuppressive therapy post-transplantation pose potential barriers to more epilepsy patients becoming potential candidates for inhibitory interneurons transplantation surgery. The present literature review weighs the evidence for and against human leukocyte antigen (HLA)-mediated graft rejection in PD and HD and examines the potential advantages and drawbacks to five broad approaches to cell-based therapies, including autologous cell culture and transplantation, in vivo reprogramming of glial cells using viral vectors, allogeneic transplantation using off-the-shelf cell lines, transplantation using inhibitory interneurons cultured from HLA-matched cell lines, and the use of hypoimmunogenic-induced pluripotent stem cell-derived inhibitory interneurons. The impact of surgical technique and associated needle trauma on graft rejection is also discussed. Non-systematic literature review. While cell-based therapies have enjoyed early successes in treating a host of central nervous system disorders, the immunologic reaction against surgical procedures and implanted materials has remained a major obstacle. Adapting cell-based therapies using iPSC-derived inhibitory interneurons for epilepsy surgery will similarly require surmounting the challenge of immunogenicity.