Literature Review Research Articles

Explaining deuterium-depleted water as a cancer therapy: a narrative review

Deuterium is a natural heavy isotope of hydrogen, containing a neutron and a proton. This gives it distinct biophysical and biochemical properties, compared with hydrogen. Deuterium alters enzymatic activity in significant ways. Human metabolic processes minimize the amount of deuterium in mitochondrial water, because it causes a dysfunction in mitochondrial ATPase pumps, leading to excessive reactive oxygen species (ROS) and loss of ATP production. Mitochondrial dysfunction is a characteristic feature of cancer and many other diseases. Lactate plays an important role in cancer progression, and a central role holds also for vacuolar ATPases (V-ATPases). In the presence of excess deuterium, cancer cells show a remarkably altered metabolic policy, enabling invasion and proliferation. Cancer cells protect their mitochondria from excessive ROS by minimizing the use of ATPase to synthesize ATP. Instead, they rely on glycolysis to supply ATP and support the massive synthesis of lactate, which is excreted into the microenvironment. They also use V-ATPases in an unusual way at the plasma membrane to pump deuterium-depleted protons out of the cell, enriching cytoplasmic deuterium. These complex processes suggest that cancer cells are able to sense deuterium levels in the medium and commit apoptosis when deuterium levels are low or proliferate when they are high. Tumorigenesis involves a metabolic switch that supports increased cellular deuterium levels, decreasing the deuterium burden overall in the organism. Strong clinical evidence supports deuterium-depleted water (DDW) as an anticancer treatment. More investigations on cancer autophagic behavior are needed to guide DDW clinical use.

Mechanisms of Post-Stroke Stiff Knee Gait: A Narrative Review

Abstract Stiff-Knee gait (SKG) is a dysfunction commonly observed post-stroke characterized by a decreased swing phase knee flexion angle. Importantly, SKG can impair walking, ultimately reducing overall activity and participation. Interventions for SKG have shown mixed results, and combined with more recent observational evidence, suggest that there are other potential causes requiring the need to re-examine the etiology of SKG. The aim of this review is to compile and appraise the current state of the science regarding the neurophysiological and biomechanical impairments of individuals post-stroke with SKG. This narrative review will address the following topics to better understand SKG: operationally define SKG and further detail its presentation, describe the potential neurophysiological and biomechanical mechanisms of SKG, and synthesize findings. We explore evidence for quadriceps hyperreflexia, abnormal tone, motor incoordination, and impaired propulsion. We conclude that SKG needs a commonly accepted definition, that more attention needs to be devoted to understanding its mechanisms, and that in prospective designs, larger sample sizes are needed to account for the heterogeneity of the condition.

Periocular Aging Across Populations and Esthetic Considerations: A Narrative Review

As the face ages, the skin, fat, muscle, and fascia descend, and the underlying bone, cartilage, and teeth may lose mass. Oculofacial aging is a multifactorial process that is influenced by genetic, environmental, and lifestyle factors. This review summarizes the patterns of oculofacial aging that are observed across populations, including variations in periorbital hollowing, eyelid ptosis, and skin elasticity. Evidence indicates significant variability in aging patterns between sex- and race-based subgroups. Nonetheless, there remains a paucity of research on the progression of aging in some under-studied demographic groups. Signs of oculofacial aging often become apparent to patients well before these changes reach full maturity in later years, leading many to seek early esthetic interventions. Others may present with more advanced signs of aging, motivating a diverse range of therapeutic options. We discuss minimally invasive esthetic interventions to mitigate the signs of aging, which may include botulinum toxin injections, dermal fillers, applied energy-based treatments (e.g., lasers), and emerging techniques such as micro-focused ultrasound and platelet-rich plasma therapies. We review evidence on outcomes related to patient satisfaction and quality of life following esthetic interventions for oculofacial aging. Finally, we outline ethical considerations and challenges faced with the delivery of esthetic surgery, including treatment complications and the influence of social media. This review provides a comprehensive overview of oculofacial aging patterns, its management, and important considerations for the provision of esthetic oculofacial treatment.

Biomarker-Directed Radiotherapy in Breast Cancer

ImportanceIntegration of molecular biomarker information into systemic therapy has become standard practice in breast cancer care. However, its implementation in guiding radiotherapy (RT) is slower. Although postoperative RT is recommended for most patients after breast-conserving surgery and, depending on risk factors, following mastectomy, emerging evidence has indicated that patients with low scores on gene expression signatures or selected clinical-pathological features may have very low local recurrence rates. This narrative review explored the potential of biomarker-directed personalized RT approaches, which may optimize treatment strategies and be associated with improved patient outcomes and experiences.ObservationsDistinctions between prognostic and predictive biomarkers were highlighted, emphasizing the importance of analytical and clinical validity in biomarker-based studies. Findings from studies investigating the prognostic and predictive value of various genomic signatures and immunohistochemical markers for guiding breast RT were presented. These included the Adjuvant Radiotherapy Intensification Classifier and the Profile for the Omission of Local Adjuvant Radiation, which have shown potential in predicting RT benefits. The genomic-adjusted radiation dose and role of tumor-infiltrating lymphocytes were also discussed. Ongoing clinical trials exploring the use of biomarkers in ductal carcinoma in situ and invasive breast cancer to refine RT decision-making were illustrated.Conclusions and RelevanceThe results of this narrative review suggest that evidence-based shared decision-making is crucial to optimize treatment according to the individual’s predicted benefits and risks along with their personal preferences. Incorporation of biomarker-directed approaches in RT for breast cancer may hold promise for personalized treatment, potentially facilitating omission of RT for patients at low risk of recurrence, while identifying those who may benefit from intensified therapy. This personalized RT approach may be associated with improved clinical outcomes and quality of life and facilitate decision-making for people with breast cancer. However, there remains a need for robust clinical and analytical validation of biomarkers to ensure reliability and clinical utility for RT optimization.

‘It's about collaboration’: a whole-systems approach to understanding and promoting movement in Suffolk

Abstract Background Population-levels of physical activity have remained stagnant for years. Previous approaches to modify behaviour have broadly neglected the importance of whole-systems approaches. Our research aimed to (i) understand, (ii) map, (iii) identify the leverage points, and (iv) develop solutions surrounding participation in physical activity across an English rural county. Methods A systems-consortium of partners from regional and local government, charities, providers, deliverers, advocacy groups, and health and social care, and public health engaged in our research, which consisted of two-phases. Within Phase 1, we used secondary data, insight-work, a narrative review, participatory workshops, and interviews in a pluralistic style to map the system-representing physical activity. Phase 2 began with an initial analysis using markers from social network analysis and the Action Scales Model. This analysis informed a participatory workshop, to identify leverage points, and develop solutions for change within the county. Results The systems-map is constructed from biological, financial, and psychological individual factors, interpersonal factors, systems partners, built, natural and social environmental factors, and policy and structural factors. Our initial analysis found 13 leverage points to review within our participatory workshop. When appraised by the group, (i) local governing policies, (ii) shared policies, strategies, vision, and working relationships, (iii) shared facilities (school, sport, community, recreation), and (iv) funding were deemed most important to change. Within group discussions, participants stressed the importance and challenges associated with shared working relationships, a collective vision, and strategy, the role of funding, and management of resources. Actions to leverage change included raising awareness with partners beyond the system, sharing policies, resources, insight, evidence, and capacity, and collaborating to co-produce a collective vision and strategy. Conclusions Our findings highlight the importance and provide insight into the early phase of a whole-systems approach to promoting physical activity. Our whole-systems approach within Suffolk needs to consider methods to (i) grow and maintain the systems-consortium, (ii) create a sustainable means to map the system and identify leverage points within it, and (iii) monitor and evaluate change.

Neoconstitucionalismo teórico

Context: Since the mid-20th century, legal theory has questioned the paradigms of positivism. Problem: There are doubts as to whether this new vision effectively structures a new theory for law, as opposed to theoretical positivism. Objective: This text aimed to demonstrate that neoconstitutionalism – derived from the phenomenon of constitutionalization and modern constitutionalisms – truly reveals the consolidation of a new theory for law. Method: Supported by a narrative review, this paper explores the theoretical bases of the neoconstitutional vision of law, establishing counterpoints to positivism. Result: The positivist theory of law is currently threatened by a series of claims that undermine its postulates: the thesis of coactivity and the source of qualification, the theories of norm, ordering and interpretation. Final considerations: Theoretical neoconstitutionalism, supported by internationalized coercion, the preeminence of rights, principle-norms, a ius commune, and a model of progressive concretization, establishes the theoretical bases for the Constitutional Theory of Law.

Potential Protective or Pathogenic Roles of Parabacteroides distasonis in Diseases: A Narrative Review

Abstract Parabacteroides distasonis is a gram-negative, non-spore-forming, rod-shaped, anaerobic bacterium, and an important gut colonizer first isolated from human feces in 1933. Over more than 90 years of research, P. distasonis has been found to be associated with liver diseases such as liver fibrosis and non-alcoholic fatty liver disease, gastrointestinal diseases such as colitis and colorectal tumors and metabolic diseases such as obesity and diabetes, potentially playing a protective or pathogenic role in the occurrence and progression of these diseases. Herein, we elaborate on the biological characteristics, antibiotic resistance and potential roles of P. distasonis in these diseases, aiming to provide researchers with comprehensive information about P. distasonis and promote in-depth investigations into its safety and protective effects.

Water-Soluble Vitamins: Hypo- and Hypervitaminosis in Pediatric Population

Background/Objectives: Water-soluble vitamins, comprising the B-complex vitamins and vitamin C, are essential for normal growth, cellular metabolism, and immune function in pediatric populations. Due to limited storage in the body, these vitamins require consistent intake to prevent deficiencies. Pediatric populations, particularly infants and young children, face a heightened risk of both deficiency and, in rare cases, toxicity due to varying dietary intake and increased developmental needs. This review explores the clinical importance of water-soluble vitamins, focusing on hypo- and hypervitaminosis in children. Methods: A narrative review of the recent literature on the sources, recommended intakes, deficiency symptoms, and potential toxicities associated with each water-soluble vitamin was conducted. Results: Deficiencies in water-soluble vitamins can lead to diverse clinical outcomes, such as neurological, hematological, and immune-related symptoms, depending on the specific vitamin involved. Pediatric populations with increased nutritional needs, such as those experiencing rapid growth or with malabsorption conditions, are particularly vulnerable to vitamin insufficiencies. Conversely, although uncommon, excessive intake of certain water-soluble vitamins may cause mild toxicity, primarily gastrointestinal or neurological. Conclusions: Monitoring water-soluble vitamin levels and providing tailored nutritional support are critical to prevent the adverse effects of hypo- and hypervitaminosis in children. Further research is needed to refine pediatric nutritional guidelines and address the specific needs of young patients, supporting optimal health outcomes.

Multidrug Resistant Gram-negative Bacteria in Surgical Site Infections: Antimicrobial Resistance and Preventive Measures

Abstract Multidrug resistant (MDR) gram-negative bacteria (GNB) are responsible for high mortality and morbidity in healthcare settings worldwide. They have been declared as priority pathogens by the WHO for their continuously escalating antimicrobial resistance. Nevertheless, data associated with MDR GNB in healthcare-associated infections are insufficient. Surgical site infections (SSIs) are among the most commonly occurring healthcare-associated infections. Such infections are particularly common when bacteria from the patient's normal microflora are transferred to the surgical sites during surgical procedures. SSIs affect approximately 0.5%-3% of patients undergoing surgery, resulting in prolonged hospital stay compared with patients without SSIs. SSIs result in severe problems and lead to a heavy economic burden. Most SSIs can be avoided if suitable preventive measures are employed. Novel findings support the dedicated usage of oral preoperative surgical antimicrobial prophylaxis for specific surgeries based on sites/organs. Immediate interventions are sought to control the transmission of MDR GNB typically found in hospital settings. The present narrative review aims to describe MDR GNB in SSIs in different sites. Antimicrobial resistance epidemiology and preventive measures for SSIs are also discussed. Different intrinsic and extrinsic factors and control measures are elaborated for curbing SSIs.

Beyond the Physical: Weight Stigma and the Bariatric Patient Journey

Background: Obesity represents a global epidemic associated with significant health risks, including diabetes, cardiovascular disease, and certain cancers. Management strategies have evolved from focusing solely on weight reduction to emphasizing overall health improvements and mitigating associated risks. Methods: This narrative review analyzed the existing peer-reviewed literature across databases such as PubMed, Scopus, EMBASE, the Cochrane Library, and Google Scholar to examine the outcomes of bariatric surgery and its interplay with weight stigma. The review incorporated data from clinical studies, systematic reviews, and meta-analyses, focusing on bariatric surgery and its psychological impact, as well as approaches to mitigate stigma in bariatric care. Results: Bariatric surgery has emerged as the most effective intervention for sustained weight loss and the resolution of obesity-related comorbidities. However, individuals undergoing surgery frequently encounter weight stigma, both pre- and postoperatively, which manifests through discriminatory healthcare interactions, societal biases, and internalized self-criticism. These factors contribute to anxiety, depression, diminished healthcare engagement, and weight regain, ultimately affecting the long-term surgical outcomes. Conclusions: Addressing weight stigma in bariatric care is critical to optimizing outcomes. Interventions such as preoperative counseling, postoperative psychological support, and multidisciplinary care can mitigate the psychological and societal burdens of stigma. This review explores the intricate relationships between obesity, bariatric surgery outcomes, weight stigma, and the health-related quality of life (HRQOL).

Circular Economy and Water Resources Management

Objective: Present the Circular Economy of water as a regenerative system that maintains the value of the water resource in the economy for as long as possible, minimizing losses and the production of waste. Theoretical Framework: The research is based on the concepts of Circular Economy applied to water resources, highlighting the role of efficient and regenerative management in the context of a global problem of water scarcity. Method: A narrative review of the literature was carried out with research in databases such as Science Direct, Capes and Research Gate. Relevant articles on the topics of circular economy and water resources were selected. Results and Discussion: Significant interactions between water systems and all sectors of society were identified, as well as major opportunities to create additional value through the application of Circular Economy principles. The benefits observed include environmental factors such as water protection; social factors such as ensuring the supply of drinking water; and economic factors from strategic decision-making for implementation in the water sector. Research Implications: The adoption of the Circular Economy in water resources provides a viable model to meet the growing demand for water while promoting environmental sustainability, social equity and economic viability. Originality/Value: This study highlights the Circular Economy as an innovative and sustainable solution for water resource management, offering insights on how to apply its principles to maximize value and minimize environmental impacts.

Dietary Interventions and Physical Activity as Crucial Factors in the Prevention and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and affects nearly 30% of the adult population and 10% of the pediatric population. It is estimated that this number will double by 2030. MASLD is one of the leading causes of hepatocellular carcinoma, cirrhosis, and liver transplantation, as well as a significant risk factor for cardiovascular disease and mortality. Due to the ever-increasing number of patients, the long-term asymptomatic course of the disease, serious complications, and lack of preventive programs, as well as insufficient awareness of the disease among patients and doctors themselves, MASLD is a growing interdisciplinary problem and a real challenge for modern medicine. The main cause of MASLD is an inappropriate lifestyle—inadequate nutrition and insufficient physical activity, which lead to various components of metabolic syndrome. Lifestyle changes—appropriate diet, weight reduction, and systematic physical activity—are also the basis for the prevention and treatment of MASLD. Hence, in recent years, so much importance has been attached to lifestyle medicine, to non-pharmacological treatment as prevention of lifestyle diseases. The narrative review presents possible therapeutic options for non-pharmacological management in the prevention and treatment of MASLD. The best documented and available diets used in MASLD were discussed, focusing on the benefits and drawbacks of the Mediterranean, high-protein, ketogenic, and intermittent fasting diets. In addition, the most recent recommendations regarding physical activity are summarized.

The Effect of Autologous Platelet Rich Plasma on Endometrial Receptivity: A Narrative Review

Background and Objectives: Autologous platelet-rich plasma (PRP) transfusions are a relatively new treatment method used in different fields of medicine, including the field of reproductive medicine. One of the applications of these concentrated platelet infusions is the treatment of endometrial receptivity, which is a key factor for embryo implantation. There are implications that PRP infusions can lead to increased endometrial thickness, endometrial receptivity, and significantly elevated clinical pregnancy rates. Our objective is to briefly understand what PRP is and to, through a narrative review, summarize the findings from studies focused on evaluating the benefits of PRP infusions to treat thin endometrium with the goal of achieving better endometrial receptivity. Materials and Methods: Reference data was searched using Medline, PubMed, and EMBASE to identify reports from 2015 to 2024. The combination of search words used was “PRP” and “platelet-rich plasma” with “thin endometrium”, “endometrial receptivity”, “endometrial thickness”, and “endometrial implantation”. Obtained articles were screened, and suited studies (randomized controlled trials, case reports, case series, pilot studies, and reviews) were included in the present review. Reports not available in the English language were eliminated from the current review. Results: The results from most of the reviewed studies showed a positive effect of autologous PRP infusions on increasing endometrial thickness, enhancing endometrial receptivity, and elevating clinical pregnancy rates. The majority of the evaluated findings revealed endometrial thickness > 7 mm (increased endometrial thickness was observed in each evaluated study) following the PRP treatment. More than 50% of the evaluated studies resulted in enhanced endometrial thickness, increased endometrial receptivity, and an elevated pregnancy rate after the PRP application. Conclusions: Autologous PRP infusions for treating endometrium are a relatively new method that has shown promising results. Its major strengths are availability and proper application, which eliminates possible immunological reactions or disease transmission. The main drawbacks are not enough data on safety (i.e., its effect on endometriosis) and the lack of uniformity in the PRP preparation, which would provide optimal standardized quality and quantity of the PRP product and, thus, optimal treatment results.

Cardiac complications of arteriovenous access: a narrative review from a multidisciplinary team perspective

Although cardiovascular disease is common among hemodialysis patients, arteriovenous access creation has been invariably implicated in the evolution of adverse cardiac outcomes or deterioration of pre-existing cardiovascular disease. In most cases, these effects are subclinical but with potential underlying echocardiographic findings. Compared with grafts, arteriovenous fistulas are implicated more often, due to the progressively increased flow from the continuous dilatation of the venous outflow tract in the long term. The increasing flow is in the majority of patients well tolerated by cardiac adaptive alterations. However, the clinical impact is based on the balance between the amount of flow volume and the patient’s cardiac reserves. Having extensively reviewed the existing English literature, we present the pathophysiology and the different types of cardiovascular complications, the indications, types, and efficacy of flow-restrictive procedures in the context of a high-flow AVF, as well as some precautions and considerations for AVF creation in high-risk patients.

Conceptualisation and Measurement of Resilience of Adults With Cancer: An Umbrella Review.

To (1) clarify the key components of resilience of adults with cancer; (2) summarise and analyse the resilience measures used in this population; and (3) discuss future evaluation directions. An umbrella review. MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane library and Epistemonikos were searched in December 2023. The Joanna Briggs Institute (JBI) guidelines were followed for undertaking this umbrella review. Systematic and narrative reviews that defined resilience of adults with cancer and reported resilience measures, published in English, were included. The methodological quality was assessed using the JBI appraisal tool. Fourteen eligible reviews were included. Four key resilience components from various resilience conceptualisations were identified. Twenty resilience measures were used among cancer patients, with the 25-item Connor-Davidson Resilience Scale providing a relatively comprehensive assessment of individual resilience. Recommended future research with cancer patients includes assessing these resilience components: (1) available individual resources-key psychological factors that enhance individual resilience; (2) access to social resources-close interpersonal relationships, family cohesion and social support; (3) adaptive coping ability-problem-solving skills, emotional management strategies and experiences in managing adversity; (4) ability to regain mental health and well-being-the capacity to recover a relatively stable psychological state and promote positive psychological functioning. The findings provide evidence for refining future resilience measurement in the adult cancer population. Examining the four key components of resilience with this population across cultures is warranted. Understanding the key components of resilience of cancer patients can help healthcare professionals identify individuals who may need further support and facilitate early intervention or referral to psychosocial support services. The 25-item Connor-Davidson Resilience Scale is recommended over other tools for use in the cancer population. Patient or public involvement is not applicable in this study.

Pathogenesis, Diagnosis, and Management of Trigeminal Neuralgia: A Narrative Review

Trigeminal neuralgia (TN) is an excruciating neurological disorder characterized by intense, stimulus-induced, and transient facial stabbing pain. The classification of TN has changed as a result of new discoveries in the last decade regarding its symptomatology, pathogenesis, and management. Because different types of facial pain have different clinical therapy and neuroimaging interpretations, a precise diagnosis is essential. Diagnosis should include magnetic resonance imaging with specific sequences to rule out secondary causes and to identify possible neurovascular contact. The purpose of demonstrating a neurovascular contact is to aid in surgical decision making, not to validate a diagnosis. Microvascular decompression is the first-line procedure for individuals who do not respond to medical management, whereas carbamazepine and oxcarbazepine are the preferred medications for long-term care. New developments in animal models and neuroimaging methods will shed more light on the biology and etiology of TN. This paper reviews the pathogenesis, the clinical features, the diagnosis, and the management of TN. Furthermore, the potential role of low-intensity pulsed ultrasound in neurological disorders is discussed.

The Role and the Regulation of NLRP3 Inflammasome in Irritable Bowel Syndrome: A Narrative Review

Irritable bowel syndrome (IBS) is a chronic disorder of the gastrointestinal tract. Its pathogenesis involves multiple factors, including visceral hypersensitivity and immune activation. NLRP3 inflammasome is part of the nucleotide-binding oligomerization domain-like receptor (NLR) family, a crucial component of the innate immune system. Preclinical studies have demonstrated that inhibiting NLRP3 reduces visceral sensitivity and IBS symptoms, like abdominal pain, and diarrhea, suggesting that targeting the NLRP3 might represent a novel therapeutic approach for IBS. This review aims to assess the NLRP3 inhibitors (tranilast, β-hydroxybutyrate, Chang-Kang-fang, paeoniflorin, coptisine, BAY 11-7082, and Bifidobacterium longum), highlighting the signaling pathways, and their potential role in IBS symptoms management was assessed. Although premature, knowledge of the action of synthetic small molecules, phytochemicals, organic compounds, and probiotics might make NLRP3 a new therapeutic target in the quiver of physicians’ therapeutic choices for IBS symptoms management.

Edible Insects as an Alternative Source of Nutrients: Benefits, Risks, and the Future of Entomophagy in Europe—A Narrative Review

According to projections by the Food and Agriculture Organization of the United Nations, the global population will reach 9 billion by 2050. This raises concerns about the ability to feed such a population. In view of the above, it is necessary to search for alternative food sources. Edible insects are rich in complete protein, essential fatty acids, vitamins and micronutrients. Despite this, entomophagy is not common in Europe. In 2021, the European Union approved Acheta domesticus, Tenebrio molitor, Locusta migratoria, and Alphitobius diaperinus for consumption. However, their consumption may also be associated with certain hazards, e.g., food allergies. The purpose of this review is to present existing knowledge, discuss the possible dangers of consuming insects, and identify areas for further research. Studies in Asian populations indicate that edible insects may be responsible for 4.2–19.4% of food allergies and 18% of fatal food-induced anaphylaxis. There are also increasing reports from Europe of food allergies to edible insects. A thorough understanding of allergens, their properties, and the mechanisms of food allergies associated with edible insects’ consumption is essential for ensuring consumers’ safety. In the future, it would be worthwhile to investigate the effects of heat treatment on the allergenicity of insect proteins.

Exercise as Medicine: Tackling Chronic Pain and Depression to Boost Quality of Life—A Narrative Review

Depression and chronic pain are prevalent and often co-occurring conditions that pose substantial treatment challenges and economic burdens in the developed world. Research suggests that depression and chronic pain share overlapping pathways, particularly within the anterior cingulate cortex, which plays a critical role in emotional regulation and pain perception. Research indicates that exercise may alleviate depression. Given the shared neurobiology between depression and chronic pain, it is plausible that exercise could improve outcomes for individuals experiencing depression and chronic pain. Therefore, this review aims to provide clinicians with evidence-based tools to assess the role of exercise in the management of patients with coexistent pain and depression.

Charles Manson: Cult Leader, Counterculture Hero, and Psychopath

Although many popular culture publications attempt to delve into the psychology of Charles Manson, most focus on his criminal behavior and subsequent trial in relation to the Tate-LaBianca murders. This narrative review uses available biographic information about Manson across his lifespan and applies Robert D. Hare’s formulation of both interpersonal and affective traits associated with the psychological construct of psychopathy. Ultimately, this review identifies multiple elements in Manson’s personal history that meet Hare’s criteria for psychopathy. The results of this study add to the growing body of psychobiographies that utilize a retrospective framework from autobiographical information to comprehensively explore the psyches of historical figures. Keywords: Charles Manson, Psychopathy, Robert D. Hare, Psychobiography