A cross-sectional study of COVID-19 vaccination patterns among patients with epilepsy in Hong Kong.

OBJECTIVE: As Hong Kong faced the 5th wave of the COVID-19 pandemic, the facilitators and hurdles toward effective vaccination is important for healthcare professionals to understand the vaccination gap among patients with epilepsy. METHODS: A cross-sectional, pragmatic study of COVID-19 vaccination was performed at a tertiary epilepsy center with regards to patterns of vaccination and any unusually high rate of adverse events. Patients having recent visits at the epilepsy center (4 months) had their anonymized electronic linkage records examined 12 months after the inception of vaccination program for types of vaccines, seizure demographics, and adverse events following immunization (AEFI). RESULTS: A total of 200 patients with epilepsy and their anonymized data were analyzed. The vaccine uptake was approximately 60% of that of the general population. Twice as many patients with epilepsy chose to receive mRNA vaccine as compared with inactivated vaccine. The proportion of patients who kept up-to-date with all available dosing was 7%. Patients with epilepsy with genetic etiology were least likely to receive vaccination (13/38, 34%, P = .02). There was no unreasonably high rate of unacceptable side effects after vaccination among patients with epilepsy. Only 3 patients reported worsening of seizures without meeting the criteria for AEFI. Refractory epilepsy, allergy to antiseizure medications and elder age (≥65) did not confer any significant difference in vaccination patterns or adverse effects. SIGNIFICANCE: A vaccination gap exists among epilepsy patients which calls for actionable strategies for improving vaccine uptake, including education and outreach programs.

Super-refractory status epilepticus in autoimmune encephalitis treated with interleukin-1 receptor antagonist, anakinra.

Autoimmune encephalitis is increasingly recognised as a major cause of new-onset refractory status epilepticus. Early immunotherapy with agents such as methylprednisolone is recommended. Anakinra is an interleukin-1 receptor antagonist used for various inflammatory disorders. It has been used successfully in the treatment of febrile infection-related epilepsy syndrome in children and in one adult case. In this case report, we describe a case of super-refractory status epilepticus in a 38-year-old female due to autoimmune encephalitis who was treated successfully with anakinra after 16 weeks of therapeutic coma and failing multiple immunotherapies. Despite a prolonged period of therapeutic coma, this patient made a reasonable recovery with effective communication and ability to walk with assistance upon discharge. We propose that the successful treatment with anakinra in our case could be due to elevated inflammatory cytokines in the pathogenesis of autoimmune encephalitis, although we acknowledge that interleukin levels were unfortunately not available. We conclude that anakinra can be a valuable alternative option in patients with autoimmune encephalitis refractory to conventional immunotherapies.

On computing critical factors based healthy behavior index for behavior assessment.

OBJECTIVE: Ubiquitous computing has supported personalized health through a vast variety of wellness and healthcare self-quantification applications over the last decade. These applications provide insights for daily life activities but unable to portray the comprehensive impact of personal habits on human health. Therefore, in order to facilitate the individuals, we have correlated the lifestyle habits in an appropriate proportion to determine the overall impact of influenced behavior on the well-being of humans. MATERIALS AND METHODS: To study the combined impact of personal behaviors, we have proposed a methodology to derive the comprehensive Healthy Behavior Index (HBI) consisting of two major processes: (1) Behaviors' Weight-age Identification (BWI), and (2) Healthy Behavior Quantification and Index (HBQI) modeling. The BWI process identifies the high ranked contributing behaviors through life-expectancy based weight-age, whereas HBQI derives a mathematical model based on quantification and indexing of behavior using wellness guidelines. RESULTS: The contributing behaviors are identified through text mining technique and verified by seven experts with a Kappa agreement level of 0.379. A real-world user-centric statistical evaluation is applied through User Experience Questionnaire (UEQ) method to evaluate the impact of HBI service. This HBI service is developed for the Mining Minds, a wellness management application. This study involves 103 registered participants (curious about the chronic disease) for a Korean wellness management organization. They used the HBI service over 12 weeks, the results for which were evaluated through UEQ and user feedback. The service reliability for the Cronbach's alpha coefficient greater than 0.7 was achieved using HBI service whereas the stimulation coefficient of the value 0.86 revealed significant effect. We observed an overall novelty of the value 0.88 showing the potential interest of participants. CONCLUSIONS: The comprehensive HBI has demonstrated positive user experience concerning the stimulation for adapting the healthy behaviors. The HBI service is designed independently to work as a service, so any other wellness management service-enabled platform can consume it to evaluate the healthy behavior index of the person for recommendation generation, behavior indication, and behavior adaptation.

Measurements of spontaneous ultraweak photon emission and delayed luminescence from human cancer tissues.

OBJECTIVE: The aim of this study was to measure spontaneous photon emission (SPE) and delayed luminescence (DL) from various human cancer tissues. MATERIALS AND METHODS: A photomultiplier tube attached to a dark chamber was used for the detection of ultraweak photon emission from cancer tissues in the chamber. The samples were illuminated with a 150 W metal halide lamp for the measurement of delayed luminescence. Frozen tissues were provided by the hospitals and preserved in saline solution in a CO2 incubator for 1 hour before starting the measurement of spontaneous photon emission. We successively measured the afterglows from the samples after 30-second irradiation of the lamp. The samples were divided into two groups: tumor tissues and normal tissues around tumor tissues. We presented experimental data and interpreted their characteristic patterns of spontaneous photon emission and delayed luminescence. RESULTS: Mean values of spontaneous photon emissions from the normal tissues and the tumor tissues were measured with the standard errors of the mean as 625 +/- 419 counts/minute/cm2 (n = 6) and 982 +/- 513 counts/minute/cm2 (n = 14), respectively. Peak values of the intensity of delayed luminescence from normal and cancerous tissues were 63 +/- 20 counts/ms (n = 6) and 48 +/- 12 counts/ms (n = 14). CONCLUSIONS: The intensity of spontaneous photon emissions from cancer tissues were mostly discriminated from those of normal tissues, and their delayed luminescent properties were investigated.

Spontaneous photon emission and delayed luminescence of two types of human lung cancer tissues: adenocarcinoma and squamous cell carcinoma.

We measured spontaneous photon emission and delayed luminescence from human cancerous lung tissue and compared with those from adjacent normal lung tissue. For the detection of extremely weak photon emission from tissue we used a sensitive photomultiplier tube attached to a dark chamber. The samples were illuminated with a metal halide lamp for measurement of delayed luminescence. Extracted samples from surgery were measured within an hour. We found that the delayed luminescence showed salient aspects in making discrimination between tumor and adjacent normal tissue. Squamous cell carcinoma had more prominent character in delayed luminescence than adenocarcinoma.

Year-long biophoton measurements: normalized frequency count analysis and seasonal dependency.

Biophoton emissions from three healthy human subjects were measured for 52 weeks. The active nature of dorsal hands and personal discernable patterns in palmar hands were investigated through frequency count analysis of biophoton emission rates. Also, the seasonal dependency of biophoton emission rates from human hands was studied and we found that emission rates were lowest in autumn. There was a reversion of relative emission rates from the palms and the dorsa depending upon the season. The emission rates from the palms remain rather stable throughout the year, but those from the dorsa vary widely depending upon the season. These features of biophoton emission rates were considered in light of the diagnostic view of traditional Chinese medicine.

Acridine orange staining method to reveal the characteristic features of an intravascular threadlike structure.

A threadlike structure in blood vessels that is considered part of the Bohghan duct system was first reported about 40 years ago. This structure has remained elusive since then due to the inability of other researchers to duplicate the original identification. In this study we identified the characteristic features of this threadlike structure in rats by the use of fluorescent microscope imaging of nuclei stained by acridine orange perfusion. The nuclei of the tissue that comprises the structure are rod-shaped, 10-20 microm long, and aligned in a broken-line striped fashion. The novel technique reported here can differentiate the intravascular threadlike structure from the fibrin strings that normally form during perfusion and can confound the observation procedure. The physiological function of the threadlike structure remains to be elucidated; however, further study may provide a new understanding of mammalian biology in general, and of acupuncture and Oriental medicine in particular.

Left-right and Yin-Yang balance of biophoton emission from hands.

Yearlong measurements of biophotons from palm and back of hand of three healthy people were performed. The detection of biophoton was done with two photomultiplier tubes whose spectral range was from 300 nm to 650 nm. The measurement was done on a circular area of diameter 46 mm whose centers were at the acupuncture point Laogong (PC8) of a palm and the mid-point of a back, respectively. The emission rates from the dorsa showed strong seasonal dependence which is consistent with the active nature of Yang meridians, while the palm sides show less seasonal dependence as they belong to the passive Yin meridians. This could be quantified simply by the standard deviations from the yearly average: They were 47.6 counts per second (cps), 66.1 cps and 66.0 cps from the dorsa, and 23.8 cps, 29.7 cps and 30.4 cps from the palms of subject 1, 2 and 3, respectively. Biophoton emission revealed qualitative individual tendencies: The subjects 1 and 2 emitted more strongly from the left dorsa, while the subject 3 from the right dorsum. The left-right balance of biophoton emission was well kept for normal people, which is in contrast with the severe imbalance for some stroke patients. Thus biophoton measurement has a diagnostic potential that encourages more studies.

Photon counting statistics analysis of biophotons from hands.

The photon counting statistics of biophotons emitted from hands is studied with a view to test its agreement with the Poisson distribution. The moments of observed probability up to seventh order have been evaluated. The moments of biophoton emission from hands are in good agreement while those of dark counts of photomultiplier tube show large deviations from the theoretical values of Poisson distribution. The present results are consistent with the conventional delta-value analysis of the second moment of probability.

Left-right asymmetry of biophoton emission from hemiparesis patients.

Left-right biophoton asymmetry from the palm and the dorsum of hands from 7 Korean hemiparesis patients were studied. There is a strong tendency that the left-hemiparesis patients emit more biophotons from the right than the left hands, while the right-hemiparesis patient emits more from the left hand. Acupuncture treatment reduces dramatically the left-right asymmetry of biophoton emission rates. However there is no systematic difference for the patients in the emission rates from the palm and the dorsum of hands.