Shifting perspectives: From "Epilepsy" to "Cerebroelectric Disorder".

BACKGROUND & OBJECTIVE: Epilepsy has long been associated with stigma and misconceptions. In response, the Korean Epilepsy Society initiated the Epilepsy Renaming project in 2008 to replace the stigmatizing term with a neutral and scientifically grounded name, "cerebroelectric disorder". This study explores the impact of changing terminology on the public discourse surrounding epilepsy. METHODS: Online news articles from distinct time periods (2001-2003, 2011-2014, 2017-2018, and 2020-2022) were analyzed using text data analysis techniques, including Latent Dirichlet Allocation topic modeling, frequency analysis, and sentiment analysis. The inclusion of data from 2017 to 2018 allowed for an examination of discourse trends independent of the COVID-19 pandemic's influence. Correlation of words in each period was visualized via network maps. Migraine was set as control term to highlight changes in perception devoid of significant stigma intervention efforts. RESULTS: The analysis revealed a significant shift in terminology preference, with cerebroelectric disorder gradually replacing epilepsy in news articles. The discourse surrounding epilepsy evolved over time from focusing on healthcare and economic aspects to patient-centered discussions, emphasizing the daily lives of individuals with epilepsy. This shift towards more empathetic and less stigmatized language was contrasted against the discourse on migraine, highlighting the specific impact of the terminological change on epilepsy's perception. CONCLUSION: The adoption of the neutral term "cerebroelectric disorder" in South Korea has influenced the discourse surrounding epilepsy, leading to more patient-centered discussions and a reduction in stigma. This study highlights the importance of terminology in shaping public perceptions of diseases and suggests that changing terminology can positively impact the understanding and destigmatization of epilepsy.

Resonant X-ray emission spectroscopy using self-seeded hard X-ray pulses at PAL-XFEL.

Self-seeded hard X-ray pulses at PAL-XFEL were used to commission a resonant X-ray emission spectroscopy experiment with a von Hamos spectrometer. The self-seeded beam, generated through forward Bragg diffraction of the [202] peak in a 100 µm-thick diamond crystal, exhibited an average bandwidth of 0.54 eV at 11.223 keV. A coordinated scanning scheme of electron bunch energy, diamond crystal angle and silicon monochromator allowed us to map the Ir Lß2 X-ray emission lines of IrO2 powder across the Ir L3-absorption edge, from 11.212 to 11.242 keV with an energy step of 0.3 eV. This work provides a reference for hard X-ray emission spectroscopy experiments utilizing self-seeded pulses with a narrow bandwidth, eventually applicable for pump-probe studies in solid-state and diluted systems.

Statistical analysis of hard X-ray radiation at the PAL-XFEL facility performed by Hanbury Brown and Twiss interferometry.

A Hanbury Brown and Twiss interferometry experiment based on second-order correlations was performed at the PAL-XFEL facility. The statistical properties of the X-ray radiation were studied within this experiment. Measurements were performed at the NCI beamline at 10 keV photon energy under various operation conditions: self-amplified spontaneous emission (SASE), SASE with a monochromator, and self-seeding regimes at 120 pC, 180 pC and 200 pC electron bunch charge. Statistical analysis showed short average pulse duration from 6 fs to 9 fs depending on the operational conditions. A high spatial degree of coherence of about 70-80% was determined in the spatial domain for the SASE beams with the monochromator and self-seeding regime of operation. The obtained values describe the statistical properties of the beams generated at the PAL-XFEL facility.

The Utilization of Core Exercises in Patients With Patellofemoral Pain: A Critically Appraised Topic.

Clinical Scenario: Patellofemoral pain (PFP) is characterized by general anterior knee pain around the patella and is one of the most prevalent knee conditions. PFP is challenging to treat due to a wide range of contributing factors and often has chronic, reoccurring symptoms. Traditional treatment focuses on quadriceps and gluteal strengthening with minimal emphasis on deep trunk musculature. Recently, there has been a growing body of literature supporting the beneficial effects of core stability exercises as a treatment option for PFP. Clinical Question: Are core stability exercises coupled with traditional rehabilitation more effective than only traditional rehabilitation techniques for decreasing pain in patients with PFP? Summary of Key Findings: Three articles met the inclusion criteria and investigated core strengthening exercises as a treatment for PFP. Two studies investigated a 4-week exercise protocol and demonstrated a greater decrease in pain when compared to the control group. The third study examined the effects of a 6-week program where both the intervention and control groups resulted in similar reduction of pain. All articles included received a minimum of 6 on the PEDro scale. Clinical Bottom Line: There is evidence that supports core stability exercise protocols coupled with traditional rehabilitation as being more effective in reducing pain in patients with PFP when compared to traditional rehabilitation alone. Strength of Recommendation: The grade of A is recommended based on the Strength of Recommendation Taxonomy.

Exertional Heat Stroke, Modality Cooling Rate, and Survival Outcomes: A Systematic Review.

Background and Objectives: The purpose of this systematic review is to synthesize the influence cooling modality has on survival with and without medical complications from exertional heat stroke (EHS) in sport and military populations. Methods and Materials: All peer-reviewed case reports or series involving EHS patients were searched in the following online databases: PubMed, Scopus, SPORTDiscus, Medline, CINAHL, Academic Search Premier, and the Cochrane Library: Central Registry of Clinical Trials. Cooling methods were subdivided into "adequate" (>0.15 °C/min) versus "insufficient" (<0.15 °C/min) based on previously published literature on EHS cooling rates. Results: 613 articles were assessed for quality and inclusion in the review. Thirty-two case reports representing 521 EHS patients met the inclusion criteria. Four hundred ninety-eight (498) patients survived EHS (95.58%) and 23 (4.41%) patients succumbed to complications. Fischer's Exact test on 2 × 2 contingency tables and relative risk ratios were calculated to determine if modality cooling rate was associated with patient outcomes. EHS patients that survived who were cooled with an insufficient cooling rate had a 4.57 times risk of medical complications compared to patients who were treated by adequate cooling methods, regardless of setting (RR = 4.57 (95%CI: 3.42, 6.28)). Conclusions: This is the largest EHS dataset yet compiled that analyzes the influence of cooling rate on patient outcomes. Zero patients died (0/521, 0.00%) when treatment included a modality with an adequate cooling rate. Conversely, 23 patients died (23/521, 4.41%) with insufficient cooling. One hundred seventeen patients (117/521, 22.46%) survived with medical complications when treatment involved an insufficient cooling rate, whereas, only four patients had complications (4/521, 0.77%) despite adequate cooling. Cooling rates >0.15 °C/min for EHS patients were significantly associated with surviving EHS without medical complications. In order to provide the best standard of care for EHS patients, an aggressive cooling rate >0.15 °C/min can maximize survival without medical complications after exercise-induced hyperthermia.

Hard X-ray self-seeding commissioning at PAL-XFEL.

A wake monochromator based on a large-area diamond single crystal for hard X-ray self-seeding has been successfully installed and commissioned in the hard X-ray free-electron laser (FEL) at the Pohang Accelerator Laboratory with international collaboration. For this commissioning, the self-seeding was demonstrated with a low bunch charge (40 pC) and the nominal bunch charge (180 pC) of self-amplified spontaneous emission (SASE) operation. The FEL pulse lengths were estimated as 7 fs and 29.5 fs, respectively. In both cases, the average spectral brightness increased by more than three times compared with the SASE mode. The self-seeding experiment was demonstrated for the first time using a crystal with a thickness of 30 µm, and a narrow bandwidth of 0.22 eV (full width at half-maximum) was obtained at 8.3 keV, which confirmed the functionality of a crystal with such a small thickness. In the nominal bunch-charge self-seeding experiment, the histogram of the intensity integrated over a 1 eV bandwidth showed a well defined Gaussian profile, which is evidence of the saturated FEL and a minimal electron-energy jitter (∼1.2 × 10-4) effect. The corresponding low photon-energy jitter (∼2.4 × 10-4) of the SASE FEL pulse, which is two times lower than the Pierce parameter, enabled the seeding power to be maximized by maintaining the spectral overlap between SASE FEL gain and the monochromator.

FEL performance achieved at PAL-XFEL using a three-chicane bunch compression scheme.

PAL-XFEL utilizes a three-chicane bunch compression (3-BC) scheme (the very first of its kind in operation) for free-electron laser (FEL) operation. The addition of a third bunch compressor allows for more effective mitigation of coherent synchrotron radiation during bunch compression and an increased flexibility of system configuration. Start-to-end simulations of the effects of radiofrequency jitter on the electron beam performance show that using the 3-BC scheme leads to better performance compared with the two-chicane bunch compression scheme. Together with the high performance of the linac radiofrequency system, it enables reliable operation of PAL-XFEL with unprecedented stability in terms of arrival timing, pointing and intensity; an arrival timing jitter of better than 15 fs, a transverse position jitter of smaller than 10% of the photon beam size, and an FEL intensity jitter of smaller than 5% are consistently achieved.

Generation of time-synchronized two-color X-ray free-electron laser pulses using phase shifters.

To optimize the intensity of X-ray free-electron lasers (XFELs), phase shifters, oriented in phase with the phases of the XFEL pulse and electron beam, are typically installed at undulator lines. Although a π-offset between the phases (i.e., an "out-of-phase" configuration) can suppress the XFEL intensity at resonant frequencies, it can also generate a side-band spectrum, which results in a two-color XFEL pulse; the dynamics of such a pulse can be described using the spontaneous radiation or low gain theory. This attributes of this two-color XFEL pulse can be amplified (log-scale amplification) through an undulator line with out-of-phase phase shifters. In this study, the features of two-color XFEL pulses were evaluated through theory, simulations and experiments performed at Pohang Accelerator Laboratory X-ray Free Electron Laser. The XFEL gain slope and energy separation between the two-color spectral peaks were consistent through theoretical expectation, and the results of simulation and experiment. The experimentally determined two-color XFEL pulse energy was 250 µJ at a photon energy of 12.38 keV with a separation of 60 eV.

Coherent synchrotron radiation monitor for microbunching instability in XFEL.

The microbunching instability is an important issue in an X-ray Free Electron Laser (XFEL). The intensity of the Free Electron Laser (FEL) can be reduced significantly by the microbunching instability so that the laser heater is widely used to reduce it. In the X-ray Free Electron Laser of the Pohang Accelerator Laboratory (PAL-XFEL), to directly monitor the microbunching instability, a visible charge coupled device camera was included into the coherent radiation monitor which uses a pyroelectric detector. It enabled us to measure the microbunching instability more clearly and optimize the FEL lasing in the PAL-XFEL.