A bibliometric analysis of the cause of sudden unexplained death in forensic medicine: Research trends, hot spots and prospects

Genetics and SUDEP: Challenges and Future Directions

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related deaths in children and adults with epilepsy. The incidence of SUDEP in children and adults is equal, approximately 1.2 per 1000-person years. Although inroads have been made in our understanding of SUDEP, its pathophysiology remains unknown. The most important risk factor for SUDEP is the presence of tonic-clonic seizures. Recently there has been growing interest in the contribution of genetic risk factors to SUDEP deaths. Pathogenic variants in epilepsy-related and cardiac genes have been found in some cases of SUDEP post-mortem. Pleiotropy may occur in which a single gene when altered may cause multiple phenotypes (i.e., epilepsy and cardiac arrhythmia). Recently it has been shown that some developmental and epileptic encephalopathies (DEEs) may also be at heightened risk of SUDEP. In addition, polygenic risk has been postulated to effect SUDEP risk with current models evaluating the additive effect of variants in multiple genes. However, the mechanisms underpinning polygenic risk in SUDEP are likely more complex than this. Some preliminary studies also highlight the feasibility of detecting genetic variants in brain tissue post-mortem. Despite the advances in the field of SUDEP genetics, the use of molecular autopsy remains underutilized in SUDEP cases. Several challenges exist concerning genetic testing post-mortem in SUDEP cases, such as interpretation, cost of testing, and availability. In this focused review, we highlight the current landscape of genetic testing in SUDEP cases, its challenges, and future directions.

The analysis of SUDEP forensic autopsies leading to preventable events

Introduction

The diagnosis of unexpected death by excluding non-natural causes, particularly in subjects with epilepsy, is a topic of interest and it is difficult to identify in the forensic field. Health professionals sometimes are faced with cases of sudden death, generally in young adults with a long history of epilepsy that require, for judicial purposes, an explanation in terms of cause and means to determine the death. SUDEP is an entity diagnosed by the exclusion of other causes that may have led to death, and then for forensic purposes, it requires particular attention and knowledge, and there is difficulty in identifying it. Our contribution aims to illustrate the scientific community pathological findings, medical history, and circumstantial evidence of four cases of sudden death in epileptic subjects.

Method

We illustrated four cases of judicial autopsies from the Institute of Forensic Medicine of Palermo, Italy; the purpose was to exclude the criminal intervention in determining the death as non-natural. The study of victims' medical history, the toxicological investigations, and the autopsy findings analyzed both from macroscopic and microscopic aspects have made it possible to highlight some findings that can be traced back to SUDEP despite the small sample of subjects studied.

Results

These presented findings of four SUDEP cases could help forensic pathologists in recognizing this entity, by highlighting its characteristics, and allowing for a pathological classification, also in relation to the use of drugs for epilepsy treatment and circumstances of death.

Discussion

To obtain a definite diagnosis of SUDEP, a complex investigation process is required in a multidisciplinary approach. Considering the literature review with criticism, it could allow health professionals to select the characteristics of epileptic patients at risk of sudden death. Processing human behaviors, molecular and histopathological findings of the autopsies, but also the physiological, and pathological human body system functions thanks to Artificial Intelligence, could be the key to explaining SUDEP mechanisms and the future results to prevent it.

The application of SUDEP in forensic diagnosis: a mini review

In the epilepsy population, the risk of sudden death from epilepsy is rare but is ~24 times greater than the risk of sudden death from other causes. Sudden unexpected death in epilepsy (SUDEP) has been widely recognized in clinical studies. Despite its significance as a cause of death, SUDEP is rarely used in forensic practice. This review focuses on the forensic characteristics of SUDEP, analyzed the reasons for its underuse in forensic practice, and illustrated the prospect of establishing uniform diagnostic criteria for sudden unexpected death in epilepsy and molecular anatomy in aiding forensic diagnosis.

A Bibliometric Review: Brain Tumor Magnetic Resonance Imagings Using Different Convolutional Neural Network Architectures

BACKGROUND

Numerous scientists and researchers have been developing advanced procedures and methods for diagnosing the kind and phase of a human tumor. Brain tumors, which are neoplastic and abnormal developments of brain cells, are one of the most prominent causes of death. Brain tumors, also known as lesions or neoplasia, may be roughly classified as either primary or metastatic. Primary brain tumors arise from brain tissue and its surrounding environment. The recognition of brain tumors using magnetic resonance images via a deep learning technique such as convolutional neural network (CNN) has garnered significant academic interest over the last few decades.

METHODS

In this study, a detailed evaluation based on bibliometrics is considered in order to synthesize and organize the available academic literature and to identify current research trends and hotspots. We used bibliometric methodologies and a literature review for the CNN-based brain tumor to synthesize and evaluate prior studies.

RESULTS

For this bibliometric analysis, we applied the Visualization of Similarity Viewer program to classify the major publications, notable journals, financial sponsors, and affiliations.

CONCLUSIONS

In conclusion, we suggest that one of the next paths of study will be the incorporation of other databases to advance CNN-based brain tumor identification from magnetic resonance images. No drug dosages are applied in this work.

Bibliometric analysis of post-traumatic stress disorder in forensic medicine: Research trends, hot spots, and prospects

Background

Post-traumatic stress disorder (PTSD) has various risk factors, complex pathogenesis, and diverse symptoms, and is often comorbid with other injuries and diseases, making forensic diagnosis difficult.

Methods

To explore the current research status and trends of PTSD, we used the Web of Science Core Collection databases to screen PTSD-related literature published between 2010 and 2021 and CiteSpace to perform bibliometric analysis.

Results

In recent years, PTSD-related research has grown steadily. The countries and institutions with the most research results were the United States and England, and King's College London and Boston University, respectively. Publications were identified from 2,821 different journals, including 13 forensic-related journals, but the journal distribution was relatively scattered and there was a lack of professional core journals. Keyword co-occurrence and clustering identified many hot topics; "rat model," "mental health," and "satisfaction" were the topics most likely to have a clear effect on future research. Analysis extracted nine turning points from the literature that suggested that neural network centers, the hypothalamic-pituitary-adrenal axis, and biomarkers were new research directions. It was found that COVID-19 can cause severe psychological stress and induce PTSD, but the relationship needs further study. The literature on stress response areas and biomarkers has gradually increased over time, but specific systemic neural brain circuits and biomarkers remain to be determined.

Conclusion

There is a need to expand the collection of different types of biological tissue samples from patients with different backgrounds, screen PTSD biomarkers and molecular targets using multi-omics and molecular biology techniques, and establish PTSD-related molecular networks. This may promote a systematic understanding of the abnormal activation of neural circuits in patients with PTSD and help to establish a personalized, accurate, and objective forensic diagnostic standard.

Mapping the intersection of nanotechnology and SARS-CoV-2/COVID-19: A bibliometric analysis

Background

Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed great medical and economic burdens on human society, and nanotechnology is a promising technique for managing the ongoing COVID-19 pandemic. To drive further studies on anti-COVID-19 nanotechnology, this paper provides an analysis, from a bibliometric perspective, of the intersection of nanotechnology and SARS-CoV-2/COVID-19.

Methods

We analyzed the 2585 publications on nanotechnology and SARS-CoV-2/COVID-19 included in the Web of Science Core Collection from January 2019 to March 2022 to determine the bibliometric landscape. The basic bibliometric characteristics are summarized in this article.

Results

Our bibliometric analysis revealed that the intersection between nanotechnology and SARS-CoV-2/COVID-19 is a cutting-edge field in the science community and that the related studies were multidisciplinary in nature. Studies on the structural basis of SARS-CoV-2, SARS-CoV-2 detection assays, and mRNA vaccines against COVID-19 provided the development foundation for this field.

Conclusions

The current research focuses are the development of nanomaterial-based vaccines and SARS-CoV-2 detection methods, and the design of nanomedicines carrying SARS-CoV-2 inhibitors is a relatively burgeoning frontier. In summary, this bibliometric analysis of the intersection of nanotechnology and SARS-CoV-2/COVID-19 highlights the current research focuses of this field to inspire future studies on anti-COVID-19 nanotechnologies.