Many pathogens cause disease in dogs, however, meaningful surveillance in small companion animals is often only possible on the most impactful diseases. We describe the first stakeholder opinion-led approach to identify which canine infectious diseases should be prioritized for inclusion in surveillance and control strategies in the UK. Participants were identified through a stakeholder analysis. A multicriteria decision analysis was undertaken to establish and weight epidemiological criteria for evaluating diseases, and a Delphi technique was employed to achieve a consensus among participants on the top-priority canine diseases. Leptospirosis and parvovirus were identified as the top two endemic diseases of concern, whilst leishmaniasis and babesiosis were the top two exotic diseases. Respiratory and gastrointestinal diseases were identified as the top two syndromes of concern. Findings from this study are being used to inform the development of a future UK-wide epidemic response strategy. This methodology could provide a blueprint for other countries.

Abstract Objective: To compare effectiveness of topical 5-aminolevulinic acid-mediated photodynamic therapy (5-ALA PDT) and loop electrosurgical excision procedure (LEEP) among patients with cervical intraepithelial neoplasia (CIN). Design：Retrospective study. Setting：Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital. Population or Sample：Female patients with a histologically confirmed CIN or HPV infection were treated by 5-ALA PDT or LEEP. Methods: Patients underwent either 5-ALA PDT or LEEP from Sep. 2012 to Dec. 2019 in Chinese PLA general hospital. Propensity score matching (PSM) was adapted to pair the baseline. Main Outcome Measures: Complete remission (CR), partial remission (PR) and the remission rate of HPV infections were used to evaluate the efficacy of 5-ALA PDT versus LEEP. Results 30 pairs were matched as the matching tolerance was set as 0.03. There was no significant difference about the CR and PR between 5-ALA PDT and LEEP group (73.33% vs 84.00%, P=0.340; 3.33% vs 4.00%, P=1.000). Among CIN1, 2, 3 group, there was also no statistic difference between 5-ALA PDT and LEEP. Moreover, in terms of HPV remission rate, 5-ALA PDT showed the same efficacy as LEEP (59.26% vs 53.85%, P=0.691). Conclusions In treating different types of CIN patients, Topical 5-ALA PDT is a successful, non-invasive, repeatable treatment with comparable results to LEEP.

ABSTRACT Background Eclampsia, an enigmatic multisystem complication of pregnancy, is commonly defined as new onset of grand mal seizure activity and /or unexplained coma during pregnancy or postpartum. Eclampsia is associated with maternal deaths ranging from, 1.8% in developed to 14% in developing countries respectively. The worldwide incidence of delayed postpartum eclampsia is on an increasing trend , now at 16-18% ,of all eclamptic seizures. Objective To study the clinical findings and morbidity, associated with postpartum eclampsia and its correlation with neuroimaging- in our institute- SRIHER, CHENNAI. Materials and methods This is a retrospective study from a period of June 2016- June 2021 , in SRIHER, Chennai. Case records of all patients with postpartum eclampsia were analysed. Results A total of 35 patients who satisfied the inclusion criteria were studied, out of which 55% of patients were diagnosed with hypertension or preeclampsia antenatally, and 45% presented as atypical eclampsia. In our institution, Postpartum eclampsia commonly occurred in the age group of 26-30 years of age (51.4%) ; was common after LSCS (71.4%) ; most commonly occurred immediate postpartum (42.8%), Most common prodromal symptom was headache (77%), followed by blurring of vision (37%). Most common MRI finding was PRES (69%). 17% patients required ICU care. There was no mortality associated with postpartum eclampsia in the study period. Conclusion This study emphasises that a high index of suspicion and a multidisciplinary approach effectively reduces mortality and morbidity associated with postpartum eclampsia. Neuroimaging is of robust help in the diagnosis and management.

Context dependence impedes accurate prediction in ecology, including the extent and impact of invasion. Using a grassland experiment, we show that the interplay of limiting factors can explain why invasion trends vary with circumstance. By manipulating invader seed dose and physical disturbance and tracking cover of groups of fast and slow invaders in three communities over three years, we examined how seed-, resource- and growth rate-limitation affected the abundance and diversity impacts of invading plants. Evidence indicated that seeds primarily limited cover of resource-acquisitive fast invaders in early and mid successional communities, growth rate limited resource conservative slow invaders in early and mid succession, and resources limited invasion of both groups in late succession. Resident community diversity declined as invader cover increased, consistent with effects of resource limitation. A greater focus on limiting factors in invasion ecology will provide us with a structure for predicting invasion outcomes in different situations.

Introduction:The term ’big data’ has become appearing these days. With the universality of social networks, Internet of things (Iots) and outsourced cloud computing, we have seen a great growth of data in larger volume. Big data offers a great value and has become a driving force in economic growth.Natural Language Processing[1]Application services and data business record user behaviors to improve their business skills and to accomplish their purpose. Growing techniques like social network, e-health system etc. offer excellent utilities for better understanding. It is now obvious that when users use these applications a lot of data points are formed and collected in real time. Well it also means that sensitive data becomes breachable. Privacy related problems occurs during data communication mining processes and even when raw data are not present because these sensitive data mining techniques can reveal private information.With the improvement of privacy awareness, every institute is trying to develop solution to accomplish the increasing requirements of privacy safety. The goal is to make privacy safe so that people can work easily without any privacy leakage. Most of the privacy technologies use privacy preservation onsmaller scale. The task is to develop most efficient privacy preserving big data analytics which can deal with any type of data. In the past, communities have proposed many solutions.From some past years many research groups take the challenge and create approaches. And they still discuss and developing more findings and clarify and summarize the existing approaches and contributions to prevent the privacy.

Aims. To provide an overview of the types of interventions performed by community pharmacists and describe their effects on patients with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). Methods. This review was conducted according to the PRISMA-Scr guidelines. PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for (non-) randomized controlled, before-after, and interrupted time series design. There was no restriction in the publication language. Included interventions had to be delivered by community pharmacists in primary care and community settings. The study quality was assessed using the National Institute of Health tools. Results were analyzed descriptively. Results. Twenty-eight studies were included representing 4,434 patients (mean age from 47.4 to 59.5 years, 55.4% female). Four studies were single- and the remaining studies were multiple-component interventions. Face-to-face counseling of patients was the most common intervention, often combined with providing printed materials, remote consultations, or conducting medication reviews. Generally, studies showed improved outcomes in the intervention group, including clinical, patient-reported and medication safety outcomes. In most studies at least one domain was judged to be of poor quality, with heterogeneity among studies. Conclusions. Community pharmacist-led interventions among T2DM patients showed positive effects in LMICs, but the quality of the evidence was poor. Face-to-face counseling of varying intensity, often combined with other strategies, was the most common type of intervention. Although these findings support the expansion of the role of the community pharmacist in diabetes care in LMICs, better quality studies are needed to evaluate further impact.

Introduction: There are no guidelines regarding the use of bovine pericardial or porcine valves for aortic valve replacement, and prior studies have yielded conflicting results. The current study sought to compare short- and long-term outcomes in propensity-matched cohorts of patients undergoing isolated AVR with bovine versus porcine valves. Methods: This was a retrospective study utilizing an institutional database of all isolated bioprosthetic surgical aortic valve replacements performed at our center from 2010 to 2020. Patients were stratified according to type of bioprosthetic valve (bovine pericardial or porcine), and 1:1 propensity-score matching was applied. Kaplan-Meier survival estimation and multivariable Cox regression for mortality were performed. Cumulative incidence functions were generated for all-cause readmissions and aortic valve reinterventions. Results: A total of 1,502 patients were identified, 1,090 (72.6%) of whom received a bovine prosthesis and 412 (27.4%) of whom received a porcine prosthesis. Propensity-score matching resulted in 412 risk-adjusted pairs. There were no significant differences in clinical or echocardiographic postoperative outcomes in the matched cohorts. Kaplan-Meier survival estimates were comparable, and, on multivariable Cox regression, valve type was not significantly associated with long-term mortality (HR 1.02, 95% CI: 0.74, 1.40, p=0.924). Additionally, there were no significant differences in competing-risk cumulative incidence estimates for all-cause readmissions (p=0.68) or aortic valve reinterventions (p=0.25) in the matched cohorts. Conclusion: The use of either bovine or porcine bioprosthetic aortic valves yields comparable postoperative outcomes, long-term survival, freedom from reintervention, and freedom from readmission.

Title page:Title : Letter to the editor: Mitral valve repair with the edge‐to‐edge technique: A 20 years single‐center experienceArticle type : Letter to the editorCorrespondence : 1. Syed HussainContact : +923323230575 Email : syedhussainar2002@gmail.comInstitute : Shaheed Mohtarma Benazir Bhutto Medical College Liyari KarachiAddress : R-75 Railway Housing Society, 13-D1, Gulshan-e-Iqbal, Karachi, 75300Co-authors : 2.Muhammad MaazContact : +923032194036 Email : maaz.27d3@gmail.comInstitute : Shaheed Mohtarma Benazir Bhutto Medical College Liyari KarachiAddress : Flat No. B-16, Hasham Apartment, Rafa-e-aam, Malir Halt, Karachi, 752103. Dr. Sumeet KumarContact : +92-3337351513Email :Dr.sumeetchhabra@gmail.comInstitute : Dow University of Health Sciences, KarachiAddress : Mission Rd, New Labour Colony Nanakwara, Karachi, Karachi City, Sindh 74200Word count : 482Conflict of interest : NoneDeclaration : NoneAcknowledgment : None

Repurposing non-oncology drugs to improve cancer therapy has been increasingly attracting drug developers due to potentially lower costs and shorter timelines. Propranolol, a non-cardiac selective, lipophilic β-adrenergic receptor blocker used to treat hypertension, arrhythmia, and anxiety, has successfully been repurposed as first-line therapy for infantile hemangioma. Thereafter, accumulating preclinical and clinical studies have demonstrated the safe and promising antitumor activity of propranolol to treat different types of human cancers. In this review, we have focused on summarizing the therapeutic potential of propranolol in both solid and hematologic malignancies. We have also discussed the current bottleneck of repurposing propranolol in cancer therapy. Taken together, these inspiring findings help to shed light on propranolol repurposing and future drug discovery.

Although the field of urban evolutionary ecology is in its infancy, much progress has been made in identifying adaptations that arise as a result of selective pressures within these unique environments. However, as studies within urban environments have rapidly increased, researchers have recognized there are challenges and opportunities in characterizing urban adaptation. Some of these challenges are novel as a consequence of increased direct and indirect human influence, which compounds long-recognized issues with research on adaptive evolution more generally. In this perspective, we discuss several common research challenges to urban adaptation related to: (1) methodological approaches, (2) trait-environment relationships and the natural history of organisms, (3) agents and targets of selection, and (4) habitat heterogeneity. Ignoring these challenges may lead to misconceptions and further impede our ability to draw conclusions regarding evolutionary and ecological processes in urban environments. Our goal is to first shed light on the conceptual challenges of conducting urban adaptation research to help avoid propagation of these misconceptions. We further summarize potential strategies to move forward productively to construct a more comprehensive picture of urban adaptation, and discuss how urban environments also offer unique opportunities and applications for adaptation research.

Any random genetic change is more likely to impair than improve fitness, a situation that owes to the fact that contemporary genotypes bear a history of having been shaped by natural selection for a very long time. Most mutations are thus deleterious and generate a genetic load that can be difficult to handle in small populations and increase the risk of extinction. We used functional annotation and evolutionary conservation scores to study deleterious variation in 200+ genomes from the highly inbred Scandinavian wolf population, founded by only three wolves and suffering from inbreeding depression, and neighboring populations in northern Europe. The masked load was high in Russia and Finland with deleterious alleles segregating at lower frequency than neutral variation. Genetic drift in the Scandinavian population led to the loss of ancestral alleles and fixation of deleterious variants. The per-individual realized load increased with the extent of inbreeding and reached several hundred homozygous deleterious genotypes in protein-coding genes, and a total of more than 50,000 homozygous deleterious genotypes in the genome. Arrival of immigrants gave a temporary genetic rescue effect with ancestral alleles re-entering the population and moving deleterious alleles into heterozygote genotypes. However, in the absence of permanent connectivity inbreeding has then again led to the exposure of deleterious mutations. These observations provide genome-wide insight into the character of genetic load and genetic rescue at the molecular level, and in relation to population history. They emphasize the importance of securing gene flow in the management of endangered populations.

Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. HPVG when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention

α-heterosubstituted 1,3-dioxane and 1,3-dithiane systems have been extensively reported for n_( X) → σ_(C-Y)^* (X, Y = heteroatoms) hyperconjugative interactions. However, the definitive interpretation for the conformational analysis of 2-carbomethoxy 1,3-diheterocyclohexane is less explored. The weaker accepting ability of C-C(carbomethoxy) antibonding orbitals in 2-substituted 1,3-diheterocyclohexane makes it an attractive candidate for estimating the role of stereoelectronic effects in such systems. This study explores conformational preferences of 2-carbomethoxy substituted 1,3-dioxane, 1,3-oxathiane and 1,3-dithiane in the light of stereoelectronic interactions and the contribution of other factors to attain stability in the respective systems. The DFT calculated results in the solvent phase reveal the delocalizing interactions operate in all the three systems examined; however, ring strain override the axial preference of 2-carbomethoxy substituent on 1,3-dioxane (2-ax) and 1,3-oxathiane (3-ax). The hyperconjugative interaction, lower ring strain and attractive C-H∙∙∙O non-bonded interactions favor axial (4-ax) over equatorial (4-eq) isomer of methyl-2-carboxylate-1,3-dithiane.

Functional role of ST6GALNAC1-mediated sialylation of mucins in preserving intestinal barrier integrity and ameliorating inflammation. Authors : Elisa Sánchez-Martínez1*, Manuel Garrido-Romero1,2,*, F. Javier Moreno21Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa, (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain.2Department of Bioactivity and Food Analysis, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Madrid, Spain.*Equal contributionCorrespondence to:F. Javier Moreno. Department of Bioactivity and Food Analysis, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Nicolás Cabrera 9, 28049 Madrid, Spain.E-mail:javier.moreno@csic.esAbbreviations:ST6GALNAC1, ST6; mucin-2, MUC2; dextran sulfate sodium, DSS; wild-type, WT; short-chain fatty acids, SCFA.Funding information : MGR is supported by an EFSA project (Grant agreement GP/EFSA/ENCO/2020/02 – 1) granted to FJM. Conclusions, findings and opinions expressed in this document reflect only the view of the authors and not the official position of EFSA.Keywords: epithelial barrier; MUC2; intestinal mucus; gut microbiota disruption; colitis.

The experience involves the use of a new foam dressing in conjunction with negative pressure wound therapy (NPWTi-D) to remove and cleanse infectious material from the wound. This paper evaluates the clinical results of patients who received VERAFLO treatment and dressing. The use of the innovative foam dressing to facilitate the evacuation of the infectious, viscous, and scabby material is regarded as a very novel and beneficial technique. According to studies, the success of the wound healing process depends not only on the features of the patient, but also on those of the wound. Expected healing with NPWTi is deemed fortunate because it guarantees that the damage has reached granulation and is, therefore, ready to be treated. Again, healthcare facilities must educate their staff on the significance of NPWTi in the operating room. VERAFLO CLEANSE CHOICE has consistently demonstrated its efficacy in eliminating infectious particles and exudate, ensuring the effective treatment of wounds. In conclusion, the approach is deemed effective since it reduces hospital mortality and length of stay and communicates the intricacies of injuries to neurosurgeons in order to choose the appropriate treatment procedures.This article evaluates the study's methodology, findings, pathophysiology, biochemistry, genetics, scientific analysis, clinical implications, and unanswered questions concerning the removal and cleansing of infectious material from a wound using a novel technique that combines negative pressure therapy with instillation.

The upgrading of oleyl alcohol synthesis via methyl oleate reduction using NaBH4 without H2 supply was investigated. It was possible to synthesize selectively the valuable unsaturated fatty alcohol with high yields. Non-catalytic and catalytic experiments were developed trying to improve the low final oleyl alcohol yield previously obtained. The effect of reaction temperature, methyl oleate/NaBH4 molar ratio and properties of different catalysts on final oleyl alcohol yield was analyzed. Thus, alumina-supported metal (M) catalysts (M = Fe, Ce, Mo) were synthesized by impregnation at incipient wetness. The M/Al2O3 catalysts were characterized in their chemical, textural, structural and acid-base properties using ICP, N2 physisorption, XRD and NH3 and CO2 TPD. During non-catalytic methyl oleate reduction final methyl oleate conversion and oleyl alcohol yield of 94% were obtained using a methyl oleate/NaBH4 molar ratio of 0.11 at 333 K. Catalytic activity of M/Al2O3 solids did not correlate with basic site number but increased as acid site number and ionic potential of M cations increase. This suggests that cations with high acid site number and polarizing power are the ones that promote the polarization of the ester C=O and anion [BH4]- bonds favoring de methyl oleate conversion. In addition, the reaction mechanism for fatty acid methyl ester reduction was investigated from a theoretical approach using Density Functional Theory method at B3LYP/6-31++G(d,p) computational level. Results obtained during theoretical calculations confirmed that the formation of reducing alcoxyborohydride species is energetically favored and allowed to understand the events at microscopic level involved in the reaction mechanism.

The core of bioprinting related research aims to reduce the gap between ex vivo cell cultures and in vivo cellular tissue models to further its application within the biomedical field. While additive manufacturing is touted as disruptive technology, bioprinter equipment costs exceed limited resource budgets of many research laboratories restricting the scope for further development for biomedical research and potential medical application. In line with this, a relatively low-cost bioprinter (SidneV1) was successfully designed and manufactured using a low-cost, commercially available FDM Delta 3D printer as a prototype base with a successfully custom designed and manufactured micro-extrusion printhead. Printing accuracies assessed were 65% (for width measurements) and 64% (for height measurements). This study aimed to demonstrate a way to achieve low-cost bioprinting and hopefully pave the way for future system modifications and refinements such that this technology becomes more accessible to under-funded research groups around the world. Although these findings are preliminary, further optimization of printing parameters, bioink formulations and sterilization techniques will allow for the engineering of viable, physiologically relevant tissue models using low-cost bioprinting technology.

Duke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown global prevalence. It typically manifests with body asymmetry, drugs resistant epilepsy, mental retardation, cerebral atrophy, skull bone thickening and hyperpneumatization of the frontal sinuses. In this report, we present an unusual case of DDMS revealed by status epilepticus.

AbstractMotile cilia move in an asymmetric pattern and implement a metachronal wave (MCW) to facilitate fluid movement in a viscous environment. Studies have been conducted to mimic MCW movement of motile cilia, but the fabrication process was too complicating or there were difficulties in accurately mimicking the shape of the cilia. To overcome these limitations, we introduce a self-assembly method to fabricate a reprogrammable magnetically actuated self-assembled (RMS) cilia array that can be reprogrammed by changing the magnetization direction through additional magnetization. Using the RMS cilia array, a unilateral cilia array (UCA) channel and a bilateral cilia array (BCA) channel were constructed, and the motion and fluid flow of the RMS cilia array were analyzed by applying different magnetic fields (strike magnetic field and rotating magnetic field). When a rotating magnetic field was applied to the UCA channel, a distinct MCW appeared. In the BCA channel test, fluid pumping was observed when a strike magnetic field, whereas fluid mixing was observed when a rotating magnetic field was applied. Based on these results, it is expected that the proposed RMS cilia array and magnetic field actuation method can be applied to lab-on-a-chip or microfluidic channels for fluid mixing and pumping.1. IntroductionCilia are hair-like, microtubule-based structures that have various distributions with a length of approximately 3–200 µm and an aspect ratio ranging from 10 to 100, depending on the location where they are found, and are divided into primary cilia and motile cilia.[1–5] Motile cilia can move objects or mix fluids by moving mucus or body fluids in the human body.[6,7] Among these motile cilia, the cilia that are found in the fallopian tube of the female reproductive system help the movement of the ovary, and the cilia existing in the lungs mix settled dust and bacteria through mucociliary clearance and move them out of the body.[8–10] The environment in which motile cilia move is normally filled with fluid with a low Reynolds number. In such an environment, the viscous force is generally more dominant than the inertial force, and has a significant influence on the fluid flow.[11–13] To be helpful in this environment, the cilium moves in an asymmetrical pattern comprising an effective stroke and a recovery stroke, creating a net fluid flow. In an effective stroke, the cilium moves in an arc that is fully stretched, while in the recovery stroke, the cilium returns to the starting point in a bent state as if swinging, which increases the moving area of the cilium.[14–16] In addition, when several cilia gather to form a cilia array, they move in a sequential pattern that forms a wave called the metachronal wave (MCW), which helps move the fluid faster and more efficiently because of their asymmetrical motion.[17–20]Several studies have reported mimicking the asymmetric motion of cilia and the MCW motion to efficiently pump or mix fluids in microfluidic devices with low Reynolds numbers.[21–23] To mimic cilia motion, many actuation methods have been used; actuation via a magnetic field is the most used method among them.[24–27] In addition, diverse manufacturing methods exist for magnetically actuated artificial cilia, and, the fabrication method using self-assembly has the advantages of simplicity and capability to mimic the appearance of natural cilia. However, it is difficult to program the magnetization direction, thus limiting the implementation of the MCW of the cilia.[28–31]Nevertheless, studies have been conducted to imitate the metachronal wave of cilia by fabricating artificial cilia using the molding method, which facilitates reprogramming.[32,33] Nelson formed a cilia array using a molding method and then reprogrammed the cilia array, which moved the cilia array to form an MCW.[34] Sitti fabricated micro-cilia using a mold, magnetized each cilium independently, and attached them to form a cilia array with the desired arrangement that implements the MCW.[35] However, these studies actuated the cilia array using only a rotating external magnetic field, and because the cilia array was fabricated using the molding method, several complex steps were required for making the cilia array.

Facial puffiness as a consequence of superior vena cava syndrome (SVCS), can be a presentation from which the physician would have to conjecture a diagnosis of a mediastinal mass including lymphomas. Pediatric SVCS can rapidly progress and pose a greater challenge for airway protection as was in our case.

Background and aim The objective of this systematic review and network meta-analysis was to compare the effects of single-shot ultrasound-guided regional anesthesia techniques on postoperative opioid consumption in patients undergoing open cardiac surgery. Methods This systematic review and network meta-analysis involved cardiac surgical patients (age >18 y) requiring median sternotomy. We searched PubMed, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science. The effects of the single-shot ultrasound-guided regional anesthesia technique were compared with those of placebo and no intervention. Results The primary outcome was opioid consumption during the first 24 h after surgery. The secondary outcomes were pain after extubation at 12 and 24 h, postoperative nausea and vomiting, extubation time, intensive care unit discharge time, and length of hospital stay. Fifteen studies with 849 patients were included. The regional anesthesia techniques included pecto-intercostal fascial block, transversus thoracis muscle plane block, erector spinae plane (ESP) block, and pectoralis nerve block I. All the regional anesthesia techniques included significantly reduced postoperative opioid consumption at 24 hours, expressed as morphine milligram equivalents (MME). The ESP block was the most effective treatment (-22.93 MME [-34.29;-11.56]). Conclusions In this meta-analysis, we concluded that fascial plane blocks were better than placebo when evaluating 24 hr MMEs. However, it is still challenging to determine which is better, given the paucity of studies available in the literature. More randomized controlled trials are required to determine which regional anesthesia technique is better.

A man with persistent dyspnea was brought to our hospital in an emergency. Cardiac catheterization revealed right coronary artery occlusion. The patient went into shock on the second day of treatment due to rapid pericardial effusion. The pericardial fluid was cloudy and non-bloody, which was judged purulent pericarditis.

Various conditions may mimic osteosarcoma. The differential diagnosis of osteosarcoma is broad. A proper history, examination, diagnostic imaging studies, and pathological analysis are essential to establish the precise diagnosis. This case report serves to illustrate the significance of recognizing similarities and other rare features to prevent late or misdiagnosis.

John Fitzgerald Kennedy (JFK), the 35th President of the USA, had chronic low back pain deemed to be centralized pain. Reportedly, attention deficit hyperactive disorder (ADHD) could associate with centralized pain. Based on his biographies, JFK could have had ADHD, being a plausible cause of pain that afflicted him.