Encefalopatia ipertensiva cronica (EIC): sensibilita\u300 delle sequenze GE-T2* a confronto con le SWI nell'identificazione dei micro-sanguinamenti

L'EIC e\u300 caratterizzata dalla presenza di lesioni parenchimali irreversibili, risultato di una lunga esposizione a regimi pressori patologici specie in pazienti che non seguono o non rispondono alle comuni terapie mediche. Si riscontrano quali reperti tipici multipli esiti gliotici, leucoaraiosi e multiple lesioni lacunari con predilezione per le localizzazioni profonde ai nuclei lenticolari, ai talami e al ponte. Piu\u300 raramente possono evidenziarsi minuti foci emorragici parenchimali, piu\u300 frequentemente localizzati nei gangli della base ma anche nel ponte e nel cervelletto, che in alcuni casi possono rappresentare la manifestazione principale della patologia: questi microsanguinamenti, visibili incostantemente in TC, sono classicamente ben individuabili in RM come aree di netta ipointensita\u300 di segnale in GRE (Gradient Recalled Echo) T2* pesate. Scopo del nostro lavoro e\u300 quello di presentare due casi in cui l'EIC si manifesta prevalentemente con un quadro micro-emorragico confrontando la sensibilita\u300 delle convenzionali sequenze GRE T2* pesate con sequenze sensibili al fenomeno della suscettivita\u300 magnetica (Susceptibility-Weighted Imaging, SWI) di piu\u300 recente introduzione nella routine diagnostica

SEMI-AUTOMATIC VOLUMETRIC SEGMENTATION OF THE UPPER AIRWAYS IN PATIENTS WITH PIERRE ROBIN SEQUENCE

Pierre Robin malformation is a rare craniofacial dysmorphism whose pathogenesis is multifactorial. Although there is some agreement in non-invasive treatment in less severe cases, the dispute is still open on cases with severe respiratory impairment. We present a semi-automatic novel diagnostic tool for calculating upper airway volume, in order to eventually address surgery in patients with Pierre Robin Sequence (PRS). Multidetector CT datasets of two patients and two controls were tested to assess the proposed method for ROI segmentation, upper airway volume computation and three-dimensional reconstructions. The experimental results show an irregular pattern and a severely reduced cross-sectional area (CSA) with a mean value of 8.3808 mm(2) in patients with PRS and a mean CSA value of 33.7692 mm(2) in controls (a ΔCSA of about -75%). Moreover, the similarity indexes and sensitivity/specificity values obtained showed a good segmentation performance. In particular, mean values of Jaccard and Dice similarity indexes were 91.69% and 94.07%, respectively, while the mean values of specificity and sensitivity were 96.69% and 98.03%, respectively. The proposed tool represents an easy way to perform a quantitative analysis of airway volume and useful 3D reconstructions

Modeling and performance assessment of the split-pi used as a storage converter in all the possible dc microgrid scenarios. Part i: Theoretical analysis

The integration of an electrical storage system (ESS) into a DC microgrid using a bidirectional DC/DC converter provides substantial benefits but requires careful design. Among such converter topologies, the Split-pi converter presents several merits at the cost of non-isolated operation. However, the few works in the literature on the Split-pi presented only closed-loop control with a single control loop; furthermore, they neglected the reactive components’ parasitic resistances and did not perform any experimental validation. This work aimed at investigating the use of the Split-pi converter as a power interface between an ESS and a DC microgrid. Five typical microgrid scenarios are presented, where each of which requires a specific state-space model and a suitable control scheme for the converter to obtain high performance. In this study, two different state-space models of the converter that consider the parasitic elements are presented, the control schemes are discussed, and criteria for designing the controllers are also given. Several simulations, as well as experimental tests on a prototype realized in the lab, were performed to validate the study. Both the simulation and experimental results will be presented in part II of this work. The proposed approach has general validity and can also be followed when other bidirectional DC/DC converter topologies are employed to interface an ESS with a DC microgrid

Examining bi-directionality between Fear of Missing Out and problematic smartphone use. A two-wave panel study among adolescents

Background: In recent years, the Fear of Missing Out (FoMO) construct has been the object of growing attention in digital technology research with previous studies finding support for the relationship between FoMO and problematic smartphone use (PSU) among adolescents and young adults. However, no previous studies clarified the causal link between FoMO and PSU using a longitudinal design. Methods: An auto-regressive, cross-lagged panel design was tested by using a longitudinal dataset with two waves of data collection (T0 and T1, one year apart). Participants included two hundred and forty-two adolescents (109 males and 133 females), with a mean age of 14.16 years, who filled out the Fear of Missing Out scale (FoMOs) and the Smartphone Addiction Scale (SAS). Moreover, participants filled out the Difficulties in Emotion Regulation Scale (DERS), at the first time-point of data collection. Results: The findings of the study show that FoMO (both FoMO-Fear and FoMO-Control subscales) and PSU are positively related at both time-points (i.e. at a cross-sectional level). However no cross-lagged associations between them were longitudinally supported. Females and older adolescents show higher FoMO-Fear at T1. Conclusions: The findings of the present study suggest caution when causal links between FoMO and PSU are inferred

Modeling and Experimental Validation of a Voltage-Controlled Split-Pi Converter Interfacing a High-Voltage ESS with a DC Microgrid

The Split-pi converter can suitably interface an energy storage system (ESS) with a DC microgrid when galvanic isolation is not needed. Usually, the ESS voltage is lower than the grid-side voltage. However, limitations in terms of the ESS current make the use of a high-voltage ESS unavoidable when high power levels are required. In such cases, the ESS voltage can be higher than the microgrid voltage, especially with low microgrid voltages such as 48 V. Despite its bidirectionality and symmetry, the Split-pi exhibits a completely different dynamic behavior if its input and output ports are exchanged. Thus, the present work aims to model the Split-pi converter operating with an ESS voltage higher than the grid-side voltage in three typical microgrid scenarios where the controlled variable is the converter's output voltage. The devised state-space model considers the parasitic elements and the correct load model for each scenario. Furthermore, it is shown that the presence of the input LC filter can make the design of the loop controllers more complicated than in the case of a lower ESS voltage than the grid-side voltage. Finally, the study is validated through simulations and experimental tests on a lab prototype, and a robustness analysis is performed

Modeling and performance assessment of the split-pi used as a storage converter in all the possible dc microgrid scenarios. Part II: Simulation and experimental results

Bidirectional DC/DC converters such as the Split-pi can be used to integrate an energy storage system (ESS) into a DC microgrid providing manifold benefits. However, this integration deserves careful design because the ESS converter must behave like a stiff voltage generator, a non-stiff voltage generator, or a current generator depending on the microgrid configuration. Part I of this work presented a comprehensive theoretical analysis of the Split-pi used as an ESS converter in all the possible DC microgrid scenarios. Five typical microgrid scenarios were identified. Each of them required a specific state-space model of the Split-pi and a suitable control scheme. The present paper completes the study validating the theoretical analysis based on simulations and experimental tests. The chosen case study encompassed a 48 V, 750 W storage system interfaced with a 180 V DC microgrid using a Split-pi converter. It can represent a reduced-power prototype of terrestrial and marine microgrids. A prototypal Split-pi converter was realized in the lab, and several experimental tests were performed to assess the performance in each scenario. The results obtained from the experimental tests were coherent with the simulations and validated the study

Malignancy course of pituitary adenoma in MEN1 syndrome: Clinical-Neuroradiological signs

Pituitary carcinomas (PCa) are extremely rare, indistinguishable from pituitary adenomas on histopathological grounds and have a poor prognosis. Most PCa start as PRL or ACTH secreting tumors in males, with relapsing invasive behaviour, refractoriness to medical and radiotherapy and increasing hormonal levels. The presence of distant metastases is still required for the diagnosis of PCa. The association with genetic endocrine diseases must be taken into account, since it adds further risk of evolution towards malignancy. Intradural spinal metastases have also been reported, so a complete craniospinal MR evaluation is recommended, when clinically indicated. We report a case of PCa, associated with MEN1 syndrome, with evidence of meningeal spread to the tentorium cerebelli, clival dura and spinal drop metastases mimicking spinal nerves schwannomas

a transverse and longitudinal mr imaging voxel based morphometry study in patients with primary cervical dystonia

BACKGROUND AND PURPOSE: Findings of standard MR imaging examinations are usually normal in primary CD. These findings are now increasingly challenged by studies using advanced neuroimaging techniques detecting abnormalities in brain areas that may be functionally involved in the pathophysiology of CD. Our purpose was to evaluate GM volumes in patients with CD at baseline and 5 years later. MATERIALS AND METHODS: We enrolled 19 patients (F/M = 15:4, mean age = 53.2 + 11.2 years), 12 of whom were studied at baseline and again approximately 5 years later. Twenty-eight healthy volunteers acted as controls (F/M = 17:11, mean age = 47.5 + 15.6 years). The subjects were imaged with a 1.5T scanner by using a 3D T1-weighted sequence on 150 contiguous axial 1-mm-thick sections to apply VBM. RESULTS: At entry, VBM analysis disclosed significantly lower GM volumes in the left caudate head and putamen and in the premotor and primary sensorimotor cortices bilaterally in patients than in controls. No correlation was found between decreased GM volumes and patient age, severity of dystonia, or disease duration. At the 5-year follow-up, GM volumes in the left primary sensorimotor cortex in patients had decreased significantly from baseline. CONCLUSIONS: The findings obtained at entry and after a 5-year follow-up consistently showed decreased caudate, putamen, and sensorimotor cortex GM volumes in patients with CD, and they probably play a pathophysiologic role in CD

Increased functional connectivity in gambling disorder correlates with behavioural and emotional dysregulation: Evidence of a role for the cerebellum

Gambling disorder (GD) is a psychiatric disease that has been recently classified as a behavioural addiction. So far, a very few studies have investigated the alteration of functional connectivity in GD patients, thus the concrete interplay between relevant function-dependent circuitries in such disease has not been comprehensively assessed. The aim of this research was to investigate resting-state functional connectivity in GD patients, searching for a correlation with GD symptoms severity. GD patients were assessed for gambling behaviour, impulsivity, cognitive distortions, anxiety and depression, in comparison with healthy controls (HC). Afterwards, they were assessed for resting-state functional magnetic resonance imaging; functional connectivity was assessed through a data-driven approach, by using independent component analysis. The correlation between gambling severity and the strength of specific resting-state networks was also investigated. Our results show that GD patients displayed higher emotional and behavioural impairment than HC, together with an increased resting state functional connectivity in the network including anterior cingulate cortex, the caudate nucleus and nucleus accumbens, and within the cerebellum, in comparison with the control group. Moreover, a significant correlation between behavioural parameters and the strength of the resting-state cerebellar network was found. Overall, the functional alterations in brain connectivity involving the cerebellum observed in this study underpin the emotional and behavioural impairment recorded in GD patients. This evidence suggests the employment of novel neuromodulatory therapeutic approaches involving specific and salient targets such as the cerebellum in addictive disorders