Narrative review of epilepsy: getting the most out of your neuroimaging

Neuroimaging represents an important step in the evaluation of pediatric epilepsy. The crucial role of brain imaging in the diagnosis, follow-up and presurgical assessment of patients with epilepsy is noted and has to be familiar to all neuroradiologists and trainees approaching pediatric brain imaging. Morphological qualitative imaging shows the majority of cerebral lesions/alterations underlying focal epilepsy and can highlight some features which are useful in the differential diagnosis of the different types of epilepsy. Recent advances in MRI acquisitions including diffusion-weighted imaging (DWI), post-acquisition image processing techniques, and quantification of imaging data are increasing the accuracy of lesion detection during the last decades. Functional MRI (fMRI) can be really useful and helps to identify cortical eloquent areas that are essential for language, motor function, and memory, and diffusion tensor imaging (DTI) can reveal white matter tracts that are vital for these functions, thus reducing the risk of epilepsy surgery causing new morbidities. Also positron emission tomography (PET), single photon emission computed tomography (SPECT), simultaneous electroencephalogram (EEG) and fMRI, and electrical and magnetic source imaging can be used to assess the exact localization of epileptic foci and help in the design of intracranial EEG recording strategies. The main role of these “hybrid” techniques is to obtain quantitative and qualitative informations, a necessary step to evaluate and demonstrate the complex relationship between abnormal structural and functional data and to manage a “patient-tailored” surgical approach in epileptic patients

The infrared vibrational spectrum of andradite-grossular solid solutions: A quantum mechanical simulation

Infrared spectroscopy is a powerful technique for the characterization of minerals, permitting insights into their structural and thermodynamic properties. The intrinsic complexity of mineral solid solutions makes the interpretation of their spectroscopic data a challenging task. In this work, the IR vibrational spectra of andradite-grossular (Ca3Fe2Si3O12–Ca3Al2Si3O12) solid solutions were simulated at the ab initio level with the CRYSTAL09 code by using a large all-electron Gaussian-type basis set and the B3LYP hybrid functional. All the 23 symmetry-independent configurations resulting from the substitution of 1 to 8 Fe atoms with Al atoms in the 16a octahedral site of the andradite primitive cell were considered. The IR active transverse optical frequencies and their intensities were computed. Graphical representation of the spectra, animation of the modes and isotopic substitution of the cations were used as additional interpretation tools. The dominant high-frequency modes, corresponding to Si-O stretching motions, show a simple linear behavior of both frequencies and intensities with respect to the binary composition; this trend is related to the linear behavior of the mean lattice parameter. Also the frequencies of the low-energy bands show, roughly speaking, a linear dependence on composition; however, the behavior of the dominant intensities is more complicated and strongly connected to the Al and Fe atomic fraction. When considering different possible structures at fixed composition, some spectral features display a dependence upon short-range Y cation ordering. Overall, we show how ab initio calculations permit to analyze complex systems such as solid solutions, establishing relations among structure and properties and providing critical and robust interpretations to the experimental findings

The role of preoperative diffusion tensor imaging in predicting and improving functional outcome in pediatric patients undergoing epilepsy surgery: a systematic review

Objective: Diffusion tensor imaging (DTI) is a useful neuroimaging technique for surgical planning in adult patients. However, no systematic review has been conducted to determine its utility for pre-operative analysis and planning of Pediatric Epilepsy surgery. We sought to determine the benefit of pre-operative DTI in predicting and improving neurological functional outcome after epilepsy surgery in children with intractable epilepsy. Methods: A systematic review of articles in English using PubMed, EMBASE and Scopus databases, from inception to January 10, 2020 was conducted. All studies that used DTI as either predictor or direct influencer of functional neurological outcome (motor, sensory, language and/or visual) in pediatric epilepsy surgical candidates were included. Data extraction was performed by two blinded reviewers. Risk of bias of each study was determined using the QUADAS 2 Scoring System. Results: 13 studies were included (6 case reports/series, 5 retrospective cohorts, and 2 prospective cohorts) with a total of 229 patients. Seven studies reported motor outcome; three reported motor outcome prediction with a sensitivity and specificity ranging from 80 to 85.7 and 69.6 to 100%, respectively; four studies reported visual outcome. In general, the use of DTI was associated with a high degree of favorable neurological outcomes after epilepsy surgery. Conclusion: Multiple studies show that DTI helps to create a tailored plan that results in improved functional outcome. However, more studies are required in order to fully assess its utility in pediatric patients. This is a desirable field of study because DTI offers a non-invasive technique more suitable for children. Advances in knowledge: This systematic review analyses, exclusively, studies of pediatric patients with drug-resistant epilepsy and provides an update of the evidence regarding the role of DTI, as part of the pre-operative armamentarium, in improving post-surgical neurological sequels and its potential for outcome prediction

A cryogenic magneto-optical device for long wavelength radiation

We present here a small-scale liquid helium immersion cryostat with an innovative optical setup suitable to work in long wavelength radiation ranges and under an applied magnetic field. The cryostat is a multi-stage device with several shielding in addition to several optical stages. The system has been designed with an external liquid nitrogen boiler to reduce liquid bubbling. The optical and mechanical properties of the optical elements were calculated and optimized for the designed configuration, while the optical layout has been simulated and optimized among different configurations based on the geometry of the device. The final design has been optimized for low-noise radiation measurements of proximity junction arrays under an applied magnetic field in the wavelength range λ = 250 μm-2500 μm

The cryogenic magneto-optical device for terahertz radiation detection

We present here a small-scale liquid Helium (LHe) immersion cryostat with an innovative optical setup suitable to work in long wavelength radiation ranges and under applied magnetic field. The cryostat is a multi stage device with several shielding in addition to several optical stages. The system has been designed with an external liquid Nitrogen boiler to reduce the liquid bubbling. The optical and mechanical properties of the optical elements were calculated and optimized for the designed configuration while the optical layout has been simulated and optimized among different configurations based on the geometry of the device. The final design has been optimized for low noise radiation measurements of proximity junction arrays under applied magnetic field in the wavelength range λ=250-2500 µm

A new classification and clinical predictivity for some naevus variants

Background. The incidence of cutaneous melanoma is rapidly increasing in Europe. Active research is directed toward the identification of naevi as a risk factor. Objective. The aim of our case-control study was to observe different numbers of moles and different mole typology associations in order to evaluate clinical predictivity and to establish a new classification for some naevus variants. Methods. A case-control study was carried out, enrolling 64 cases affected by melanoma and 183 controls, between October 2009 and February 2011. Each patient was interviewed and subjected to clinical examination. The resulting data were analysed using the statistical elaboration program SPSS 16.0. Results. The association of target naevus with other variants increases the degree of risk (target + small brown Odds Ratio 5.25; confidence interval 1.8-15.4); (target + small brown + small black + large brown odds ratio 5.0; confidence interval 1.1-22.4). Therefore, other variants and/or other variant combinations do not significantly increase risk. Conclusion. People presenting two naevus variants in association with other naevus variants seem to run a major risk. The general nonuniformity of the whole naevus panorama should be carefully considered

Seasonal variability of the HO.RE.CA. food leftovers employed as a feeding substrate for black soldier fly (Hermetia illucens L.) larvae and effects on the rearing performance

The SCALIBUR project (Horizon, 2020) aimed to explore innovative solutions, including the use of black soldier fly larvae, for the bio-urban waste management. This research work describes the evaluation of the variability in water, proteins, fat, ashes, and carbohydrates present in the HO.RE.CA. food leftovers which were withdrawn from a local canteen over a 12-month period and the relationship with (i) the growth parameters of the larvae, (ii) the percentage of substrate reduction and the percentage of frass separated through the mechanical sieve at the end of the rearing process. HO.RE.CA. food leftovers are overall a suitable feeding substrate for larval rearing. Water contained in the HO.RE.CA. food leftovers was sufficient for larval rearing without resorting to further addition. As for water content, a seasonal trend was not observed, on the contrary, it was proved to be totally random. However, high amount of water (>80%) was correlated with higher larval mortality rate. The larval weight was significantly correlated to the amount of protein (r = 0.80; p ≤ 0.001) present in the substrate, and to a lesser extent to the amount of fat (r = 0.43; p ≤ 0.05). The feed conversion rate and bioconversion rate were both in agreement with literature data. The statistical test did not show any significant correlation between the amount of water contained in the initial fresh HO.RE.CA. food leftovers and the percentage of substrate reduction and the percentage of frass separated through the mechanical sieve at the end of the rearing process

Teledermatology: From Prevention to Diagnosis of Nonmelanoma and Melanoma Skin Cancer

Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting remote medical procedures or examinations, reducing the time of consultation for patients. Teledermatology as an application of telemedicine was developed in 1995: it turns out to be a gradually more ordinary mean of delivering dermatologic healthcare worldwide and will almost certainly have a greater medical function in the future. In particular, teledermatology can aid in the prevention and diagnosis of nonmelanoma and melanoma skin cancer; telemedicine and teledermatology offer the opportunity to make available consultations with experts also by long distance. Overall, patients seem to accept teledermatology, considering it as an excellent mean to obtain healthcare, particularly in those areas with no expert dermatologists available. Clinicians have also generally reported affirmative experiences with teledermatology in the skin cancer field. Further studies focusing on cost effectiveness, patient outcomes, and patient and clinician satisfaction will facilitate to delineate the potential of teledermatology as a mean of prevention and diagnosis of nonmelanoma and melanoma skin cancer

Constitutional mismatch repair deficiency (CMMRD) presenting with high-grade glioma, multiple developmental venous anomalies and malformations of cortical development-a multidisciplinary/multicentre approach and neuroimaging clues to clinching the diagnosis

Constitutional mismatch repair deficiency syndrome (CMMRD) is a rare cancer-predisposition syndrome associated with a high risk of developing a spectrum of malignancies in childhood and adolescence, including brain tumours. In this report, we present the case of an 8-year-old boy with acute headache, vomiting and an episode of unconsciousness in whom brain imaging revealed a high-grade glioma (HGG). The possibility of an underlying diagnosis of CMMRD was suspected radiologically on the basis of additional neuroimaging findings, specifically the presence of multiple supratentorial and infratentorial developmental venous anomalies (DVAs) and malformations of cortical development (MCD), namely, heterotopic grey matter. The tumour was debulked and confirmed to be a HGG on histopathology. The suspected diagnosis of CMMRD was confirmed on immunohistochemistry and genetic testing which revealed mutations in PMS2 and MSH6. The combination of a HGG, multiple DVAs and MCD in a paediatric or young adult patient should prompt the neuroradiologist to suggest an underlying diagnosis of CMMRD. A diagnosis of CMMRD has an important treatment and surveillance implications not only for the child but also the family in terms of genetic counselling

A New Classification and Clinical Predictivity for Some Naevus Variants

Background. The incidence of cutaneous melanoma is rapidly increasing in Europe. Active research is directed toward the identification of naevi as a risk factor. Objective. The aim of our case-control study was to observe different numbers of moles and different mole typology associations in order to evaluate clinical predictivity and to establish a new classification for some naevus variants. Methods. A case-control study was carried out, enrolling 64 cases affected by melanoma and 183 controls, between October 2009 and February 2011. Each patient was interviewed and subjected to clinical examination. The resulting data were analysed using the statistical elaboration program SPSS 16.0. Results. The association of target naevus with other variants increases the degree of risk (target + small brown Odds Ratio 5.25; confidence interval 1.8–15.4); (target + small brown + small black + large brown odds ratio 5.0; confidence interval 1.1–22.4). Therefore, other variants and/or other variant combinations do not significantly increase risk. Conclusion. People presenting two naevus variants in association with other naevus variants seem to run a major risk. The general nonuniformity of the whole naevus panorama should be carefully considered