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Abstract Quantum magnetometers based on spin defects in solids enable sensitive imaging of various magnetic phenomena, such as ferro- and antiferromagnetism, superconductivity, and current-induced fields. Existing protocols primarily focus on static fields or narrow-band dynamical signals, and are optimized for high sensitivity rather than fast time resolution. Here, we report detection of fast signal transients, providing a perspective for investigating the rich dynamics of magnetic systems. We experimentally demonstrate our technique using a single nitrogen-vacancy (NV) center magnetometer at room temperature, reaching a best-effort time resolution of 1.1 ns, an instantaneous bandwidth of 0.9 GHz, and a time-of-flight precision better than 20 ps. The time resolution can be extended to the picosecond range by use of on-chip waveguides. At these speeds, NV quantum magnetometers will become competitive with time-resolved synchrotron X-ray techniques. Looking forward, adding fast temporal resolution to the spatial imaging capability further promotes single-spin probes as powerful research tools in spintronics, mesoscopic physics, and nanoscale device metrology.

Abstract In patients with type II diabetes, the development of diabetic cardiomyopathy (DC) is associated with a high risk of mortality. Left ventricular hypertrophy, diastolic dysfunction, and exercise intolerance are the first signs of DC. The underlying mechanisms are not fully elucidated, and there is an urgent need for specific biomarkers and molecular targets for early diagnosis and treatment. Mitochondrial alterations play a key role in the development of DC, and microRNAs regulating mitochondrial function are emerging as potential biomarkers of metabolic stress in DC. L-Arginine (Arg) supplementation has been shown to be an effective strategy for improving mitochondrial function and energetics, with a significant impact on physical performance. The aim of the current study was to evaluate the effects of Arg supplementation on cardiac mitochondrial function, DC development, and relative phenotypes including exercise intolerance. We used db/db mice as a model of type II diabetes, chronically treated with Arg (1 mg/kg/day) for 12 weeks. Arg-treated db/db mice showed preserved diastolic function and left ventricular morphology compared with untreated diabetic mice. Arg supplementation also improved exercise tolerance and the propensity to physical activity. Mitochondrial respiration was significantly increased in cardiomyocytes isolated from treated db/db mice, as well as in diabetic cardiomyocytes treated with Arg in vitro. The improvement of cardiac mitochondrial function in db/db + Arg mice was associated with an increase in PGC-1-alpha levels, mitochondrial biogenesis, recycling, and antioxidant capacity. Arg treatment prevented the accumulation of circulating and cardiac miR-143 in db/db mice, which is an index of metabolic stress and activation of mitochondrial damage mechanisms. In conclusion, Arg supplementation is effective in preventing the development of DC, preserving diastolic function and exercise tolerance by improving mitochondrial fitness and homeostasis. Additionally, miR-143 could potentially be employed to monitor cardiac metabolic stress and the effects of Arg treatment in diabetes.

Purpose Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure. Methods This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group). Results The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P

Abstract Objective Rare and complex epilepsies encompass a diverse range of disorders characterized by seizures. We aimed to establish a consensus on key issues related to these conditions through collaboration among experienced neurologists, neuropediatricians, and patient advocacy representatives. Methods Employing a modified Delphi method, a scientific board comprising 20 physicians and 4 patient advocacy representatives synthesized existing literature with their expertise to formulate statements on contentious topics. A final 32‐member expert panel, representing diverse regions of Italy, validated these statements through a two‐round voting process, with consensus defined as an average score ≥7. Results Sixteen statements reached a consensus, emphasizing the necessity for epidemiological studies to ascertain the true prevalence of rare epilepsies. Etiology emerged as a crucial factor influencing therapeutic strategies and outcome prediction, with particular concern regarding prolonged and tonic–clonic seizures. The importance of early implementation of specific drugs and non‐pharmacological interventions in the treatment algorithm for developmental and epileptic encephalopathies (DEEs) was underscored. Multidisciplinary care involving experts with diverse skills was deemed essential, emphasizing non‐seizure outcomes in adolescence and adulthood. Significance This national consensus underscores the imperative for personalized, comprehensive, and multidisciplinary management of rare epilepsies/DEEs. It advocates for increased research, particularly in epidemiology and therapeutic approaches, to inform clinical decision‐making and healthcare policies, ultimately enhancing patients' outcomes. Plain Language Summary The modified Delphi method is broadly used to evaluate debated topics. In this work, we sought the consensus on integrated and social care in epilepsy management. Both representatives of high‐level epilepsy centers and patients' caregivers were directly involved.

Abstract The objective of this study is to ascertain whether subvalvular papillary muscle repair in conjunction with restrictive mitral valve annuloplasty represents the most efficacious treatment for patients presenting with secondary ischemic mitral regurgitation, as compared to restrictive mitral valve annuloplasty alone and to mitral valve replacement. A network meta-analysis was conducted to investigate outcomes of randomized controlled trials, propensity-matched studies, and observational studies, comparing various treatments for secondary ischemic mitral regurgitation. The average follow-up duration for late mortality was 4.4 years. Coronary artery bypass grafting (CABG) without mitral valve surgery had a late mortality incidence of 3.7%. Restrictive mitral annuloplasty demonstrated a rate of 6.5%, while restrictive mitral annuloplasty + CABG resulted in a rate of 4.1%. Subvalvular papillary muscle repair plus restrictive mitral annuloplasty ± CABG and mitral valve replacement + CABG had rates of 4.4% and 5.1%. SUCRA analysis showed that CABG was the most effective treatment for reducing late mortality (70.0%). This was followed by subvalvular papillary muscle repair plus restrictive mitral annuloplasty with or without CABG (62.4%). The top strategy for decreasing early death, reoperation, and readmission to the hospital for heart failure is subvalvular papillary muscle repair plus restrictive mitral annuloplasty with or without CABG, based on SUCRA probabilities (84.6%, 85.54%, and 86.3%, respectively). Subvalvular papillary muscle repair plus restrictive mitral annuloplasty ± CABG has potential to reduce the risks associated with early mortality, reoperation, and re-hospitalization for heart failure. However, further research is required to substantiate these findings.

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterised by lipid accumulation in the liver and is often associated with obesity and type 2 diabetes. The gut microbiome recently emerged as a significant player in liver metabolism and health. Hippurate, a host-microbial co-metabolite has been associated with human gut microbial gene richness and with metabolic health. However, its role on liver metabolism and homeostasis is poorly understood. Methods: We characterised liver biospies from 318 patients with obesity using RNAseq and metabolomics in liver and plasma to derive associations among hepatic hippurate, hepatic gene expression and MASLD and phenotypes. To test a potential beneficial role for hippurate in hepatic insulin resistance, we profile the metabolome of (IHH) using ultra-high-performance liquid chromatography coupled to high-resolution tandem mass spectrometry (UHPLC-MS/MS), and characterised intracellular triglyceride accumulation and glucose internalisation after a 24 h insulin exposure. Results: We first report significant associations among MASLD traits, plasma and hepatic hippurate. Further analysis of the hepatic transcriptome shows that liver and plasma hippurate are inversely associated with MASLD, implicating lipid metabolism and regulation of inflammatory responses pathways. Hippurate treatment inhibits lipid accumulation and rescues insulin resistance induced by 24-hour chronic insulin in IHH. Hippurate also improves hepatocyte metabolic profiles by increasing the abundance of metabolites involved in energy homeostasis that are depleted by chronic insulin treatment while decreasing those involved in inflammation. Conclusions: Altogether, our results further highlight hippurate as a mechanistic marker of metabolic health, by its ability to improve metabolic homeostasis as a postbiotic candidate.

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.

Place and meaning: the creation and signification of spaces in the global world “This will kill that. The book will kill the edifice”. These are the sober word that Victor Hugo makes the priest pronounce when, at the down of modern age, he looked on with prophetic dismay at the advent of printing with movable type, a revolution that would completely transform not only the face and features of the human being, but even the stones, the physical and material space of signification, the dimension of belonging and the sacred, that an “emancipated humanity” would change with the use of reason, undermining every form of dogmatic authority and its symbol. If the ways human beings shaped the space around them indicate their evolution - the changes in their anthropological profile - then we wonder what form stones could take in an era when even the paper book is replaced by the changing words that appear on bright and seductive screens – the irreplaceable extensions of a super-emancipated species. Actually, the digital revolution also contributes to the current changing in the organization of physical space. After all, anthropogenesis is always a “Home business” , evolution is “the unspoken drama” of creating space. Phenomenologically and biologically living means “positioning oneself”, being in space first as sentient and signifying body, even before the logos has formalized – in the sense of representation – this original experience. So living is always a delimitation experience, the delineation of boundaries. The “Sapiens 2.0” continues to construct his world as a place of signification and habitability, modelling his own “surroundings” in a way that is once again unprecedented, due to the transformations that he produces and which, in a circular and recursive process, continue to renew his features As plastic, versatile and changing entities, we exist in a global world, we easily move between semantically relevant places – home, neighbourhood, square, café – and the so-called “non-places”, spaces of transit, from airports and shopping malls to the web, which has now became the sapiens’ second home, the home within the home, or rather the ubiquitous home, in which we spend most of our time. The end of the strong subject of Cartesian metaphysics, replaced by a nomadic and fluid subjectivity, seems to be in line with a new reconfiguration of space: the temporary exposition replaces the monument; event supplants the codified liturgy of the ritual; online forum or the participation to the initiative through the click “Going”, replaces the square and the physical space of the relationship and contestation; smart working succeeds the factory and the office as spaces of production and sharing of work and ideas. From these renewed material and existential assumptions, does it still make sense to think the space as a cultural homeland? Moreover, globalized contemporaneity is developing through paradoxes that affect our own political, economic and social organization and have repercussions on spaces. Politically, the old nation-state, the space par excellence of belonging and identity, seems to have been supplanted by a series of supranational agencies who actually make decisions. The lucky inhabitants of the West easily traverse a seemingly borderless world, feeling themselves citizens of the world; neo-liberalism relies on the freedom of movement of goods and men reduced to commodities. There is a clear division that determines two hierarchically places: a center and a periphery that is always a marginality to be kept under control through more or less overtly violent practices of control-exclusion. This dossier intends to investigate the anthropological evolutions affecting the present, starting from the way in which contemporary man shapes and signifies spaces. The perception and configuration of space is in fact changing abruptly, in the light of the end of “grand narratives”, that is, of the possibility of investing places with mythical-ritual elements capable of establishing shared values and a feeling of “us”.

White sharks (Carcharodon carcharias) are among the most widespread, charismatic, and studied predators in the ocean. However, their conservation status is concerning in many ocean sectors, most notably the Mediterranean Sea, which hosts one of the least known and most endangered populations globally. Though they were historically abundant and widely distributed in the region, Mediterranean white sharks have declined to dangerously low abundance levels, impacted by centuries of coastal and, more recently, industrial fishing. The IUCN lists this species as Critically Endangered in the region, but information about its current abundance and ecology is scarce, hindering effective management and conservation. Here, we describe our initial effort to find and track the remaining Mediterranean white sharks and report what we have learned from these activities. In 2021-2023, we conducted three pilot expeditions in the Sicilian Channel, covering four major sites, collecting 159 eDNA samples, and carrying out 359 hrs of pelagic mid-water baited video surveys, 43 hours of deep-water benthic baited video surveys, and 111 hrs of fishing. Baited video surveys detected 42 species of bony fishes, elasmobranchs, marine mammals, and turtles. We detected white sharks at four sites from eDNA samples. Though we did not observe white sharks directly, these activities supported the identification of one of the last strongholds of this population in the region and started a multi-institutional white shark conservation program in the Mediterranean Sea, aiming to track the last white sharks in the region, estimate their abundance and extinction risk, characterize the species’ ecology and inform management and conservation.

Abstract Objectives Myotonia is a clinical sign typical of a group of skeletal muscle channelopathies, the non‐dystrophic myotonias. These disorders are electrophysiologically characterized by altered membrane excitability, due to specific genetic variants in known causative genes (CLCN1 and SCN4A). Juvenile Myoclonic Epilepsy (JME) is an epileptic syndrome identified as idiopathic generalized epilepsy, its genetics is complex and still unclarified. The co‐occurrence of these two phenotypes is rare and the causes likely have a genetic background. In this study, we have genetically investigated an Italian family in which co‐segregates myotonia, JME, or abnormal EEG without seizures was observed. Methods All six individuals of the family, 4 affected and 2 unaffected, were clinically evaluated; EMG and EEG examinations were performed. For genetic testing, Exome Sequencing was performed for the six family members and Sanger sequencing was used to confirm the candidate variant. Results Four family members, the mother and three siblings, were affected by myotonia. Moreover, EEG recordings revealed interictal generalized sharp‐wave discharges in all affected individuals, and two siblings were affected by JME. All four affected members share the same identified variant, c.644 T > C, p.Ile215Thr, in SCN4A gene. Variants that could account for the epileptic phenotype alone, separately from the myotonic one, were not identified. Significance These results provide supporting evidence that both myotonic and epileptic phenotypes could share a common genetic background, due to variants in SCN4A gene. SCN4A pathogenic variants, already known to be causative of myotonia, likely increase the susceptibility to epilepsy in our family. Plain Language Summary This study analyzed all members of an Italian family, in which the mother and three siblings had myotonia and epilepsy. Genetic analysis allowed to identify a variant in the SCN4A gene, which appears to be the cause of both clinical signs in this family.

Abstract Mild mesial temporal lobe epilepsy (MTLE) patients may remain untreated for a considerable time after disease onset or achieve seizure control with a single anti‐seizures medication (ASM). Thus, they represent an optimal population to investigate whether ASMs might have influence on brain structure. We consecutively enrolled 56 mild MTLE patients (22/56 untreated, 34/56 on‐monotherapy) and 58 healthy controls, matched for age and gender. All subjects underwent 3T‐brain MRI, using FreeSurfer for automated morphometry. Differences in gray matter were assessed using one‐way Analysis of Covariance (ANCOVA), adjusting for age, disease duration and intracranial volume. No significant change was observed between treated and untreated patients. We observed a significant reduction in cortical thickness of left inferior parietal, inferior temporal, middle temporal gyri, and right inferior parietal gyrus, temporal pole in monotherapy patients compared to healthy controls, as well as an increase in left isthmus of cingulate gyrus in untreated MTLE subjects compared to controls. Surface and subcortical volumes analysis revealed no differences among groups. Our study demonstrated no substantial morphological abnormalities between untreated mild MTLE patients and those undergoing monotherapy. Although exploratory, these results may reassure about safety of commonly used drugs and their marginal role in influencing neuroimaging results. Plain Language Summary This study investigated the following question: can medications against epileptic seizures have an effect on brain structure in mild mesial temporal lobe? Preliminary results from our analyses suggest not, as we did not find any difference in brain gray matter between untreated patients and those treated with a single anti‐seizures medication. On the other hand, epilepsy patients presented cortical thinning compared to healthy controls in several regions of the temporal and parietal lobes, in line with previous studies investigating the disease.

Abstract Myoclonus classically presents as a brief (10–50 ms duration), non‐rhythmic jerk movement. The etiology could vary considerably ranging from self‐limited to chronic or even progressive disorders, the latter falling into encephalopathic pictures that need a prompt diagnosis. Beyond the etiological classification, others evaluate myoclonus' body distribution (i.e., clinical classification) or the location of the generator (i.e., neurophysiological classification); particularly, knowing the anatomical source of myoclonus gives inputs on the observable clinical patterns, such as EMG bursts duration or EEG correlate, and guides the therapeutic choices. Among all the chronic disorders, myoclonus often presents itself as a manifestation of epilepsy. In this context, myoclonus has many facets. Myoclonus occurs as one, or the only, seizure manifestation while it can also present as a peculiar type of movement disorder; moreover, its electroclinical features within specific genetically determined epileptic syndromes have seldom been investigated. In this review, following a meeting of recognized experts, we provide an up‐to‐date overview of the neurophysiology and nosology surrounding myoclonus. Through the dedicated exploration of epileptic syndromes, coupled with pragmatic guidance, we aim to furnish clinicians and researchers alike with practical advice for heightened diagnostic management and refined treatment strategies. Plain Language Summary In this work, we described myoclonus, a movement characterized by brief, shock‐like jerks. Myoclonus could be present in different diseases and its correct diagnosis helps treatment.

Background and Objectives: Although breast surgery has undergone a drastic de-escalation in recent decades, axillary dissection is still indicated in some selected cases. Unfortunately, in 3–85% of cases, complications such as seroma formation occur, highlighting the need for more accurate hemostasis systems. The aim of this study is to evaluate the effectiveness of absorbable polysaccharide hemostatic such as HaemocerTM in preventing postoperative seroma. Materials and Methods: Patients referred to two surgery centers for a diagnosed breast cancer and candidates for axillary lymph node dissection were retrospectively evaluated and included in Group A (treated with HaemocerTM) and B (control group). The primary endpoints were the drain output after 48 h, the daily amount just before the removal, and the duration of axillary drainage placement. Secondary endpoints included the presence of seroma at the ultrasound (US) follow-up, significant blood loss, hematoma, the duration of surgery, and postsurgical complications. Results: The drain output within 48 h was 196 ± 93 vs. 286 ± 38 mL in Groups A and B, respectively (p = 0.013). The daily output before the removal was 40 ± 7 mL in Group A and 47 ± 2 mL in Group B (p = 0.049). The duration of axillary drainage placement was shorter in the experimental group (7 ± 3 days) compared to the control group (10 ± 1 days) with a statistically significant difference (0.037). During the US follow-up, on days 7, 15, and 30, the number of patients affected by seroma and the volumes were lower in the experimental group. Conclusions: The adsorbable hemostatic powder proved to be effective both in reducing the volume of drained fluid postoperatively and in decreasing the number and volume of reported seromas during the US follow-up.

Functional seizures (FS) are classified as conversion disorders in the DSM-5 and dissociative disorders in the ICD-11, showing a multifactorial psychopathology with various psychiatric comorbidities, such as depression and anxiety. Several studies have found a correlation between FS and personality disorders, mainly those in cluster B. Within this cluster, borderline personality disorder (BPD) or borderline personality traits are the most prevalent in FS. Emotion dysregulation is a hallmark of BPD and is commonly reported in individuals with FS. Cluster C personality disorders, such as avoidant or obsessive-compulsive disorders, have also been reported in FS. In this review, we aim to evaluate the relationship between FS and personality disorders. Assessing personality disorders in the context of FS is relevant for determining the most appropriate intervention. Cognitive-behavioral therapy (CBT) is considered the first-line approach to treating FS. Among various CBT strategies, dialectical behavior therapy, which specifically targets emotion dysregulation, may be helpful for individuals with BPD. Future research should assess the advantages of systematically evaluating personality disorders in FS to address specific treatment planning and evaluate its effectiveness on seizure recurrence, psychological comorbidities, and quality of life.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPEROFILES/509286_STRATEGY_20240203.pdf, identifier CRD42024509286.

In the rapidly evolving landscape of digital competencies, the need for a robust and universal method to assess students’ algorithmic thinking (AT) skills has become increasingly pronounced. Algorithmic thinking refers to the ability to analyse a problem and develop a step-by-step process to solve it.This research investigates the efficacy of the Cross Array Task (CAT) as an assessment tool for AT skills within Switzerland’s compulsory education system. Originally conceptualised as an unplugged activity, where students performed the task without digital technologies (e.g., by using gestures on paper) and an administrator manually assessed them, the CAT evolved into a digital activity that runs on an iPad. The CAT’s digital transformation has automated the scoring of student responses and data collection, streamlining the assessment processes and facilitating efficient large-scale assessments. It has also enhanced scalability, making the CAT suitable for widespread use in educational settings. Furthermore, it provides immediate feedback to students and educators, supporting timely interventions and personalised learning experiences.Our study aims to comprehensively investigate algorithmic competencies in compulsory education, examining their variations and influencing factors. This research examines key variables, such as age, sex, educational environment and school characteristics (e.g., the level and grade of education), and regional factors (e.g., the canton of the school) in Switzerland, and characteristics related to the specific assessment tool, including the type of artefact used, the complexity of the algorithms generated, and the level of autonomy. Additionally, it seeks to analyse the effectiveness of the unplugged and digital approaches in assessing AT skills, specifically comparing the unplugged and virtual CAT versions, aiming to provide insights into their advantages and potential synergies.This investigation delineates the developmental progression of AT skills across compulsory education, emphasising the influence of age on algorithm development and problem-solving strategies. Furthermore, we reveal the impact of artefacts and the potential of digital tools to facilitate advanced AT skill development across diverse age groups. Finally, our investigation delves into the influence of school environments and sex disparities on AT performance, alongside the significant individual variability influenced by personal abilities and external circumstances.These findings underscore the importance of tailored educational interventions and equitable practices to accommodate diverse learning profiles and optimise student outcomes in AT across educational settings.

The toxicity of three phthalates (PAEs) - butylbenzyl phthalate (BBP), diethyl phthalate (DEP), and di-(2-ethylhexyl) phthalate (DEHP) - was tested on the Mediterranean sea urchin Paracentrotus lividus. Fertilized eggs were exposed to environmental and high PAE concentrations for 72 h. The potential toxic effects on larval development and any morphological anomalies were then assessed to estimate PAEs impact. Environmental concentrations never affected development, while high concentrations induced toxic effects in larvae exposed to BBP (EC50: 2.9 ×103 µg/L) and DEHP (EC50: 3.72 ×103 µg/L). High concentrations caused skeletal anomalies, with a slight to moderate impact for DEP/DEHP and BBP, respectively. PAE toxicity was: BBP>DEHP>DEP. In conclusion, the three PAEs at environmental concentrations do not pose a risk to sea urchins. However, PAE concentrations should be further monitored in order not to constitute a concern to marine species, especially at their early developmental stages.

The outcome of a psychodynamic counselling intervention for students seeking psychological help at a university counselling centre in Italy was evaluated by examining its effect on clinical symptoms of the students. The intervention consisted of four counselling sessions and a later three-month follow-up session. The sample (N = 160) was drawn from a population of 360 university students. An in-treatment group (n = 86) was compared to a waiting-list comparison group (n = 74). Post-test measures were administered one month after baseline for each group. The psychodynamic counselling intervention was found to be a valid method to reduce psychopathological symptoms and to improve psychological adjustment among university students.

Abstract Objective Cardio‐facio‐cutaneous syndrome (CFC) is a genetic disorder due to variants affecting genes coding key proteins of the Ras/MAPK signaling pathway. Among the different features of CFC, neurological involvement, including cerebral malformations and epilepsy, represents a common and clinically relevant aspect. Status epilepticus (SE) is a recurrent feature, especially in a specific subgroup of CFC patients with developmental and epileptic encephalopathy (DEE) and history of severe pharmacoresistant epilepsy. Here we dissect the features of SE in CFC patients with a particular focus on longitudinal magnetic resonance imaging (MRI) findings to identify clinical‐radiological patterns and discuss the underlying physiopathology. Methods We retrospectively analyzed clinical, electroencephalogram (EEG), and MRI data collected in a single center from a cohort of 23 patients with CFC carrying pathogenic BRAF variants who experienced SE during a 5‐year period. Results Seven episodes of SE were documented in 5 CFC patients who underwent EEG and MRI at baseline. MRI was performed during SE/within 72 hours from SE termination in 5/7 events. Acute/early post‐ictal MRI findings showed heterogenous abnormalities: restricted diffusion in 2/7, focal area of pcASL perfusion change in 2/7, focal cortical T2/FLAIR hyperintensity in 2/7. Follow‐up images were available for 4/7 SE. No acute changes were detected in 2/7 (MRI performed 4 days after SE termination). Significance Acute focal neuroimaging changes concomitant with ictal EEG focus were present in 5/7 episodes, though with different findings. The heterogeneous patterns suggest different contributing factors, possibly including the presence of focal cortical malformations and autoinflammation. When cytotoxic edema is revealed by MRI, it can be followed by permanent structural damage, as already observed in other genetic conditions. A better understanding of the physiopathology will provide access to targeted treatments allowing to prevent long‐term adverse neurological outcome. Plain Language Summary Cardio‐facio‐cutaneous syndrome is a genetic disorder that often causes prolonged seizures known as status epilepticus. This study has a focus on electroclinical and neuroimaging patterns in patients with cardio‐facio‐cutaneous syndrome. During these status epilepticus episodes, we found different abnormal brain imaging patterns in patients, indicating various causes like brain malformations and inflammation. Understanding these patterns could help doctors find specific treatments, protecting cardio‐facio‐cutaneous syndrome patients from long‐term brain damage.

Intrahepatic cholangiocarcinoma (ICC) is a rare, heterogeneous, highly lethal tumor of the biliary tract. Due to the lack of effective treatments, an early identification of ICC is essential to achieve the best outcome in terms of therapy and prognosis aiming for a curative intent. ICC may arise on a normal liver or with an underlying liver disease, making the diagnosis more difficult and complex. Contrast-enhancement ultrasound (CEUS) is an accurate procedure able to detect ICC-specific contrast vascular pattern, and thus facilitating the correlation between radiological and histopathological findings with high specificity and sensitivity. CEUS has been shown to have a high diagnostic potential in the diagnosis of ICC thanks to the possibility of studying in real time the intralesional microcirculation and evaluating the precocity of the enhancement of the lesion during the arterial phase. All these features allow to differentiate the ICC from hepatocarcinoma (HCC) with high sensitivity and specificity. Furthermore, CEUS is a rapid, non-invasive, non-nephrotoxic or non-allergenic tool. The only limitations CEUS may have are related to the disease site and patient characteristics (obesity) and compliance, including the operator’s experience. A clinical evaluation of the patient, together with tumor markers and biochemical tests assessment, to differentiate ICC from HCC are highly suggested.