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• Seizure onset pattern (SOP) represents an alteration of electroencephalography (EEG) morphology at the beginning of seizure. • Many morphological SOP classifications have been reported without established consensus in stereotactic electroencephalography (SEEG). Some types of SOP were quite similar, but named differently between each report, which make difficulties to communicate among doctors. • From this review, SOP can be classified into five major types including 1.Low voltage fast activity (LVFA), 2.Sharp activity, 3.Burst of polyspikes, 4.Periodic polyspikes (with one special subtype; Delta brush) and 5.Spike and wave (with one special subtype; Low-frequency, high-amplitude periodic spike [LFPS]). • A clear algorithm for determining SOP morphology was also proposed. The issue of clinical correlation to SOP will be further studied after a systematic classification is established and generalized. Seizure onset pattern (SOP) represents an alteration of electroencephalography (EEG) morphology at the beginning of seizure activity in epilepsy. With stereotactic electroencephalography (SEEG), a method for intracranial EEG evaluation, many morphological SOP classifications have been reported without established consensus. These inconsistent classifications with ambiguous terminology present difficulties to communication among epileptologists. We reviewed SOP in SEEG by searching the PubMed database. Reported morphological classifications and the ambiguous terminology used were collected. After thoroughly reviewing all reports, we reconsidered the definitions of these terms and explored a more consistent and simpler morphological SOP classification. Of the 536 studies initially found, 14 studies were finally included after screening and excluding irrelevant studies. We reconsidered the definitions of EEG onset, period for determining type of SOP, core electrode and other terms in SEEG. We proposed a more consistent and simpler morphological SOP classification comprising five major types with two special subtypes. A scoping review of SOP in SEEG was performed. Our classification may be suitable for describing SOP morphology. [ABSTRACT FROM AUTHOR]

Hemispherotomy is a surgical procedure aimed at the treatment of hemispheric epilepsy. Hemispherotomy disconnects the commissural fibers, projecting fibers, and limbic system while preserving most of the brain parenchyma, unlike conventional hemispherectomy. 1 Hemispherotomy is one of most complicated operations currently used in epilepsy surgery and requires a high-level understanding of the intrinsic neuroanatomy. Generally, 2 main techniques are applied in hemispherotomy: lateral hemispherotomy and vertical hemispherotomy. 2,3 Vertical hemispherotomy was developed after the lateral technique. Despite a deeper, narrower surgical corridor, vertical hemispherotomy requires a smaller craniotomy and a shorter disconnection line and allows easier disconnection of the insula than the lateral approach. 1 In performing vertical hemispherotomy, 2 options are available: the interhemispheric approach 4 and the parasagittal approach. 3 With the parasagittal approach, the lateral ventricle is opened and entered via superior frontal gyrus. To ease the surgery and minimize the operation time, we apply "partial superior frontal gyrus removal." This procedure is useful to widen a shallower surgical field while skipping the need for interhemispheric dissection. Total callosotomy is then performed via the lateral ventricle. To disconnect limbic system, we used the technique following the falx and tentorial edge as a landmark. 5 Here, we present our surgical steps for parasagittal hemispherotomy in a 5-month-old girl diagnosed as hemimegalencephaly (Figures 1-8). [ABSTRACT FROM AUTHOR]

The microscopic mechanical properties including the bending strength and Young's modulus for Si 3 N 4 ceramics doped with Y 2 O 3 and Al 2 O 3 which was immersed in 5 wt% sulfuric acid solution using microcantilever beam specimens was investigated in comparison with the macroscopic results obtained in conventional three-point bending tests. Both the properties sharply dropped in very short periods of the corrosion in the microcantilever tests, resulting from the dissolutions of yttrium and aluminum ions of grain boundary glass networks, followed by the hydration. After the drops at the beginning of the corrosion, they showed little degradation afterwards. The degradation behaviors of the mechanical properties are basically the same as those in conventional macroscopic approaches; however, they changes appear in very short periods of the corrosion in the microcantilever bending tests. This study also verified that a small difference of a ratio of sintering additives results in different grain boundary strengths of Si 3 N 4 ceramics. [ABSTRACT FROM AUTHOR]

The coronavirus disease-2019 (COVID-19) pandemic presented an unprecedented challenge to societies, necessitating adaptations in infection prevention measures. While there is ample data on infection prevention practices in workplace and healthcare settings, comprehensive data specific to childcare facilities has been lacking. We conducted a nationwide web-based survey capturing responses from various childcare facilities (N = 549). This aimed to understand the adaptation in infection prevention measures between fiscal years 2022 and 2023, the status of events and activities, and the factors influencing decision-making related to infection prevention. From 2022 to 2023, most childcare facilities reduced infection prevention practices like mandatory mask-wearing (46.9 %–7.5 %) and eating without conversing (56.5 %–7.4 %), whereas they continued high levels of hand sanitization and checking child's health condition before attendance. The frequency of events and activities (e.g., athletic meets, field trips) increased, with many being held without restrictions. Surprisingly, 62.8 % of facilities used items not recommended for infection prevention. The influence of local government guidelines (risk ratio, 0.69; 95%CI, 0.53–0.90) and the input from junior teachers (risk ratio, 0.85; 95%CI, 0.72–0.99) were associated with reduced risk of using inappropriate items. Furthermore, childcare facilities emphasized the need to collaborate with public health and medical professionals for more accurate and efficient decision-making during pandemics. The survey provides insights into the evolving practices of Japanese childcare facilities during the COVID-19 pandemic. It underscores the importance of refining information sources, enhancing decision-making processes, and fostering collaboration with the medical community for future pandemics and natural disasters. [ABSTRACT FROM AUTHOR]

• We evaluated trends of pediatric varicella and herpes zoster incidence for 18 years. • Varicella was largely reduced after the vaccine introduction and COVID-19 pandemic. • The vaccine and COVID-19 pandemic had a small impact on herpes zoster incidence. • Risk of herpes zoster was low in children born after the routine vaccine. To determine the epidemiological trends in pediatric varicella and herpes zoster incidence and changes in healthcare resource use from 2005 to 2022 using a nationally representative database in Japan. We conducted a retrospective observational study consisting of 3.5 million children with 177 million person-months during 2005–2022 using Japan Medical Data Center (JMDC) claims database in Japan. We investigated trends in incidence rates of varicella and herpes zoster and changes in healthcare resource use (e.g., antiviral use, office visits, and healthcare costs) over 18 years. Interrupted time-series analyses were used to investigate the impact of the routine varicella vaccination program in 2014 and infection prevention measures against COVID-19 on incidence rates of varicella and herpes zoster and related healthcare utilization. After the introduction of the routine immunization program in 2014, we observed level changes in incidence rates (45.6 % reduction [95 %CI, 32.9–56.0] of varicella cases, antiviral use (40.9 % reduction [95 %CI, 25.1–53.3]), and relevant healthcare costs (48.7 % reduction [95 %CI, 38.2–57.3]). Furthermore, infection prevention measures against COVID-19 were associated with additional level changes in varicella rates (57.2 % reduction [95 %CI, 44.5–67.1]), antiviral use (65.7 % reduction [59.7–70.8]), and healthcare costs (49.1 % [95 %CI, 32.7–61.6]). In contrast, the changes in incidence and healthcare costs for herpes zoster were relatively small, which showed 9.4 % elevated level change with a decreasing trend and 8.7 % reduced level change with a decreasing trend after the vaccine program and the COVID-19 pandemic. The cumulative incidence of herpes zoster in children born after 2014 was lower than that before 2014. Varicella incidence and healthcare resource use were largely affected by the routine immunization program and infection prevention measures against COVID-19, while these impacts on herpes zoster were relatively small. Our study indicates that immunization and infection prevention measures largely changed pediatric infectious disease practices. [ABSTRACT FROM AUTHOR]

Electrodes for stereotactic electroencephalography (SEEG) are typically fixed to the skull with anchor bolts. When anchor bolts are unavailable, electrodes have to be fixed using other methods, carrying the possibility of electrode shift. This study, therefore, evaluated the characteristics of electrode tip shift during SEEG monitoring in patients with electrodes fixed using the suture technique. We retrospectively included patients who underwent SEEG implantation with suture fixation and evaluated the tip shift distance (TSD) of electrodes. Possible influences evaluated included: 1) implantation period, 2) lobe of entry, 3) unilateral or bilateral implantation, 4) electrode length, 5) skull thickness, and 6) scalp thickness difference. A total of 50 electrodes in 7 patients were evaluated. TSD was 1.4 ± 2.0 mm (mean ± standard deviation). Implantation period was 8.1 ± 2.2 days. Entry lobe was frontal for 28 electrodes and temporal for 22 electrodes. Implantation was bilateral for 25 electrodes and unilateral for 25 electrodes. Electrode length was 45.4 ± 14.3 mm. Skull thickness was 6.0 ± 3.7 mm. Scalp thickness difference was −1.5 ± 2.1 mm, which was found greater in temporal lobe entry compared with frontal lobe entry. According to univariate analyses, neither implantation period nor electrode length correlated with TSD. Multivariate regression analysis showed that only greater scalp thickness difference correlated significantly with greater TSD (P = 0.0018). Greater scalp thickness difference correlated with greater TSD. Surgeons need to consider the degree of scalp thickness difference and electrode shift when using suture fixation, especially with temporal lobe entry. [ABSTRACT FROM AUTHOR]