Bipolar type I diagnosis after a manic episode secondary to SARS-CoV-2 infection: A case report.

RATIONALE: Our objective is to provide awareness about psychotic vulnerability in patients infected with SARS-CoV-2 and to better understand the role of steroid withdrawal in manic episodes, especially with its common usage in respiratory disease caused by SARS-CoV-2. PATIENT CONCERNS: We present the case of a patient who was hospitalized twice after discontinuing steroid therapy for SARS-CoV-2 infection and presented with a manic episode despite not having a psychiatric history. DIAGNOSIS: The patient tested positive on a polymerase chain reaction test for SARS-CoV-2 and developed pneumonia. Other organic differential diagnoses such as encephalitis were also investigated and excluded. Manic episodes were diagnosed according to DSM-V criteria. Subsequently, the patient was diagnosed with type I bipolar disorder. INTERVENTIONS: According to the protocols, supplemental oxygen therapy, prophylactic enoxaparin and intravenous (IV) steroids were administered. Steroid dosage was gradually reduced under supervision. During the acute mania, antipsychotics and benzodiazepines were administered. OUTCOMES: After discharge, the patient was admitted to the psychiatric consultation service. He first received mood stabilizer therapy and then received supportive psychotherapy. LESSONS: Psychotic symptoms commonly occur after the discontinuation of high-dose steroid therapy; however, controlled tapering may prevent these side effects. Only a few cases have reported concomitant SARS-CoV-2 infection and manic episodes, often with an apparent relationship with steroid withdrawal syndrome. In this case, we considered psychotic vulnerability a condition that is often underestimated. In consideration of the SARS-CoV-2 pandemic, the case may represent an underlying trigger for psychotic decompensation, which, in concert with neuroinflammation, may induce a manic episode.

An Amperometric Sensor for Thiocholine Based on Cluster-Assembled Zirconia Modified Electrodes.

Here we report on the fabrication and characterization of cluster-assembled nanostructured zirconia electrodes for the electrochemical detection of enzymatically produced thiocholine. Zirconia nanostructures are produced by Supersonic Cluster Beam Deposition on thin gold films. This technique enables nanoscale control of the deposited film surface morphology, providing high active surface area for electrochemical detection of the analyte, along with high double-layer capacitance and suitable charge transfer resistance of the system. The electrochemical behavior of the electrodes has been characterized in the presence of the Potassium ferricyanide/Potassium ferrocyanide redox couple and the system performance showed to be enhanced starting from a thickness of the deposited layer of 60 nm. The electrochemical response for the oxidation of an enzymatic product was assessed by means of cyclic voltammetry, electrochemical impedance spectroscopy and chronoamperometry. The nanostructured zirconia film yields a good electrochemical detection of thiocholine. The limit of detection for thiocholine under working potential of 0.810-0.820 V versus reference was found to be comprised between 0.25 µM and 1.3 µM. Nanostructured electrodes, combining gold and zirconia nanoparticles can be implemented as functional transducers in biosensing devices, for example based on Acetylcholinesterase for electrochemical detection of polluting agents.

Electroactive Ionic Soft Actuators with Monolithically Integrated Gold Nanocomposite Electrodes.

Electroactive ionic gel/metal nanocomposites are produced by implanting supersonically accelerated neutral gold nanoparticles into a novel chemically crosslinked ion conductive soft polymer. The ionic gel consists of chemically crosslinked poly(acrylic acid) and polyacrylonitrile networks, blended with halloysite nanoclays and imidazolium-based ionic liquid. The material exhibits mechanical properties similar to that of elastomers (Young's modulus ≈ 0.35 MPa) together with high ionic conductivity. The fabrication of thin (≈100 nm thick) nanostructured compliant electrodes by means of supersonic cluster beam implantation (SCBI) does not significantly alter the mechanical properties of the soft polymer and provides controlled electrical properties and large surface area for ions storage. SCBI is cost effective and suitable for the scaleup manufacturing of electroactive soft actuators. This study reports the high-strain electromechanical actuation performance of the novel ionic gel/metal nanocomposites in a low-voltage regime (from 0.1 to 5 V), with long-term stability up to 76 000 cycles with no electrode delamination or deterioration. The observed behavior is due to both the intrinsic features of the ionic gel (elasticity and ionic transport capability) and the electrical and morphological features of the electrodes, providing low specific resistance (<100 Ω cm-2 ), high electrochemical capacitance (≈mF g-1 ), and minimal mechanical stress at the polymer/metal composite interface upon deformation.

A Fully Integrated Dual-Channel On-Coil CMOS Receiver for Array Coils in 1.5-10.5 T MRI.

Magnetic resonance imaging (MRI) is among the most important medical imaging modalities. Coil arrays and receivers with high channel counts (16 and more) have to be deployed to obtain the image quality and acquisition speed required by modern clinical protocols. In this paper, we report the theoretical analysis, the system-level design, and the circuit implementation of the first receiver IC (RXIC) for clinical MRI fully integrated in a modern CMOS technology. The dual-channel RXIC sits directly on the sensor coil, thus eliminating any RF cable otherwise required to transport the information out of the magnetic field. The first stage LNA was implemented using a noise-canceling architecture providing a highly reflective input used to decouple the individual channels of the array. Digitization is performed directly on-chip at base-band by means of a delta-sigma modulator, allowing the subsequent optical transmission of data. The presented receiver, implemented in a CMOS technology, is compatible with MRI scanners up to . It reaches sub- noise figure for MRI units and features a dynamic range up to at a power consumption below per channel, with an area occupation of . Mounted on a small-sized printed circuit board (PCB), the receiver IC has been employed in a commercial MRI scanner to acquire in-vivo images matching the quality of traditional systems, demonstrating the first step toward multichannel wearable MRI array coils.

Miniaturized supercapacitors: key materials and structures towards autonomous and sustainable devices and systems.

Supercapacitors (SCs) are playing a key role for the development of self-powered and self-sustaining integrated systems for different fields ranging from remote sensing, robotics and medical devices. SC miniaturization and integration into more complex systems that include energy harvesters and functional devices are valuable strategies that address system autonomy. Here, we discuss about novel SC fabrication and integration approaches. Specifically, we report about the results of interdisciplinary activities on the development of thin, flexible SCs by an additive technology based on Supersonic Cluster Beam Deposition (SCBD) to be implemented into supercapacitive electrolyte gated transistors and supercapacitive microbial fuel cells. Such systems integrate at materials level the specific functions of devices, like electric switch or energy harvesting with the reversible energy storage capability. These studies might open new frontiers for the development and application of new multifunction-energy storage elements.

Interfacial properties of a carbyne-rich nanostructured carbon thin film in ionic liquid.

Nanostructured carbon sp(2) (ns-C) thin films with up to 30% of sp-coordinated atoms (carbynes) were produced in a high vacuum by the low kinetic energy deposition of carbon clusters produced in the gas phase and accelerated by a supersonic expansion. Immediately after deposition the ns-C films were immersed in situ in an ionic liquid electrolyte. The interfacial properties of ns-C films in the ionic liquid electrolyte were characterized by electrochemical impedance spectroscopy and cyclic voltammetry (CV). The so-prepared carbyne-rich electrodes showed superior electric double layer (EDL) capacitance and electric conductivity compared to ns-C electrodes containing only sp(2) carbon, showing the substantial influence of carbynes on the electrochemical properties of nanostructured carbon electrodes.

Nickel nanoparticles effect on the electrochemical energy storage properties of carbon nanocomposite films.

The growth of nanostructured nickel : carbon (Ni : C) nanocomposite thin films by the supersonic cluster beam deposition of nickel and carbon clusters co-deposited from two separate beam sources has been demonstrated. Ni : C films retain the typical highly disordered structure with predominant sp(2) hybridization, low density, high surface roughness and granular nanoscale morphology of cluster assembled nanostructured carbon, but display enhanced electric conductivity. The electric double layer (EDL) capacitance of Ni : C films featuring the same thickness (200 nm) and different nickel volumetric concentrations (0-35%) has been investigated by electrochemical impedance spectroscopy employing an aqueous solution of potassium hydroxide (KOH 1 M) as electrolyte solution. Evidence of increased electric conductivity, facilitated EDL formation and negligible porous structure modification was found as consequence of Ni embedding. This results in the ability to synthesize electrodes with tailored specific power and energy density by the accurate control of the amount of deposited Ni and C clusters. Moreover, nickel nanoparticles were shown to catalyze the formation of tubular onion-like carbon structures upon mild thermal treatment in inert atmosphere. Electrochemical characterization of the heated nanocomposite electrodes revealed that the presence of long range ordered sp(2) structures further improves the power density and energy storage properties.

Diagnostic yield of short-term video-EEG monitoring for epilepsy and PNESs: a European assessment.

INTRODUCTION: Although long-term video-EEG monitoring (LVEM) is routinely used to investigate paroxysmal events, short-term video-EEG monitoring (SVEM) lasting <24 h is increasingly recognized as a cost-effective tool. Since, however, relatively few studies addressed the yield of SVEM among different diagnostic groups, we undertook the present study to investigate this aspect. METHODS: We retrospectively analyzed 226 consecutive SVEM recordings over 6 years. All patients were referred because routine EEGs were inconclusive. Patients were classified into 3 suspected diagnostic groups: (1) group with epileptic seizures, (2) group with psychogenic nonepileptic seizures (PNESs), and (3) group with other or undetermined diagnoses. We assessed recording lengths, interictal epileptiform discharges, epileptic seizures, PNESs, and the definitive diagnoses obtained after SVEM. RESULTS: The mean age was 34 (±18.7) years, and the median recording length was 18.6 h. Among the 226 patients, 127 referred for suspected epilepsy - 73 had a diagnosis of epilepsy, none had a diagnosis of PNESs, and 54 had other or undetermined diagnoses post-SVEM. Of the 24 patients with pre-SVEM suspected PNESs, 1 had epilepsy, 12 had PNESs, and 11 had other or undetermined diagnoses. Of the 75 patients with other diagnoses pre-SVEM, 17 had epilepsy, 11 had PNESs, and 47 had other or undetermined diagnoses. After SVEM, 15 patients had definite diagnoses other than epilepsy or PNESs, while in 96 patients, diagnosis remained unclear. Overall, a definitive diagnosis could be reached in 129/226 (57%) patients. CONCLUSIONS: This study demonstrates that in nearly 3/5 patients without a definitive diagnosis after routine EEG, SVEM allowed us to reach a diagnosis. This procedure should be encouraged in this setting, given its time-effectiveness compared with LVEM.