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This article reports a very preliminary analysis of five different feedthroughs for the ICRH system of the Divertor Tokamak Test (DTT) facility, designed by the Italian DTT Limited Liability Consortium (S.C. a r.l.). The analysis has been performed from the RF perspective using the ANSYS HFSS code with the aim of defining the most efficient feedthrough for the DTT ICRH system.

Pathogenic variants in SCN8Aare associated with a broad phenotypic spectrum, including Self‐Limiting Familial Infantile Epilepsy (SeLFIE), characterized by infancy‐onset age‐related seizures with normal development and cognition. Movement disorders, particularly paroxysmal kinesigenic dyskinesia typically arising after puberty, may represent another core symptom. We present the case of a 1‐year‐old girl with a familial disposition to self‐limiting focal seizures from the maternal side and early‐onset orofacial movement disorders associated with SCN8A‐SeLFIE. Brain MRI was normal. Genetic testing revealed a maternally inherited SCN8Avariant [c.4447G > A; p.(Glu1483Lys)]. After the introduction of valproic acid, she promptly achieved seizure control as well as complete remission of strabismus and a significant decrease in episodes of tongue deviation. Family history, genetic findings, and epilepsy phenotype are consistent with SCN8A‐SeLFIE. Movement disorders are an important part of the SCN8Aphenotypic spectrum, and this case highlights the novel early‐onset orofacial movement disorders associated with this condition. The episodes of tongue deviation and protrusion suggest focal oromandibular (lingual) dystonia. Additionally, while infantile strabismus or esophoria is a common finding in healthy individuals, our case raises the possibility of an ictal origin of the strabismus. This study underscores the importance of recognizing and addressing movement disorders in SCN8A‐SeLFIE patients, particularly the rare early‐onset orofacial manifestations. It adds to the growing body of knowledge regarding the diverse clinical presentations of SCN8A‐associated disorders and suggests potential avenues for clinical management and further research. Content available: Video

Paragangliomas of the thyroid gland are rare and usually they originate from the inferior laryngeal paraganglia. In this case report, we describe the case of a 78-year-old woman who presented with an incidental finding of thyroid nodule dislocating the trachea. After a systemic and radiological evaluation, right lobo-isthmectomy was performed, and the definitive diagnosis of paraganglioma was reached. Diagnosis of these thyroidal lesions could be difficult due to their rarity, to their specific radiological aspects and the need of employing specific histological staining techniques. Once the definitive diagnosis is reached, patients should undergo a systemic and genetic evaluation. Surgery is the gold standard treatment; radiotherapy should be considered when aggressive behavior is suspected. Regular long-lasting follow-up should be proposed to these patients considering the unpredictable behavior of these lesions.

Purpose: COVID-19 pandemic transformed the health system response worldwide. The aim of this study is to report changes about numbers and reason for ENT consultations in emergency department (ED) during COVID-19 pandemic comparing with those occurred the previous year (2019).Methods: Data about patients admitted to adult and pediatric ED were collected from March 1 to May 31, 2019 and 2020. Patients referred for urgency from general practitioners were excluded from the study.Results: Global ED admission (except for dyspnea or COVID-19–related symptoms) dramatically decreased during pandemic (−50.9% among adults and −71.4% among pediatrics). At the same time, ENT consultancy significantly reduced too, by 71.5% (P< .01) among adults and 45.1% (P< .01) for pediatrics. Among adults, it was reported a statistically significant decrease in consultation for ear problems (−88.5%, P= .0146). Reduction in ENT referral for bone fracture (−40%, P= .059), vertigo (−77.8%, P= .637), and tonsillitis (−87.5%, P= .688) was consistent, but not significant. Among pediatric patients, it was observed an increase by 25% about foreign bodies (12 vs 15, P< .01). A reduction in numbers of consults for ear problem (−90.8%; P= .045), epistaxis (−80%; P= .196), and nasal fracture (−70%; P= .36) was also observed.Conclusion: Fear of infection and the forced lock down caused a significant decrease in the number of ED accesses and in ENT consultancy. These data may suggest that some ED referral usually could be deferred, but on the other hand, pandemic will cause a great diagnostic delay.

ABSTRACTBackgroundObstructive sleep apnea (OSA) is frequently encountered in adult sleep disorders and needs careful differential diagnosis.Ear, nose, throat examination, including naso-laryngeal endoscopy, is mandatory in all cases to rule out potential obstructing lesions causing OSA.Clinical presentationThis report presents a 64-year-old male with snoring, nasal blockage (especially during night-time), and mild OSA. Physical-examination and CT revealed a unilateral vascularized left sinonasal mass extending to the nasopharynx and protruding into the oropharynx during inhalation. Due to suspicions of malignancy or vascular tumor, the patient also underwent contrast MRI. Endoscopic surgery was performed, and the final diagnosis was a sinonasal angiomatous polyp (SAP). SAPs are rare, and this is the first reported case of an adult solitary unilateral angiomatous polyp referral for OSA.ConclusionNasal masses need to be considered in the differential diagnosis of patients with obstructive sleep disorders in order to avoid wrong or ineffective treatment.

The size and weight of a high power microwave (HPM) source can make a difference in strategic use. The compactness of the virtual cathode oscillator (vircator) is undoubtedly the most significant advantage of this device. Civil industry and agriculture can use it to treat objects, food, and soils for disinfestation and disinfection. Vircators could also generate electromagnetic pulses (EMPs) to force the arrest of vehicles and drones; EMPs could inhibit or activate improvised explosive devices (IEDs). The coaxial type vircator is a highly compact device. Due to its symmetric geometry, coaxial vircator is typically designed to work with a TM01 mode. Still, when radiated into space, this mode gives maximum RF energy away from the antenna axis, a situation not desired. Instead, the TE11 is convenient in applications involving precise antenna pointing since this mode gives a maximum RF energy precisely aligned to the antenna axis. By studying Mathieu functions applied to elliptical waveguides, we improve the performances of a TE11 mode coaxial vircator using an elliptic drift tube (EDT). This is a completely innovative solution to reduce the mode competition inside the coaxial vircator. The rms and peak output power efficiency of the EDT coaxial vircator were measured on the TE11 mode, obtaining the values of 6.1% and 10%, respectively, with a peak power of 450 MW in a highly compact device.

ABSTRACTBackground: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by the ossification of entheses. When localized in the cervical paravertebral region, typical signs and symptoms include stiffness, pain, loss of range of motion, and difficulty swallowing.Clinical Presentation: The authors present two less typical respiratory manifestations of DISH due to cervical osteophytes protrusion and obstruction of the upper airway. The first patient was treated conservatively (application of CPAP during nighttime), while the second required emergency intubation and a combined ENT-neurosurgical operation for the removal of osteophytes.Clinical Relevance: Even though dysphagic symptoms are more frequent, DISH may be a cause of airway obstruction and should be included in the differential diagnosis of respiratory distress and OSA.