Management of stroke with minor symptoms may represent a therapeutical dilemma as the hemorrhage risk of acute thrombolytic therapy may eventually outweigh the stroke severity. However, around 30% of patients presenting with minor stroke symptoms are ultimately left with disability. The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.

Woody biomass fuel combustion for industrial heating and processing is increasing in northwestern North Carolina. Sources are mainly biomass waste and residues, including sawdust and chips from the furniture and wood processing industries, greenwood chips from construction sites and right-of-way clearing operations, and wood removed from landfill streams. This paper evaluates 5 hypothetical scenarios for use and disposal of biomass waste to demonstrate effects of industrial combustion of this biofuel on the greenhouse gas emissions bundle. Conclusions are that use of biomass residue as a fuel can be a positive strategy for mitigating greenhouse gas emissions.

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For patients with refractory focal epilepsy, surgical resection of the epileptogenic zone can lead to a drastic reduction in seizure frequency. Careful localisation of the epileptogenic zone is imperative in the presurgical workup. Up to 20% patients with refractory focal epilepsy have a normal MRI and are less likely to be referred for epilepsy surgery. As a result, 18-FDG-PET has been employed to localise the epileptogenic focus, which appears as a region of hypometabolism. This study examines the real-world utility of 18-FDG-PET imaging among patients undergoing for presurgical assessments over a 5-year period.Between January 2015 and March 2020, 65/90 patients referred for presurgical assessment underwent 18-FDG PET. In total, 26/65 (40%) patients had corresponding focal abnormalities on 18-FDG PET and MRI studies, of whom 22 had focal epileptiform activity on video-EEG (80.1%). Therefore, where 18-FDG PET and MRI agree, there is a high predictive value for successful seizure localisation with video-EEG moni- toring. Furthermore, 33/65 (40.7%) patients had MRI-negative epilepsy, of whom 17/33 (51.1%) had focal hypometabolism on 18-FDG PET. Thus, over half of our patient cohort with “non-lesional” or MRI-negative epilepsy were able to proceed to intracranial video-EEG monitoring or resective surgery with the help of supportive data from 18-FDG PET imaging.

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