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Objectives: Gliomas are often diagnosed due to epileptic seizures as well as neurocognitive deficits. First treatment choice for patients with gliomas in speech-related areas is awake surgery, which aims at maximizing tumor resection while preserving or improving patient’s neurological status. The present study aimed at evaluating neurocognitive functioning and occurrence of epileptic seizures in patients suffering from gliomas located in language-related areas before and after awake surgery as well as during their follow up course of disease.
Materials and Methods: In this prospective study we included patients who underwent awake surgery for glioma in the inferior frontal gyrus, superior temporal gyrus, or anterior temporal lobe. Preoperatively, as well as in the short-term (median 4.1 months, IQR 2.1-6.0) and long-term (median 18.3 months, IQR 12.3-36.6) postoperative course, neurocognitive functioning, neurologic status, the occurrence of epileptic seizures and number of antiepileptic drugs were recorded.
Results: Between 09/2012 and 09/2019, a total of 27 glioma patients, aged 36.1 ± 11.8 years, were included. Tumor resection was complete in 15, subtotal in 6 and partial in 6 patients, respectively. While preoperatively impairment in at least one neurocognitive domain was found in 37.0% of patients, postoperatively, in the short-term, 36.4% of patients presented a significant deterioration in word fluency (p=0.009) and 34.8% of patients in executive functions (p=0.049). Over the long-term, scores improved to preoperative baseline levels. The number of patients with mood disturbances significantly declined from 66.7% to 34.8% after surgery (p=0.03). Regarding seizures, these were present in 18 (66.7%) patients prior to surgery. Postoperatively, 22 (81.5%) patients were treated with antiepileptic drugs with all patients presenting seizure-freedom.
Conclusions: In patients suffering from gliomas in eloquent areas, the combination of awake surgery, regular neurocognitive assessment - considering individual patients´ functional outcome and rehabilitation needs – and the individual adjustment of antiepileptic therapy results in excellent patient outcome in the long-term course.
Production of K0S, Λ (Λ), Ξ± and Ω± in jets and in the underlying event in pp and p–Pb collisions
(2022)
The production of strange hadrons (K0S, Λ, Ξ±, and Ω±), baryon-to-meson ratios (Λ/K0S, Ξ/K0S, and Ω/K0S), and baryon-to-baryon ratios (Ξ/Λ, Ω/Λ, and Ω/Ξ) associated with jets and the underlying event were measured as a function of transverse momentum (pT) in pp collisions at s√=13 TeV and p-Pb collisions at sNN−−−√=5.02 TeV with the ALICE detector at the LHC. The inclusive production of the same particle species and the corresponding ratios are also reported. The production of multi-strange hadrons, Ξ± and Ω±, and their associated particle ratios in jets and in the underlying event are measured for the first time. In both pp and p-Pb collisions, the baryon-to-meson and baryon-to-baryon yield ratios measured in jets differ from the inclusive particle production for low and intermediate hadron pT (0.6−6 GeV/c). Ratios measured in the underlying event are in turn similar to those measured for inclusive particle production. In pp collisions, the particle production in jets is compared with PYTHIA 8 predictions with three colour-reconnection implementation modes. None of them fully reproduces the data in the measured hadron pT region. The maximum deviation is observed for Ξ± and Ω±, which reaches a factor of about six. In p-Pb collisions, there is no significant event-multiplicity dependence for particle production in jets, in contrast to what is observed in the underlying event. The presented measurements provide novel constraints on hadronisation and its Monte Carlo description. In particular, they demonstrate that the fragmentation of jets alone is insufficient to describe the strange and multi-strange particle production in hadronic collisions at LHC energies.