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(1) Background: A lesion within the dentato-rubro-olivary pathway (DROP) in the posterior fossa can cause secondary neurodegeneration of the inferior olivary nucleus: so-called hypertrophic olivary degeneration (HOD). The clinical syndrome of HOD occurs slowly over months and may be overlooked in progressive neuro-oncological diseases. Posterior fossa tumors are often located near these strategic structures. The goal of this study was to analyze the systematics of HOD occurrence in neuro-oncological patients.
(2) Methods: The neuroradiological database of the university healthcare center was scanned for HOD-related terms from 2010 to 2019. After excluding patients with other causes of HOD, 12 datasets from neuro-oncological patients were analyzed under predetermined criteria.
(3) Results: Patients received multimodal tumor treatments including neurosurgery, radiotherapy, and chemotherapy. HOD occurred both unilaterally (left n = 4; right n = 5) and bilaterally (n = 3). Though the mass effect of posterior fossa tumors had already affected strategic structures of the DROP, none of the patients showed signs of HOD on MRI until therapeutic measures including neurosurgery affecting the DROP were applied. HOD was visible on MRI within a median of 6 months after the neurosurgical intervention. In 67%, the presumed underlying surgical lesion in the DROP lay in the contralateral dentate nucleus.
(4) Conclusion: In a selected cohort of neuro-oncological patients, therapeutic lesions within the DROP were associated with HOD occurrence.
Neutron total cross sections are an important source of experimental data in the evaluation of neutron-induced cross sections. The sum of all neutron-induced reaction cross sections can be determined with a precision of a few per cent in a relative measurement. The neutron spectrum of the photoneutron source nELBE extends in the fast region from about 100 keV to 10 MeV and has favourable conditions for transmission measurements due to the low instantaneous flux of neutrons and low gamma-flash background. Several materials of interest (in part included in the CIELO evaluation or on the HPRL of OECD/NEA) have been investigated: 197Au [1, 2], natFe [2], natW [2], 238U, natPt, 4He, natO, natNe, natXe. For gaseous targets high pressure gas cells with flat end-caps have been built that hold up to 200 bar pressure. The experimental setup will be presented including results from several transmission experiments and the data analysis leading to the total cross sections will be discussed.
Posterior fossa tumor surgery is challenging due to the proximity and exposure of cerebellar structures. A favorable operative approach is unknown. Following lesions to the dentato–rubro–olivary-pathway, a neurodegenerative disease called hypertrophic olivary degeneration (HOD) can occur. This study for the first time demonstrates that paravermal trans-cerebellar approaches are associated with a significantly higher likelihood of HOD on MRI when compared to other approaches. This finding can well be attributed to dentate nucleus (DN) injury. Furthermore, cerebellar mutism syndrome (CMS) was discussed in the literature to be correlated with HOD due to a functional overlap of pathways involved. We found no such correlation in this study, but HOD was shown to be a reliable indicator for surgical disruption of efferent cerebellar pathways involving the DN. Henceforth, neurosurgeons should consider more midline or lateral approaches in posterior fossa surgery to spare the DN whenever feasible, and focus on cerebellar functional anatomy in their preoperative planning.
Purpose: Bilateral vocal cord dysfunction (bVCD) is a rare but feared complication of thyroid surgery. This long term retrospective study determined the effect of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) during thyroid surgeries with regard to the rate of bVCD and evaluated the frequency as well as the outcome of staged operations. Methods: Retrospective analysis of prospectively documented data (2000–2019) of a tertiary referral centers’ database. IONM started in 2000 and, since 2010, discontinuation of surgery was encouraged in planned bilateral surgeries to prevent bVCD, if non-transient loss of signal (ntLOS) occurred on the first side. Datasets of the most recent 40-month-period were assessed in detail to determine the clinical outcome of unilateral ntLOS in planned bilateral thyroid procedures. Results: Of 22,573 patients, 65 had bVCD (0.288%). The rate of bVCD decreased from 0.44 prior to 2010 to 0.09% after 2010 (p < 0.001, Chi2). Case reviews of the most recent 40 months period identified ntLOS in 113/3115 patients (3.6%, 2.2% NAR), of which 40 ntLOS were recorded during a planned bilateral procedure (n = 952, 2.1% NAR). Of 21 ntLOS occurring on the first side of the bilateral procedure, 15 procedures were stopped, subtotal contralateral resections were performed, and thyroidectomy was continued in 3 patients respectively, with the use of continuous vagal IONM. Eighteen cases of VCD were documented postop, and all but one patient had a full recovery. Seven patients had staged resections after 1 to 18 months (median 4) after the first procedure. Conclusion: IONM facilitates reduced postoperative bVCD rates. IONM is, therefore, recommendable in planned bilateral procedures. The rate of non-complete bilateral surgery after intraoperative non-transient LOS was 2%.
Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"- exposure in relation to non-"traffic zone"-exposure. Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including including NO2, SO2, nanoparticles, and ozone.
Background: Thymostimulin is a thymic peptide fraction with immune-mediated cytotoxicity against hepatocellular carcinoma (HCC) in vitro and palliative efficacy in advanced HCC in two independent phase II trials. The aim of this study was to assess the efficacy of thymostimulin in a phase III trial. Methods: The study was designed as a prospective randomised, placebo-controlled, double-blind, multicenter clinical phase III trial. Between 10/2002 and 03/2005, 135 patients with locally advanced or metastasised HCC (Karnofsky [greater than or equal to]60% / Child-Pugh [less than or equal to]12) were randomised to receive thymostimulin 75 mg s.c. 5x/week or placebo stratified according to liver function. Primary endpoint was twelve-month survival, secondary endpoints overall survival (OS), time to progression (TTP), tumor response, safety and quality of life. A subgroup analysis according to liver function, KPS and tumor stage (Okuda, CLIP and BCLC) formed part of the protocol. Current Controlled Trials ISRCTN64487365. Results: Twelve-month survival was 28% [95%CI 17-41; treatment] and 32% [95%CI 19-44; control] with no significant differences in median OS (5.0 [95% CI 3.7-6.3] vs. 5.2 [95% CI 3.5-6.9] months; p=0.87, HR=1.04 [95% CI 0.7-1.6]) or TTP (5.3 [95%CI 2.0-8.6] vs. 2.9 [95%CI 2.6-3.1] months; p=0.60, HR=1.13 [95% CI 0.7-1.8]). Adjustment for liver function, Karnofsky status or tumor stage did not affect results. While quality of life was similar in both groups, fewer patients on thymostimulin suffered from accumulating ascites and renal failure. Conclusions: In our phase III trial, we found no evidence of any benefit to thymostimulin in the treatment of advanced HCC and there is therefore no justification for its use as single-agent treatment. The effect of thymostimulin on hepato-renal function requires further confirmation. trial registration: Current Controlled Trials ISRCTN64487365
We present measurements of exclusive ensuremathπ+,0 and η production in pp reactions at 1.25GeV and 2.2GeV beam kinetic energy in hadron and dielectron channels. In the case of π+ and π0 , high-statistics invariant-mass and angular distributions are obtained within the HADES acceptance as well as acceptance-corrected distributions, which are compared to a resonance model. The sensitivity of the data to the yield and production angular distribution of Δ (1232) and higher-lying baryon resonances is shown, and an improved parameterization is proposed. The extracted cross-sections are of special interest in the case of pp → pp η , since controversial data exist at 2.0GeV; we find \ensuremathσ=0.142±0.022 mb. Using the dielectron channels, the π0 and η Dalitz decay signals are reconstructed with yields fully consistent with the hadronic channels. The electron invariant masses and acceptance-corrected helicity angle distributions are found in good agreement with model predictions.
Partial wave analysis of the reaction p(3.5 GeV) + p → pK +Λ to search for the "ppK−" bound state
(2015)
Employing the Bonn–Gatchina partial wave analysis framework (PWA), we have analyzed HADES data of the reaction p(3.5 GeV) + p → pK +Λ. This reaction might contain information about the kaonic cluster “ppK −” (with quantum numbers J P = 0− and total isospin I = 1/2) via its decay into pΛ. Due to interference effects in our coherent description of the data, a hypothetical KNN (or, specifically “ppK −”) cluster signal need not necessarily show up as a pronounced feature (e.g. a peak) in an invariant mass spectrum like pΛ. Our PWA analysis includes a variety of resonant and non-resonant intermediate states and delivers a good description of our data (various angular distributions and two-hadron invariant mass spectra) without a contribution of a KNN cluster. At a confidence level of CLs = 95% such a cluster cannot contribute more than 2–12% to the total cross section with a pK +Λ final state, which translates into a production cross-section between 0.7 μb and 4.2 μb, respectively. The range of the upper limit depends on the assumed cluster mass, width and production process.
Many QCD based and phenomenological models predict changes of hadron properties in a strongly interacting environment. The results of these models differ significantly and the experimental determination of hadron properties in nuclear matter is essential. In this paper we present a review of selected physics results obtained at GSI Helmholtzzentrum für Schwerionenforschung GmbH by HADES (High-Acceptance Di-Electron Spectrometer). The e+e− pair emission measured for proton and heavy-ion induced collisions is reported together with results on strangeness production. The future HADES activities at the planned FAIR facility are also discussed.
The knowledge of baryonic resonance properties and production cross sections plays an important role for the extraction and understanding of medium modifications of mesons in hot and/or dense nuclear matter. We present and discuss systematics on dielectron and strangeness production obtained with HADES on p+p, p+A and A+A collisions in the few GeV energy regime with respect to these resonances.
The High Acceptance DiElectron Spectrometer HADES [1] is installed at the Helmholtzzentrum für Schwerionenforschung (GSI) accelerator facility in Darmstadt. It investigates dielectron emission and strangeness production in the 1-3 AGeV regime. A recent experiment series focusses on medium-modifications of light vector mesons in cold nuclear matter. In two runs, p+p and p+Nb reactions were investigated at 3.5 GeV beam energy; about 9·109 events have been registered. In contrast to other experiments the high acceptance of the HADES allows for a detailed analysis of electron pairs with low momenta relative to nuclear matter, where modifications of the spectral functions of vector mesons are predicted to be most prominent. Comparing these low momentum electron pairs to the reference measurement in the elementary p+p reaction, we find in fact a strong modification of the spectral distribution in the whole vector meson region.
The first measurement of e+e− pair production at mid-rapidity (|ηe| < 0.8) in pp collisions at s√=7 TeV with ALICE at the LHC is presented. The dielectron production is studied as a function of the invariant mass (mee < 3.3 GeV/c2), the pair transverse momentum (pT,ee < 8 GeV/c), and the pair transverse impact parameter (DCAee), i.e., the average distance of closest approach of the reconstructed electron and positron tracks to the collision vertex, normalised to its resolution. The results are compared with the expectations from a cocktail of known hadronic sources and are well described when PYTHIA is used to generate the heavy-flavour contributions. In the low-mass region (0.14 < mee < 1.1 GeV/c2), prompt and non-prompt e+e− sources can be separated via the DCAee. In the intermediate-mass region (1.1 < mee < 2.7 GeV/c2), a double-differential fit to the data in mee and pT,ee and a fit of the DCAee distribution allow the total cc¯¯ and bb¯¯¯ cross sections to be extracted. Two different event generators, PYTHIA and POWHEG, can reproduce the shape of the two-dimensional mee and pT,ee spectra, as well as the shape of the DCAee distribution, reasonably well. However, differences in the cc¯¯ and bb¯¯¯ cross sections are observed when using the generators to extrapolate to full phase space. Finally, the ratio of inclusive to decay photons is studied via the measurement of virtual direct photons in the transverse-momentum range 1 < pT < 8 GeV/c. This is found to be unity within the statistical and systematic uncertainties and consistent with expectations from next-to-leading order perturbative quantum chromodynamic calculations.
The production yield of prompt D mesons and their elliptic flow coefficient v2 were measured with the Event-Shape Engineering (ESE) technique applied to mid-central (10–30% and 30–50% centrality classes) Pb-Pb collisions at the centre-of-mass energy per nucleon pair sNN−−−√=5.02 TeV, with the ALICE detector at the LHC. The ESE technique allows the classification of events, belonging to the same centrality, according to the azimuthal anisotropy of soft particle production in the collision. The reported measurements give the opportunity to investigate the dynamics of charm quarks in the Quark-Gluon Plasma and provide information on their participation in the collective expansion of the medium. D mesons were reconstructed via their hadronic decays at mid-rapidity, |η| < 0.8, in the transverse momentum interval 1 < pT < 24 GeV/c. The v2 coefficient is found to be sensitive to the event-shape selection confirming a correlation between the D-meson azimuthal anisotropy and the collective expansion of the bulk matter, while the per-event D-meson yields do not show any significant modification within the current uncertainties.
Medium modification of the shape of small-radius jets in central Pb-Pb collisions at √sNN = 2.76 TeV
(2018)
We present the measurement of a new set of jet shape observables for track-based jets in central Pb-Pb collisions at sNN−−−√=2.76 TeV. The set of jet shapes includes the first radial moment or angularity, g; the momentum dispersion, pTD; and the difference between the leading and sub-leading constituent track transverse momentum, LeSub. These observables provide complementary information on the jet fragmentation and can constrain different aspects of the theoretical description of jet-medium interactions. The jet shapes were measured for a small resolution parameter R = 0.2 and were fully corrected to particle level. The observed jet shape modifications indicate that in-medium fragmentation is harder and more collimated than vacuum fragmentation as obtained by PYTHIA calculations, which were validated with the measurements of the jet shapes in proton-proton collisions at s√=7 TeV. The comparison of the measured distributions to templates for quark and gluon-initiated jets indicates that in-medium fragmentation resembles that of quark jets in vacuum. We further argue that the observed modifications are not consistent with a totally coherent energy loss picture where the jet loses energy as a single colour charge, suggesting that the medium resolves the jet structure at the angular scales probed by our measurements (R = 0.2). Furthermore, we observe that small-R jets can help to isolate purely energy loss effects from other effects that contribute to the modifications of the jet shower in medium such as the correlated background or medium response.
Neutral pion and η meson invariant differential yields were measured in non-single diffractive p–Pb collisions at sNN−−−√ = 5.02 TeV with the ALICE experiment at the CERN LHC. The analysis combines results from three complementary photon measurements, utilizing the PHOS and EMCal calorimeters and the Photon Conversion Method. The invariant differential yields of π0 and η meson inclusive production are measured near mid-rapidity in a broad transverse momentum range of 0.3<pT<20 GeV/c and 0.7<pT<20 GeV/c, respectively. The measured η/π0 ratio increases with pT and saturates for pT > 4 GeV/c at 0.483±0.015stat±0.015sys. A deviation from mT scaling is observed for pT< 2 GeV/c. The measured η/π0 ratio is consistent with previous measurements from proton-nucleus and pp collisions over the full pT range. The measured η/π0 ratio at high pT also agrees within uncertainties with measurements from nucleus–nucleus collisions. The π0 and η yields in p–Pb relative to the scaled pp interpolated reference, RpPb, are presented for 0.3<pT< 20 GeV/c and 0.7<pT< 20 GeV/c, respectively. The results are compared with theoretical model calculations. The values of RpPb are consistent with unity for transverse momenta above 2 GeV/c. These results support the interpretation that the suppressed yield of neutral mesons measured in Pb–Pb collisions at LHC energies is due to parton energy loss in the hot QCD medium.
The ALICE Collaboration has measured the energy dependence of exclusive photoproduction of J/ψ vector mesons off proton targets in ultra–peripheral p–Pb collisions at a centre-of-mass energy per nucleon pair sNN−−−√=5.02 TeV. The e+e− and μ+μ− decay channels are used to measure the cross section as a function of the rapidity of the J/ψ in the range −2.5<y<2.7, corresponding to an energy in the γp centre-of-mass in the interval 40<Wγp<550 GeV. The measurements, which are consistent with a power law dependence of the exclusive J/ψ photoproduction cross section, are compared to previous results from HERA and the LHC and to several theoretical models. They are found to be compatible with previous measurements.
Cerebral radiation necrosis is a common complication of the radiotherapy of brain tumours that can cause significant mortality. Corticosteroids are the standard of care, but their efficacy is limited and the consequences of long-term steroid therapy are problematic, including the risk of adrenal insufficiency (AI). Off-label treatment with the vascular endothelial growth factor A antibody bevacizumab is highly effective in steroid-resistant radiation necrosis. Both the preservation of neural tissue integrity and the cessation of steroid therapy are key goals of bevacizumab treatment. However, the withdrawal of steroids may be impossible in patients who develop AI. In order to elucidate the frequency of AI in patients with cerebral radiation necrosis after treatment with corticosteroids and bevacizumab, we performed a retrospective study at our institution’s brain tumour centre. We obtained data on the tumour histology, age, duration and maximum dose of dexamethasone, radiologic response to bevacizumab, serum cortisol, and the need for hydrocortisone substitution for AI. We identified 17 patients with cerebral radiation necrosis who had received treatment with bevacizumab and had at least one available cortisol analysis. Fifteen patients (88%) had a radiologic response to bevacizumab. Five of the 17 patients (29%) fulfilled criteria for AI and required hormone substitution. Age, duration of dexamethasone treatment, and time since radiation were not statistically associated with the development of AI. In summary, despite the highly effective treatment of cerebral radiation necrosis with bevacizumab, steroids could yet not be discontinued due to the development of AI in roughly one-third of patients. Vigilance to spot the clinical and laboratory signs of AI and appropriate testing and management are, therefore, mandated.
The pT-differential production cross section of prompt Λ +c charmed baryons was measured with the ALICE detector at the Large Hadron Collider (LHC) in pp collisions at s√=7 TeV and in p-Pb collisions at sNN−−−√=5.02 TeV at midrapidity. The Λ +c and Λ¯¯¯¯c¯¯¯ were reconstructed in the hadronic decay modes Λ +c → pK−π+, Λ +c → pK 0S and in the semileptonic channel Λ +c → e+νeΛ (and charge conjugates). The measured values of the Λ +c/D0 ratio, which is sensitive to the c-quark hadronisation mechanism, and in particular to the production of baryons, are presented and are larger than those measured previously in different colliding systems, centre-of-mass energies, rapidity and pT intervals, where the Λ +c production process may differ. The results are compared with the expectations obtained from perturbative Quantum Chromodynamics calculations and Monte Carlo event generators. Neither perturbative QCD calculations nor Monte Carlo models reproduce the data, indicating that the fragmentation of heavy-flavour baryons is not well understood. The first measurement at the LHC of the Λ +c nuclear modification factor, RpPb, is also presented. The RpPb is found to be consistent with unity and with that of D mesons within the uncertainties, and consistent with a theoretical calculation that includes cold nuclear matter effects and a calculation that includes charm quark interactions with a deconfined medium.
Measurement of deuteron spectra and elliptic flow in Pb–Pb collisions at √sNN = 2.76 TeV at the LHC
(2017)
The transverse momentum (pT) spectra and elliptic flow coefficient (v2) of deuterons and anti-deuterons at mid-rapidity (|y|<0.5) are measured with the ALICE detector at the LHC in Pb–Pb collisions at sNN−−−√ = 2.76 TeV. The measurement of the pT spectra of (anti-)deuterons is done up to 8 GeV/c in 0–10% centrality class and up to 6 GeV/c in 10–20% and 20–40% centrality classes. The v2 is measured in the 0.8 < pT < 5 GeV/c interval and in six different centrality intervals (0–5, 5–10, 10–20, 20–30, 30–40 and 40–50%) using the scalar product technique. Measured π ±, K± and p+p¯¯¯ transverse-momentum spectra and v2 are used to predict the deuteron pT spectra and v2 within the Blast-Wave model. The predictions are able to reproduce the v2 coefficient in the measured pT range and the transverse-momentum spectra for pT > 1.8 GeV/c within the experimental uncertainties. The measurement of the coalescence parameter B2 is performed, showing a pT dependence in contrast with the simplest coalescence model, which fails to reproduce also the measured v2 coefficient. In addition, the coalescence parameter B2 and the elliptic flow coefficient in the 20–40% centrality interval are compared with the AMPT model which is able, in its version without string melting, to reproduce the measured v2(pT) and the B2(pT) trend.
The second (v2) and third (v3) flow harmonic coefficients of J/ψ mesons are measured at forward rapidity (2.5 < y < 4.0) in Pb-Pb collisions at sNN−−−√=5.02 TeV with the ALICE detector at the LHC. Results are obtained with the scalar product method and reported as a function of transverse momentum, pT, for various collision centralities. A positive value of J/ψ v3 is observed with 3.7σ significance. The measurements, compared to those of prompt D0 mesons and charged particles at mid-rapidity, indicate an ordering with vn(J/ψ) < vn(D0) < vn(h±) (n = 2, 3) at low and intermediate pT up to 6 GeV/c and a convergence with v2(J/ψ) ≈ v2(D0) ≈ v2(h±) at high pT above 6–8 GeV/c. In semi-central collisions (5–40% and 10–50% centrality intervals) at intermediate pT between 2 and 6 GeV/c, the ratio v3/v2 of J/ψ mesons is found to be significantly lower (4.6σ) with respect to that of charged particles. In addition, the comparison to the prompt D0-meson ratio in the same pT interval suggests an ordering similar to that of the v2 and v3 coefficients. The J/ψ v2 coefficient is further studied using the Event Shape Engineering technique. The obtained results are found to be compatible with the expected variations of the eccentricity of the initial-state geometry.