Objective The study aimed to explore the association between the site of interictal epileptic discharges(IEDs)on postoperative electroencephalogram(EEG)and seizure recurrence after antiepileptic drug(AED)withdrawal.The study hypothesizes that the concordance of IED sites with surgical sites indicates incomplete resection of epileptic focus,while non-concordance of IED sites with surgical sites indicates postoperative changes or cortical stimulation.The former has a higher risk of seizure recurrence.Methods We retrospectively analyzed the postoperative EEG pattern of 182 consecutive children who underwent resection surgery.To identify the risk factors for seizure recurrence,we compared the attributes of seizure recurred and seizure-free groups by univariate and multivariate analyses.AED tapering was standardized,involving a 25% reduction in the dose of a single type of AED every 2 weeks,independent of the presurgical AED load.Results We attempted AED withdrawal in 116(63.7%)children.Twenty-eight(24.1%)children experienced seizure recurrence during or after AED withdrawal.A greater number of AEDs used at the time of surgery(p=0.005),incomplete resection(p=0.001),and presence of IED on postoperative EEG(p=0.011)are predictors of seizurerecurrence.Thecompletenessof resectionand seizure recurrence after AED withdrawal were related to the presence of IED on the EEG,but not to the concordance of IED with surgical sites.Conclusion For children with abnormal EEG,the decision to discontinue AED should be made more cautiously,regardless of the relative location of the discharge site and the surgical site.
The Hubble tension persists as a challenge in cosmology.Even early dark energy(EDE)models,initially considered the most promising for alleviating the Hubble tension,fall short of addressing the issue without exacerbating other tensions,such as the S_(8)tension.Considering that a negative dark matter(DM)equation of state(EoS)parameter is conducive to reduce the value of the σ_(8)parameter,we extend the axion-like EDE model in this paper by replacing the cold dark matter(CDM)with DM characterized by a constant EoS w_(dm)(referred to as WDM hereafter).We then impose constraints on this axion-like EDE extension model,along with three other models:the axion-like EDE model,ΛWDM,and ΛCDM.These constraints are derived from a comprehensive analysis incorporating data from the Planck 2018 cosmic microwave background,baryon acoustic oscillations,and the Pantheon compilation,as well as a prior on H_(0)(i.e.H_(0)=73.04±1.04,based on the latest local measurement by Riess et al)and a Gaussianized prior on S_(8)(i.e.S_(8)=0.766±0.017,determined through the joint analysis of KID1000+BOSS+2dLenS).We find that although the new model maintains the ability to alleviate the Hubble tension to~1.4σ,it still exacerbates the S_(8)tension to a level similar to that of the axion-like EDE model.
