The white blood cell count to mean platelet volume ratio for ischemic stroke patients after intravenous thrombolysis.

Background and Purpose: White blood cell count to mean platelet volume ratio (WMR) is increasingly recognized as a promising biomarker. However, its predictive capability for acute ischemic stroke (AIS) patients is relatively less researched. The primary aim of this study is to explore its prognostic value in AIS patients after reperfusion regarding 3-month poor functional outcome. Methods: A total of 549 AIS patients who had undergone vascular reperfusion procedure with complete 3-month follow-up were retrospectively recruited in this study. White blood cell count, mean platelet volume at 24 h of admission were recorded. Stroke severity had been estimated using the National Institutes of Health Stroke Scale (NIHSS) and poor outcome was defined as modified Rankin Scale (mRS) 3-6 at 3 months. Results: AIS patients with poor functional outcome at 3 months displayed higher WMR. A positive correlation between WMR and NIHSS score was found (r = 0.334, p < 0.001). After adjusting potential confounders, WMR was still an independent risk factor for poor prognosis at 3 months (OR = 2.257, 95% CI [1.117-4.564], p = 0.023) in multivariate logistic regression model. Subgroup analyses further suggested a significant association between WMR and poor outcome in high baseline NIHSS (per 0.1-point increase: OR = 1.153, 95% CI [1.014-1.312], p = 0.030) group. Receiver operating characteristic (ROC) curves analysis was utilized to assess the predictive ability of WMR, indicating a cut-off value of 0.86. A nomogram that includes age, sex, NIHSS on admission, high WMR for predicting 1-year all-cause survival was also developed (C-index = 0.628). Conclusions: WMR is significantly correlated with stroke severity on admission and is proved to be an important prognostic indicator for AIS outcomes, especially in high NIHSS on admission group. Additionally, the developed nomogram that includes high WMR for predicting 1-year survival provides us with an effective visualization tool.

Modeling the groundwater recharge in karst aquifers by using a reservoir model.

The estimation of the groundwater recharge in a karstic system becomes an important challenge due to the great hydrodynamic variability in both time and space. This paper proposes a two reservoir conceptual model to simulate inflow into both the conduit system and the fissure network system based on the analysis of the spring hydrograph. The structure of the model and the governing equations are proposed on the basis of the physical considerations, with the assumption that flow at the outlet of the reservoirs obeys a linear threshold function. The model is applied on the Houzhai karstic underground river basin where it successfully reflects the temporal recharge distribution. The simulated accumulation recharge is 34.29 mm, which is reasonable in relation to the actual rainfall of 92.8 mm. The variations of water volume in two reservoirs represent the storage and transform characteristics of the karst aquifer system. However, this model is particularly well suited to simulate the recharge event after intensive rainfall.