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BACKGROUND: Abnormal levels of glutamate constitute a key pathophysiologic mechanism in epilepsy. The use of glutamate chemical exchange saturation transfer (GluCEST) imaging to measure glutamate levels in pediatric epilepsy is rarely reported in research. PURPOSE: To investigate hippocampal glutamate level variations in pediatric epilepsy and the correlation between glutamate and hippocampal subregional volumes. STUDY TYPE: Cross-sectional, prospective. SUBJECTS: A total of 38 school-aged pediatric epilepsy patients with structurally normal MRI as determined by at least two independent radiologists (60% males; 8.7 ± 2.5 years; including 20 cases of focal pediatric epilepsy [FE] and 18 cases of generalized pediatric epilepsy [GE]) and 17 healthy controls (HC) (41% males; 9.0 ± 2.5 years). FIELD STRENGTH/SEQUENCE: 3.0 T; 3D magnetization prepared rapid gradient echo (MPRAGE) and 2D turbo spin echo GluCEST sequences. ASSESSMENT: The relative concentration of glutamate was calculated through pixel-wise magnetization transfer ratio asymmetry (MTRasym) analysis of the GluCEST data. Hippocampal subfield volumes were computed from MPRAGE data using FreeSurfer. STATISTICAL TESTS: This study used t tests, one-way analysis of variance, Kruskal-Wallis tests, and Pearson correlation analysis. P < 0.05 was considered statistically significant. RESULTS: The MTRasym values of both the left and right hippocampi were significantly elevated in GE (left: 2.51 ± 0.23 [GE] vs. 2.31 ± 0.12 [HCs], right: 2.50 ± 0.22 [GE] vs. 2.27 ± 0.22 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly elevated in FE (2.49 ± 0.28 [ipsilateral] vs. 2.29 ± 0.16 [HCs]). The MTRasym values of the ipsilateral hippocampus were significantly increased compared to the contralateral hippocampus in FE (2.49 ± 0.28 [ipsilateral] vs. 2.35 ± 0.34 [contralateral]). No significant differences in hippocampal volume were found between different groups (left hippocampus, P = 0.87; right hippocampus, P = 0.87). DATA CONCLUSION: GluCEST imaging have potential for the noninvasive measurement of glutamate levels in the brains of children with epilepsy. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 1.
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The oxygen reduction/evolution reaction (ORR/OER) represents a pivotal process in metal-air batteries; however, it is constrained by the limitations of slow kinetics. Nevertheless, the creation of long-lasting and bifunctional catalysts represents a significant challenge. This study presents a series of hierarchical porous carbon-supported cobalt pyrophosphate (Co2P2O7-N/C-T) catalysts, prepared through the pyrolysis of porphyrin-based NTU-70 nanosheets with red phosphorus at varying temperatures. The Co2P2O7-N/C-800 not only demonstrates remarkable OER performance with an overpotential of only 290 mV at a current density of 10 mA cm-2 in 1 M KOH, but also exhibits an excellent ΔE of 0.74 V in 0.1 M KOH, which is lower than that of Pt/C + RuO2 (0.76 V). The utilization of Co2P2O7-N/C-800 as an air cathode in a rechargeable Zn-air battery (ZAB) results in a stable discharge voltage plateau of 1.405 V and a high gravimetric energy density of 801.2 mA h gZn-1. This work presents a promising strategy for the design of efficient bifunctional catalysts and demonstrates the critical importance of the interplay between the active center and the supported hierarchical porous carbon.
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Excessive application of mineral fertilizers has accelerated soil acidification in China, affecting crop production when the pH drops below a critical value. However, the contributions of natural soil acidification, induced by leaching of bicarbonate, and anthropogenic causes of soil acidification, induced by nitrogen (N) transformations and removal of base cations over acid anions, are not well quantified. In this study, we quantified soil acidification rates, in equivalents (eq) of acidity, by assessing the inputs and outputs of all major cations and anions, including calcium, magnesium, potassium, sodium, ammonium, nitrate, bicarbonate, sulphate, phosphate and chloride, for 13 long-term experimental sites in southern China. The acidification rates strongly varied among fertilizer treatments and with the addition of animal manure. Bicarbonate leaching was the dominant acid production process in calcareous soils (23 keq ha-1 yr-1) and in non-calcareous paddy soils (9.6 keq ha-1 yr-1), accounting for 80 % and 68 % of the total acid production rate, respectively. The calcareous soils were strongly buffered, and acidification led no or a limited decline in pH. In contrast, N transformations were the most important driver for soil acidification at one site with upland crops on a non-calcareous soil, accounting for 72 % of total acid production rate of 8.4 keq ha-1 yr-1. In this soil, the soil pH considerably decreased being accompanied by a substantial decline in exchangeable base cation. Reducing the N surplus decreased the acidification rate with 10 to 54 eq per kg N surplus with the lowest value occurring in paddy soils and the highest in the upland soil. The use of manure, containing base cations, partly mitigated the acidifying impact of N fertilizer inputs and crop removal, but enhanced phosphorus (P) accumulation. Combining mineral fertilizer, manure and lime in integrative management strategies can mitigate soil acidification and minimize N and P losses.
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OBJECTIVE: To establish and validate a clinical prediction model of acupuncture and moxibustion for Bell's palsy so as to provide a tool for predicting the effect of acupuncture and moxibustion on Bell's palsy. METHODS: A total of 269 patients with Bell's palsy were collected from department of acupuncture, moxibustion and tuina, Shengli Oilfield Central Hospital, neurology department, Shenxian County Central Hospital and department of rehabilitation medicine, Dongying Municipal Hospital of TCM from June 2018 to June 2023. All of these cases were treated with acupuncture and moxibustion. Of them, 182 cases, from department of acupuncture, moxibustion and tuina, Shengli Oilfield Central Hospital and neurology department, Shenxian County Central Hospital, were randomized into a training group (128 cases) and an internal validation group (54 cases); 87 cases from department of rehabilitation medicine, Dongying Municipal Hospital of TCM were assigned to an external validation group. The clinical data of all of the cases were extracted from the electronic medical record information platform. Using SPSS25.0 and R4.2.3, through univariate and multivariate Logistic regression analysis, the independent factors influencing the effects of acupuncture and moxibustion on Bell's palsy were identified. By means of internal and external validations, the receiver operating characteristic curve (ROC), the goodness-of-fit curve (GFC) and the decision curve analysis (DCA) were plotted. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the model were calculated; and its comprehensive performance was evaluated. RESULTS: The results of the multivariate Logistic regression analysis showed that the independent factors for the unsatisfactory effect on Bell's palsy were advanced age, severe symptoms before treatment, no use of steroids within 72 h of onset, and lack of acupuncture-moxibustion therapy during the acute phase or single acupuncture-moxibustion protocol (P<0.05, P<0.01). Based on these factors, nomogram model and online columnar plot prediction tool (https://bmuchen.shinyapps.io/dynnomapp/) were established. The area under the ROC curve of the model was 0.921 (95% CI: 0.877, 0.966), 0.876 (95% CI: 0.787, 0.966), and 0.846 (95% CI: 0.766, 0.926) in the training group, the internal validation group, and the external validation group, respectively, indicating good predictive value. The model showed a satisfactory calibration curve alignment. The decision threshold in the range of 0 to 0.8 provided clinical benefits for participants. The model exhibited the sensitivity from 65.9% to 88.0%, the specificity ranging from 77.3% to 90.7%, the accuracy from 77.8% to 85.9%, the positive predictive value from 83.3% to 90.1%, and the negative predictive value from 70.8% to 78.7%. The comprehensive evaluation indicated a satisfactory clinical application value of the model. CONCLUSION: The clinical prediction model of acupuncture and moxibustion for Bell's palsy is valuable in its practice and promotion to a certain extent. The predicted results are conductive to clinicians' judgement of the effect of acupuncture and moxibustion for this disease and making effective and high-quality clinical decisions, as well as formulating the optimal therapeutic regimen.
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Terapia por Acupuntura , Parálisis de Bell , Moxibustión , Humanos , Masculino , Femenino , Parálisis de Bell/terapia , Persona de Mediana Edad , Adulto , Adulto Joven , Anciano , Adolescente , Resultado del Tratamiento , Curva ROCRESUMEN
Elevated nitrogen (N) fertilization has largely increased crop production in China, but also increased acidification risks, thereby threatening crop yields. However, natural soil acidification due to bicarbonate (HCO3) leaching and base cation (BC) removal by crop harvest also affect soil acidity whereas the input of HCO3 and BC via fertilizers and manure counteract soil acidification. Insights in rates and drivers of soil acidification in different land use types is too limited to support crop- and site-specific mitigation strategies. In this study, we assessed the historical changes in cropland acidification rates and their drivers for the period 1985-2019 at 151 sites in a typical Chinese county with the combined nutrient and soil acidification model VSD+. VSD+ could well reproduce long-term changes in pH and in the BC concentrations of calcium, magnesium and potassium between 1985 and 2019 in non-calcareous soils. In paddy soils, the acidity production rate decreased from 1985 onwards, mainly driven by a pH-induced reduction in HCO3 leaching and N transformations. In upland soils, however, acidity production was mainly driven by N transformations and hardly changed over time. Crop BC removal by harvesting played a minor role in both paddy and upland soils, but its relative importance increased in paddy soils. The acidity input was partly neutralized by HCO3 input from fertilizers and manure, which decreased over time due to a change from ammonia bicarbonate to urea. Soil buffering by both BC and aluminium release decreased in paddy soils due to a reduction in net acidity production, while it stayed relatively constant in upland soils. We conclude that acidification management in paddy soils requires a focus on avoiding high HCO3 leaching whereas the management in upland soils should focus on balancing N with recycling organic manure and crop residues.
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PURPOSE: To develop a non-invasive auxiliary assessment method based on CT-derived extracellular volume (ECV) to predict the pathological grading (PG) of hepatocellular carcinoma (HCC). METHODS: The study retrospectively analyzed 238 patients who underwent HCC resection surgery between January 2013 and April 2023. Six machine learning algorithms were employed to construct predictive models for HCC PG: logistic regression, extreme gradient boosting, Light Gradient Boosting Machine (LightGBM), random forest, adaptive boosting, and Gaussian naive Bayes. Model performance was evaluated using receiver operating characteristic curve analysis, including area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F1 score. Calibration plots were used for visual evaluation of model calibration. Clinical decision curve analysis was performed to assess potential clinical utility by calculating net benefit. RESULTS: 166 patients from Hospital A were allocated to the training set, while 72 patients from Hospital B (constituting 30.25% of the total sample) were assigned to the test set. The model achieved an AUC of 1.000 (95%CI: 1.000-1.000) in the training set and 0.927 (95%CI: 0.837-0.999) in the validation set, respectively. Ultimately, the model achieved an AUC of 0.909 (95%CI: 0.837-0.980) in the test set, with an accuracy of 0.778, sensitivity of 0.906, specificity of 0.789, negative predictive value of 0.556, and F1 score of 0.908. CONCLUSION: This study successfully developed and validated a non-invasive auxiliary assessment method based on CT-derived ECV to predict the HCC PG, providing important supplementary information for clinical decision-making.