Enhancing soil health and nutrient cycling through soil amendments: Improving the synergy of bacteria and fungi

The synergy between bacteria and fungi is a key determinant of soil health and have a positive effect on plant development under drought conditions, with the potentially enhancing the sustainability of amending soil with natural materials. However, identifying how soil amendments influence plant growth is often difficult due to the complexity of microorganisms and their links with different soil amendment types and environmental factors. To address this, we conducted a field experiment to examine the impact of soil amendments (biochar, Bacillus mucilaginosus, Bacillus subtilis and super absorbent polymer) on plant growth. We also assessed variations in microbial community, links between fungi and bacteria, and soil available nutrients, while exploring how the synergistic effects between fungus and bacteria influenced the response of soil amendments to plant growth. This study revealed that soil amendments reduced soil bacterial diversity but increased the proportion of the family Enterobacteriaceae, Nitrosomonadaceae, and also increased soil fungal diversity and the proportion of the sum of the family Lasiosphaeriaceae, Chaetomiaceae, Pleosporaceae. Changes in soil microbial communities lead to increase the complexity of microbial co-occurrence networks. Furthermore, this heightened network complexity enhanced the synergy of soil bacteria and fungi, supporting bacterial functions related to soil nutrient cycling, such as metabolic functions and genetic, environmental, and cellular processes. Hence, the BC and BS had 3.0-fold and 0.5-fold greater root length densities than CK and apple tree shoot growth were increased by 62.14 %,50.53 % relative to CK, respectively. In sum, our results suggest that the synergistic effect of bacteria and fungi impacted apple tree growth indirectly by modulating soil nutrient cycling. These findings offer a new strategy for enhancing the quality of arable land in arid and semi-arid regions.

Carbon reduction and water saving potentials for growing corrugated boxes for express delivery services in China

Corrugated packaging for express grew by 90 times to 16.5 Mt y-1 in China, where 81% of recent global express delivery growth occurred. However, the environmental impacts of production, usage, disposal, and recycling of corrugated boxes under the entire supply chain remain unclear. Here, we estimate the magnitudes, drivers, and mitigation potentials of cradle-to-grave life-cycle carbon footprint (CF) and three colors of water footprints (WFs) for corrugated cardboard packaging in China. Over 2007 to 2021, CF, blue and gray WFs per unit package decreased by 45%, 60%, and 84%, respectively, while green WF increased by 23% with growing imports of virgin pulp and China's waste ban. National total CF and WFs were 21 to 102 folded with the scale effects. Only a combination of the supply chain reconstruction, lighter single-piece packaging, and increased recycling rate can possibly reduce the environmental footprints by 24 to 44% by 2035.

Effect of quercetin on granulosa cells development from hierarchical follicles in chicken

1. The bioflavonoid quercetin is a biologically active component, but its functional regulation of granulosa cells (GCs) during chicken follicular development is little studied. To investigate the effect of quercetin on follicular development in laying hens, an in vitro study was conducted on granulosa cells from hierarchical follicles treated with quercetin.2. The effect of quercetin on cell activity, proliferation and apoptosis of granulosa cells was detected by CCK-8, EdU and apoptosis assays. The effect on progesterone secretion from granulosa cells was investigated by enzyme-linked immunosorbent assay (ELISA). Expression of proliferating cell nuclear antigen (PCNA) mRNA and oestrogen receptors (ERs), as well as the expression of steroid acute regulatory protein (StAR), cytochrome P450 cholesterol side chain cleavage enzyme (P450scc) and 3β-hydroxysteroid dehydrogenase (3β-HSD) mRNA during progesterone synthesis, were measured by real-time quantitative polymerase chain reaction (RT-qPCR). PCNA, StAR and CYP11A1 protein expression levels were detected using Western blotting (WB).3. The results showed that treatment with quercetin in granulosa cells significantly enhanced cell vitality and proliferation, reduced apoptosis and promoted the expression of gene and protein levels of PCNA. The levels of progesterone secretion increased significantly following quercetin treatment, as did the expression levels of StAR and CYP11A1 using the Western Blot (WB) method.4. The mRNA expression levels of ERα were significantly upregulated in the 100 ng/ml and 1000 ng/ml quercetin-treated groups, while there was no significant difference in expression levels of ERβ mRNA.

Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

[Risks to predict blood loss and cranial nerve injury in carotid body paraganglioma resection]

Objective: To investigate clinical and imaging parameters to predict blood loss and cranial nerve injury (CNI) following carotid body paraganglioma (CBP) resection. Methods: A retrospective examination of clinical and imaging data was conducted on 63 patients who underwent CBP resection at Xiangya Hospital of Central South University from January 2016 to December 2022, including 23 males and 40 females, aged 26-87 years old. Three imaging parameters including tumor volume, the angle of contact with the internal carotid artery (ICA), and the distance to the base of skull (DTBOS) were gauged using the IMEDPACS software on CTA and MR imaging. The predictive efficacies of age, gender, Shamblin classification, and three imaging parameters for blood loss and CNI following surgery were analysed. Logistic composite parameter models were constructed and their predictive validity was assessed. Results: Multivariate logistic regression analysis underscored that only tumor volume (OR=1.381,95%CI:1.167-1.507,P=0.001) showed significant statistical correlations with blood loss following surgery. Area under curve (AUC) values of 0.910 for receiver operating characteristic (ROC) curves showed a sensitivity of 1.000 and a specificity of 0.694. Tumor volume (OR=1.126,95%CI:1.030-1.231, P=0.002) and DTBOS (OR=0.225,95%CI:0.081-0.630,P=0.005) were significantly associated with postoperative CNI. The analysis of logistic composite model showed AUC values for tumor volume, DTBOS and combination of the two parameters were 0.858, 0.788, and 0.872, respectively. The model for combination of tumor volume and DTBOS also proved superior in predicting postoperative CNI (Z=3.106, P<0.001), with a sensitivity of 0.833 and a specificity of 0.769. Conclusions: Tumor volume and DTBOS emerged as effective predictors for blood loss and/or CNI in patients with CBP resection. Moreover, the logistic composite parameter model outclassed single-parameter models in terms of their predictive clinical value.

Feature pyramid network-based computer-aided detection and monitoring treatment response of brain metastases on contrast-enhanced MRI

AIM

To investigate the value of feature pyramid network (FPN)-based computer-aided detection (CAD) of brain metastases (BMs) before and after non-surgical treatment, and to evaluate its performance in monitoring treatment response of BM on contrast-enhanced (CE) magnetic resonance imaging (MRI).

MATERIAL AND METHODS

Eighty-five cancer patients newly diagnosed with BM who had undergone initial and follow-up three-dimensional (3D) CE MRI at Liaocheng People's Hospital were included retrospectively in this study. Manual detection (MD) was performed by reviewer 1. Computer-aided detection (CAD) was performed by reviewer 2 using uAI Discover-BMs software. The treatment response was assessed by the two reviewers for each patient separately. A paired chi-square test was used to compare the differences in the detection of BM between MD and CAD. Agreement between MD and CAD in monitoring treatment response was assessed by kappa test.

RESULTS

The sensitivities of MD and CAD on initial 3D CE MRI were 78.65% and 99.13%, respectively. The sensitivities of MD and CAD on follow-up 3D CE MRI were 76.32% and 98.24%, respectively. There was a very good agreement between Reviewer 1 and Reviewer 2 in evaluating the treatment response of BM.

CONCLUSION

FPN-based CAD has a higher sensitivity of close to 100% and lower false negatives (FNs) for BM detection, compared to MD. Although CAD had a few shortcomings in reflecting changes of BMs after treatment, it had high performance in monitoring treatment response of BM on CE MRI.

Predictive value of total ischaemic time and T1 mapping after emergency percutaneous coronary intervention in acute ST-segment elevation myocardial infarction

AIM

To investigate the predictive value of ischaemic time and cardiac magnetic resonance imaging (CMRI) T1 mapping in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

MATERIALS AND METHODS

A total of 127 patients with STEMI treated by primary PCI were studied. All patients underwent CMRI with native T1 and extracellular volume (ECV) measurement, 61 of whom also had 4-month follow-up data. The total ischaemic (symptom onset to balloon, S2B) time expressed in minutes was recorded. CMRI cine, T1 mapping, and late gadolinium enhancement (LGE) images were analysed to evaluate left ventricular (LV) function, T1 value, ECV, and myocardial infract (MI) scar characteristics, respectively. The correlation between S2B time and T1 mapping was evaluated. The predictive values of S2B time and T1 mapping for large final infarct size were estimated.

RESULTS

The incidence of microvascular obstruction (MVO) increased with the prolongation of ischaemia time. Regardless of MVO or not, ECV in myocardial infarction (ECVMI) was significantly correlated with S2B time (r=0.61, p<0.001), while native T1 in MI (T1MI) was not (r=-0.19, p=0.029). In the 4-month follow-up, native T1MI was improved (1385.1 ± 90.4 versus 1288.6 ± 74 ms, p<0.001). Furthermore, ECVMI was independently associated with final larger infarct size (AUC = 0.89, 95% confidence interval [CI] = 0.81-0.98, p<0.001) in multivariable regression analysis.

CONCLUSION

ECVMI was correlated with total ischaemic time and was an independent predictor of final larger infarct size.

Tracking indirect water footprints, virtual water flows, and burden shifts related to inputs and supply chains for croplands: A case for maize in China

Increasing crop yields to ensure an adequate food supply under water and land scarcity is dependent on intensive agricultural inputs (such as fertilizers, pesticides, agri-films, or energy) which consume water resources and generate water pollution. However, the burden shifting of water quantity and quality stress from producers to importer and consumers through agricultural input production, trade, and consumption have been largely overlooked. Here, taking maize in China as the study case, we mapped step-by-step indirect water footprint (IWF) of maize production, virtual water (VW) flows related to inputs driven by maize consumption, and the resulting burden shifting of water quantity and quality. Bottom-up WF accounting approach was applied. The maize consumption was intercepted into two stages: the crop production stage (CPS) from raw materials to the farm, and the crop trade stage (CTS) from farm to fork. Results show that the national average blue and grey IWF of maize production was 3.91 and 26.86 m³/t, respectively. In the CPS, the input-related VW flowed from the west and east coast to the north. In the CTS, the VW flows from the north to the south. Blue and grey VW flows in CTS caused by secondary flows of VW in CPS accounted for 48% and 18% of the total flows, respectively. In total VW flows along the maize supply chain, 63% of blue VW and 71% of grey VW net exports occurred in the north of severe water scarcity and water pollution levels. The analysis highlights the impact of the crop supply chain on water quantity and water quality in the consumption of agricultural inputs, the importance of step-by-step supply chain analysis for regional crop water conservation management, and the urgent need for integrated management of agricultural and industrial water resources.

"Water-Carbon" redistribution caused by China's interprovincial grain transportation

Water resource and carbon emission involved in grain production in mainland China are redistributed among provinces as the grain was transported in recent years. This study first calculated the water consumption and carbon emission during the growth of grain crops based on the water-carbon footprint theory, and then used the social-equity method to calculate the inter-regional grain virtual water and virtual carbon flow. Finally, the regional and national trends in water saving and carbon emission reduction were calculated based on the spatial and temporal differences in grain planting among provinces. In terms of virtual water-carbon, from 2000 to 2017, the amount of the inter-provincial grain virtual water flow increased from 717.4 × 10⁸ m³ to 1472.6 × 10⁸ m³. Heilongjiang and Guangdong are the provinces with the largest amount of grain virtual water outflow (670.9 × 10⁸ m³) and inflow (402.8 × 10⁸ m³) in 2017, respectively. And the total inter-provincial grain virtual carbon flow increased from 2362.7 × 10⁴ t CO₂e to 12,680.6 × 10⁴ t CO₂e. Grain transport leads to water saving and carbon emission reduction, the amount of water saving increased from 25.6 × 10⁸ m³ to 77.0 × 10⁸ m³ and the carbon emission reduction increased from 2.4 × 10⁴ t CO₂e to 847.4 × 10⁴ t CO₂e from 2000 to 2017. Based on research results and from the perspective of socio-hydrology combined with water saving and carbon emission reduction, the regions could optimize the integration of water saving, carbon emission reduction, and sustainable development based on coordinating the grain planting structure according to their own climatic condition, soil and water resource condition, and socioeconomic condition.

Reduction of pathogenic bacteria from irrigation water through a copper-loaded porous ceramic emitter

The increasing pathogenic bacteria threat in irrigation water has become a worldwide concern, prompting efforts to discover a new cost-effective method for pathogenic bacteria eradication, different than those currently in use. In this study, a novel copper-loaded porous ceramic emitter (CPCE) was developed via molded sintering method to kill bacteria from irrigation water. The material performance and hydraulic properties of CPCE are discussed herein, and the antibacterial effect against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) was evaluated. The incremental copper content in CPCE improved flexural strength and pore size, which was conducive to enhancing CPCE discharge. Moreover, antibacterial tests showed that CPCE displayed efficient antimicrobial activity, killing 99.99% and more than 70% of S. aureus and E. coli, respectively. The results reveal that CPCE, with both irrigation and sterilization functions, can provide a low-cost and effective solution for bacterial removal from irrigation water.

Impact of sarcopenia and low muscle attenuation on outcomes of ovarian cancer: a systematic review and meta-analysis

OBJECTIVE

The aim of this study was to examine the association of sarcopenia and low muscle attenuation with survival and other clinical outcomes in patients with ovarian cancer.

MATERIALS AND METHODS

Systematic search was done in PubMed, EMBASE and Scopus databases for observational studies that documented the link between sarcopenia and outcomes of interest in patients with ovarian cancer, with long-term survival as a primary outcome. Other outcomes included risk of recurrence, progression-free survival and complications. Pooled effect sizes were reported as hazards ratio (HR), relative risk ratio (RR) or weighted mean difference (WMD). Random effects model was used for the analysis.

RESULTS

Twenty-two studies were selected, of which all, except one, were retrospective in design. Low skeletal muscle index (SMI, indicating muscle mass) (HR 1.30, 95% CI: 1.07, 1.58) and low muscle quality (HR 1.24, 95% CI: 1.03, 1.49) were associated with poor long-term survival, but not with the risk of recurrence and progression-free survival. Both low skeletal muscle index (SMI) (RR 1.49, 95% CI: 1.13, 1.98) and low muscle quality (RR 1.99, 95% CI: 1.04, 3.79) were associated with increased risk of complications.

CONCLUSIONS

Both low skeletal muscle mass and low muscle quality showed significant association with poor long-term survival and an increased risk of complications. However, they do not have a significant association with the risk of recurrence and progression-free survival. There is a need for more prospective studies to confirm these associations.

Three-dimensional quantification of fibrosis and ossification after cochlear implantation via virtual re-sectioning: Potential implications for residual hearing

Hearing preservation may be achieved initially in the majority of patients after cochlear implantation, however, a significant proportion of these patients experience delayed hearing loss months or years later. A prior histological report in a case of delayed hearing loss suggested a potential cochlear mechanical origin of this hearing loss due to tissue fibrosis, and older case series highlight the frequent findings of post-implantation fibrosis and neoosteogenesis though without a focus on the impact on residual hearing. Here we present the largest series (N = 20) of 3-dimensionally reconstructed cochleae based on digitally scanned histologic sections from patients who were implanted during their lifetime. All patients were implanted with multichannel electrodes via a cochleostomy or an extended round window insertion. A quantified analysis of intracochlear tissue formation was carried out via virtual re-sectioning orthogonal to the cochlear spiral. Intracochlear tissue formation was present in every case. On average 33% (SD 14%) of the total cochlear volume was occupied by new tissue formation, consisting of 26% (SD 12%) fibrous and 7% (SD 6%) bony tissue. The round window was completely covered by fibro-osseous tissue in 85% of cases and was associated with an obstruction of the cochlear aqueduct in 100%. The basal part of the basilar membrane was at least partially abutted by the electrode or new tissue formation in every case, while the apical region, corresponding with a characteristic frequency of < 500 Hz, appeared normal in 89%. This quantitative analysis shows that after cochlear implantation via extended round window or cochleostomy, intracochlear fibrosis and neoossification are present in all cases at anatomical locations that could impact normal inner ear mechanics.

Spatiotemporal exploration of ecosystem service, urbanization, and their interactive coercing relationship in the Yellow River Basin over the past 40 years

Understanding how ecosystem services (ESs) interact with urbanization is crucial for formulating sustainable development policies. Although previous literature has paid attention to this topic, information on complex spatiotemporal interactions between ESs and urbanization remains inadequate, especially in the Yellow River Basin (YRB), a typical basin that will usher in rapid progress of ecological protection and urbanization. In this study, we constructed a framework for evaluating ecosystem service values (ESV) and urbanization by synthesizing multi-source data in the YRB from 1980 to 2018, and further revealing the interactive coercing mechanisms of ESV and urbanization. We found that the YRB has experienced rapid urbanization, with an increasing growth trend for all urbanization indicators, especially from 2000 onwards. ESV had a significant negative correlation with urbanization, showing a decreasing trend with urbanization growth before 2000, but reversed this trend after 2000 as ecological restoration projects offset the adverse effects of urbanization on ESV. Furthermore, while significant negative spatial correlations occurred between ESV and urbanization, these correlations diminished over time. The results also revealed differences in the spatial correlations between global and local scales, with three types of spatial correlations at the local scale: High-Low (high ESV and low urbanization), Low-High (low ESV and high urbanization), and Low-Low (low ESV and low urbanization). Our results contribute to understanding the interactive coercing relationship between ESV and urbanization in the YRB, particularly at the local scale, and insights into coordinating future ecological protection and urban development.

Effects of Different Land Use Patterns on Soil Water in Loess Hilly and Gully Regions of China

Soil water is a major barrier to ecological restoration and sustainable land use in China’s Loess Hilly Region. For the restoration of local vegetation and the optimal use of the region’s land resources, both theoretically and practically, it is essential to comprehend the soil water regimes under various land use types. The soil water content in the 0−160 cm soil profile of slope cropland, terraced field, jujube orchard, and grassland was continuously measured using EC-5 soil moisture sensors during the growing season (May−October) in the Yuanzegou catchment in the Loess Hilly Region to characterize the changes in soil water in these four typical land use types. The results showed that in both years of normal precipitation and drought, land use patterns varied in seasonal variability, water storage characteristics, and vertical distribution of soil water. In the dry year of 2015, the terraced field effectively held water. During the growing season, the 0−60 cm soil layer’s average soil water content was 2.6%, 4.2%, and 1.8% higher than the slope cropland, jujube orchard, and grassland, respectively (p < 0.05), and the 0−160 cm soil layer’s water storage was 43.90, 32.08, and 18.69 mm higher than the slope cropland, jujube orchard, and grassland, respectively. The average soil water content of the 0−60 cm soil layer in the jujube orchard was 2.9%, 3.8%, and 4.5% lower than that of slope cropland, terraced field, and grassland, respectively, during the normal precipitation year (2014) (p < 0.05). Only 35.0% of the total soil water storage was effectively stored in the 0−160 cm soil layer of the jujube orchard during the drought year. There was a significant difference in the grey relational grade between the soil water in the top layer (0−20 cm) and the soil water in the middle layer (20−100 cm) under different land use types, with the terraced field having the highest similarity degree of soil water variation trend, followed by grassland, slope cropland, and jujube orchard. Slope croplands in the study region may be converted into terraced fields to enhance the effective use of rainfall resources and encourage the expansion of ecological agriculture. Proper water management practices must be employed to reduce jujube tree water consumption and other wasteful water usage in order to guarantee the jujube orchard’s ability to expand sustainably. This would address the issue of the acute water deficit in the rain-fed jujube orchards in the Loess Hilly Region.

[Impact of different obesity patterns on coronary microvascular function in male patients with non-obstructive coronary artery disease]

Objective: This study sought to investigate the impact of different obesity patterns on coronary microvascular function in male patients with non-obstructive coronary artery disease. Methods: We retrospectively analyzed clinical data of male patients diagnosed with suspected coronary microvascular dysfunction (CMD) in the First Hospital of Shanxi Medical University between December 2015 and August 2021. All patients underwent the one-day rest and stress ¹³N-ammonia positron emission tomography myocardial perfusion imaging. Overall obesity was defined by body mass index (BMI) ≥28 kg/m² and abdominal obesity was defined by waist circumference ≥90 cm. Hyperemic myocardial blood flow (MBF)<2.3 ml·min^-1·g^-1 or coronary flow reserve (CFR)<2.5 were referred as CMD. All patients were grouped based on their BMI and waist circumference. MBF, CFR, the incidence of CMD, hemodynamic parameters, and cardiac function were compared among the groups. Results: A total of 136 patients were included. According to BMI and waist circumference, patients were categorized into 3 groups: control group (n=45), simple abdominal obesity group (n=53) and compound obesity group (n=38). Resting MBF did not differ between groups (F=0.02,P=0.994). Compared with the control group, hyperemic MBF was significantly lower in the simple abdominal obesity and compound obesity groups ((2.82±0.64) ml·min^-1·g^-1, (2.44±0.85) ml·min^-1·g^-1 and (2.49±0.71) ml·min^-1·g^-1, both P<0.05, respectively). Hyperemic MBF was comparable among the groups of patients with obesity (P=0.772). CFR was significantly lower in the simle abdominal obesity group compared with the control group (2.87±0.99 vs. 3.32±0.62,P=0.012). Compared with the control group, CFR tended to be lower in the compound obesity group (3.02±0.91 vs. 3.32±0.62,P=0.117). The incidence of CMD was significantly higher in both the simple abdominal obesity and compound obesity groups than in the control group (62.3%, 52.6% vs. 22.2%, both P<0.01, respectively). Waist circumference was an independent risk factor for male CMD (OR=1.057, 95%CI: 1.013-1.103, P=0.011). Conclusions: In male patients with non-obstructive coronary artery disease, abdominal obesity is associated with decreased coronary microvascular function. Male patients with simple abdominal obesity face the highest risk of CMD.

A new small-scale system of rainwater harvesting combined with irrigation for afforestation in mine area: Optimizing design and application

Afforestation plays a crucial role in the remission of water and soil erosion, adsorption of heavy metals, and protection of soil microbial community structure for mining areas. However, soil drought, the variability of precipitation, and low rainwater use efficiency severely limit the early survival rate of trees. A new small-scale system of rainwater harvesting combined with irrigation (RWHI) for afforestation in mining areas was established, which consisted of a rainwater catching board, storage tanks, and ceramic emitters. A daily water balance model under variable water supply was presented and experimentally verified to confirm the optimum catchment area, the storage capacity of tanks, and the rated discharge of ceramic emitters. Taking the Wuda mining area in Wuhai, China, as a case study, three representative years, including dry, normal, and wet years were selected by analysing local rainfall features. The results showed that the soil water content in the root zone maintained a suitable range (between field capacity and wilting coefficient) using the RWHI system. With the aim of the maximum system operating reliability for various weather conditions and tree species, it was recommended that the rated discharge of the ceramic emitter of 6 ml h^-1, storage tanks of 25 L, the catchment area of 1 m², and filling water schedule of twice a year were employed. A generalised equation for the estimation of the filling water amount was given. The vegetation coverage of the mine was significantly improved, and the survival rate of trees (Murraya paniculate) exceeded 90% using the RWHI system. It was indicated that the RWHI system has a broad application prospect in the afforestation of the mining areas.

Limited water scarcity mitigation by expanded interbasin physical and virtual water diversions with uneven economic value added in China

Interbasin water diversion projects and virtual water transfers embedded in exchanged goods and services are two effective solutions to water deficits. However, the associated real responses in water quantity and quality scarcities and the economic efficiencies remain unclear. Here, we tracked the blue water scarcities, water pollution levels, and economic value added through interbasin physical and virtual water diversions across nine river basins by sector in China from 2007 to 2015. The total national blue and grey water footprints were 365 Gm³yr^-1 and 592 Gm³ yr^-1, in which the Yangtze River basin accounts the most for 32 % and 37 %, respectively, by 2015. The physical water diversions increased by 52 % to 16.9 Gm³yr^-1. The blue virtual water transfers increased by 24 % to 176 Gm³yr^-1, whereas the grey virtual water transfers decreased by 10 % to 266 Gm³yr^-1. Agriculture related interbasin virtual water flows showed opposite directions to those driven by the industry sector. Although with uneven value added while growing, limited effects mitigated water quantity and quality stresses, especially in the drier Yellow, Northwest, and Hai River basins where the capital is located. Half of the basins had low and declining synergy scores, suggesting an urgent need to achieve synergies between resources, the environment, and the economy across basins.

Effects of Living Mulch and Branches Mulching on Soil Moisture, Temperature and Growth of Rain-Fed Jujube Trees

The influence of different mulching measures on soil moisture, soil temperature, and crop growth was investigated during the jujube growing season in rain-fed jujube orchards using micro-plot experiments. The mulching treatments included clean tillage (CT, control treatment), jujube branches mulching (JBM), and white clover planting (WCP). The results revealed that: (1) The average soil moisture content of JBM was greater than that of CT by 3.76% and 2.34%, respectively, during the 2013 and 2014 jujube growth periods, and its soil water deficit was minimal in each soil layer from 0 to 70 cm. WCP had the greatest soil water deficit. The average soil moisture content of the 0−70 cm soil layer in WCP was 3.88% and 5.55% lower than that in CT during the 2013 and 2014 jujube growth seasons, respectively (p < 0.05). (2) JBM had the highest annual average soil moisture content in each soil layer from 0 to 70 cm, followed by CT, while WCP had the lowest. White clover and jujube competed for water in the 20−40 cm soil layer, and JBM had the lowest variation in soil moisture. (3) Mulching with jujube branches and planting white clover could both control the temperature of the 0−25 cm soil layer and narrow the daily temperature range, with JBM being the least affected by air temperature. (4) Jujube’s leaf area index and stem diameter increase in JBM were both significantly greater than in CT and WCP. In conclusion, using pruned jujube branches as surface mulch is appropriate for rain-fed jujube orchards because it can preserve soil moisture, regulate soil temperature, and promote jujube growth.

[Mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 regimen in the treatment of pediatric Burkitt lymphoma]

Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.

[A brief discussion on precision nutrition support for severe burn patients from theory to practice]

Severe burns can lead to sustained hypermetabolism in the body, resulting in delayed wound healing, and malnutrition, dysfunction, and even death of patients. It is critical to carry out adequate nutritional risk assessment and provide individualized nutritional support to improve the prognosis of patients with severe burns. This paper describes and summarizes precision nutrition support for severe burn patients from theory to clinical practice.

The feasibility of amide proton transfer imaging at 3 T for bladder cancer: a preliminary study

AIM

To investigate the optimal amide proton transfer (APT) imaging parameters for bladder cancer (BCa), the influence of different protein concentrations and pH values on APT imaging, and to establish the reliability of APT imaging in healthy volunteers and patients with BCa.

MATERIALS AND METHODS

The optimal APT imaging parameters for BCa were experimentally optimised using cross-linked bovine serum albumin (BSA) phantoms. BSA phantoms were scanned with different values for the saturation power, saturation duration and number of excitations. Meanwhile, BSA phantoms containing different protein concentrations and solutions of different pH levels were scanned. The interobserver agreement of the asymmetric magnetisation transfer ratio (MTR_asym) was assessed in 11 healthy volunteers and 18 patients with BCa.

RESULTS

The optimal scanning scheme consisted of 1 excitation, a saturation power of 2 μT, and a saturation time of 2 s. The APT signal intensity increased as the protein concentration increased and as the pH decreased. The MTR_asym showed good concordance for all subjects. The MTR_asym of BCa tissue was significantly higher (1.81 ± 0.71) than that of bladder wall in healthy volunteers (0.34 ± 0.12) and normal bladder wall in patients with BCa (0.31 ± 0.11; p<0.001). There was no significant difference between the bladder wall of healthy volunteers and the normal bladder wall of patients with BCa.

CONCLUSION

APT imaging showed potential value for application in BCa.

Inputs for staple crop production in China drive burden shifting of water and carbon footprints transgressing part of provincial planetary boundaries

Crop production is the biggest water user and key contributor to anthropogenic greenhouse gas emissions. Increasing crop yields to ensure adequate food supply under water and land scarcity is excessively dependents on intensive agricultural inputs (such as fertilizers, pesticides, agri-films, or energy), resulting in unintended environmental consequences. Supply chains bringing environmental-intensive inputs from their place of production to the croplands. However, most food-related environmental assessments ignore the environmental burden of agricultural input production, trade, and consumption. Here, we estimate spatially-detailed water (WF) and carbon footprints (CF) of wheat, maize, and rice production in China with extended system boundary from upstream raw material mining to the field. The agricultural inputs account for up to 24% and 89% of a crop's WF and CF, respectively, at the provincial level. The total local generated WF in Chinese northern provinces and CF in Shanxi and Inner Mongolia provinces for producing crops and agricultural inputs transgresses the corresponding downscaled blue water and carbon planetary boundaries. The study broadens the scope of traditional environmental impact assessments in agricultural production and sheds light on the significances to manage the linkages between the crop production and the agricultural inputs' upstream supply chains towards more efficient water use and less greenhouse gas emissions in food system.

Land use affects the response of soil moisture and soil temperature to environmental factors in the loess hilly region of China

Changes in soil moisture and soil temperature result from the combined effects of several environmental factors. Scientific determination of the response characteristics of soil moisture and soil temperature to environmental factors is critical for adjusting the sloping land use structure and improving the ecological environment in China's loess hilly region. Soybean sloping fields, maize terraced fields, jujube orchards, and grasslands in the loess hilly region were selected as the research areas. The change in characteristics of soil moisture and soil temperature, as well as their interactions and statistical relationships with meteorological factors, were analyzed using continuously measured soil moisture, soil temperature, and meteorological factors. The results revealed that air temperature and humidity were the main controlling factors affecting soil moisture changes in the 0-60 cm soil layer of soybean sloping fields and grasslands in the normal precipitation year (2014) and the dry year (2015). Humidity and wind speed were the main meteorological factors affecting soil moisture changes in the maize terraced field. Air temperature had a significant negative effect on soil moisture in the jujube orchard. Soil moisture and soil temperature were all negatively correlated under the four sloping land use types. In normal precipitation years, atmospheric humidity had the greatest direct and comprehensive effect on soil moisture in soybean sloping fields, maize terraced fields, and grasslands; soil temperature had a relatively large impact on soil moisture in jujube orchards. The direct and comprehensive effects of soil temperature on soil moisture under all sloping land use types were the largest and most negative in the dry year. Air temperature had a high correlation with soil temperature in the 0-60 cm soil layer under the four sloping land use types, and the grey relational grade decreased as the soil layer deepened. The coefficient of determination between the 0-20 cm soil temperature and air temperature in the maize terraced field was low, indicating a weak response to air temperature. The above findings can serve as a scientific foundation for optimizing sloping land use structures and maximizing the efficient and sustainable utilization of sloping land resources in China's loess hilly region.

Joint synthesis and registration network for deformable MR-CBCT image registration for neurosurgical guidance

Objective.The accuracy of navigation in minimally invasive neurosurgery is often challenged by deep brain deformations (up to 10 mm due to egress of cerebrospinal fluid during neuroendoscopic approach). We propose a deep learning-based deformable registration method to address such deformations between preoperative MR and intraoperative CBCT.Approach.The registration method uses a joint image synthesis and registration network (denoted JSR) to simultaneously synthesize MR and CBCT images to the CT domain and perform CT domain registration using a multi-resolution pyramid. JSR was first trained using a simulated dataset (simulated CBCT and simulated deformations) and then refined on real clinical images via transfer learning. The performance of the multi-resolution JSR was compared to a single-resolution architecture as well as a series of alternative registration methods (symmetric normalization (SyN), VoxelMorph, and image synthesis-based registration methods).Main results.JSR achieved median Dice coefficient (DSC) of 0.69 in deep brain structures and median target registration error (TRE) of 1.94 mm in the simulation dataset, with improvement from single-resolution architecture (median DSC = 0.68 and median TRE = 2.14 mm). Additionally, JSR achieved superior registration compared to alternative methods-e.g. SyN (median DSC = 0.54, median TRE = 2.77 mm), VoxelMorph (median DSC = 0.52, median TRE = 2.66 mm) and provided registration runtime of less than 3 s. Similarly in the clinical dataset, JSR achieved median DSC = 0.72 and median TRE = 2.05 mm.Significance.The multi-resolution JSR network resolved deep brain deformations between MR and CBCT images with performance superior to other state-of-the-art methods. The accuracy and runtime support translation of the method to further clinical studies in high-precision neurosurgery.

[A nationalsurveyandresults analysisof seizure prophylaxis after aneurismal subarachnoid hemorrhage]

Investigate theclinical practice of seizure prophylaxis after aneurysmal subarachnoid hemorrhage in Chinese neurosurgeons.Aquestionnaire for this theme was designed and was sent to respondents through the internet.From July 2021 to October 2021, atotal of forty-three eligible questionnaires were collected. All responders come from affiliated hospitals of medical schools in China. Each of these hospitals admitted more than one hundred patients with aneurysmal subarachnoid hemorrhage per year. Only 9.3% (4/43) of responders disagree with the prophylactic use of anticonvulsants. 86.04% (37/43) of responders perform seizure prophylaxis in clinical practice. Sodium valproate is the most commonly used regimen; 94.59% (35/37) of responders who perform prophylaxis chose this drug. The medication period differs sharply fromlessthan 3 daystolongerthan 14 daysamong different hospitals. The use of EEG was insufficient in Chinese patients. A low seizure rate was reported according to the feedback from Chinese neurosurgeons.In China, seizure prophylaxis after subarachnoid hemorrhage was not yet standardized. Clinicians' mastery of relevant knowledge is still not enough. Carrying out high-quality clinical research can help justify the use of anticonvulsants, which could also positively impact rational drug use.

[Research advances on the techniques for diagnosing burn wound depth]

The accurate diagnosis of burn wound depth is particularly important for evaluating the disease prognosis of burn patients. In the past, the diagnosis of burn wound depth often relied on the subjective judgment of doctors. With the continuous development of diagnostic technology, the methods for judging the depth of burn wound have also been updated. This paper mainly summarizes the research progress in the applications of indocyanine green angiography, laser Doppler imaging, laser speckle contrast imaging, and artificial intelligence in the diagnosis of burn wound depth, and compares the advantages and disadvantages of these techniques, so as to provide ideas for accurate diagnosis of burn wound depth.

Layer-by-layer assembly of nanocomposite interlayers on a kaolin substrate for enhancing membrane performance of Pb(II) and Cd(II) removal

Developing an ultra-thin polyamide selective layer with sufficient mechanical robustness on a highly porous ceramic substrate is challenging for removing heavy metal ions from wastewater. We synthesized a reliable ceramic-polyamide membrane by assembling nanocomposite interlayers of alumina and carbon black on the kaolin substrate. The surface morphology, pore size distribution, and roughness of ceramic substrates were improved by introducing the nanocomposite interlayer. The corresponding optimized water flux, Pb(II), and Cd(II) removal efficiency are 2.75 L m^-2 h^-1, 98.44%, and 97.51%, respectively, which are better than those of the polyamide films constructed directly on the ceramic substrate. This facile structure provides more active sites for forming ultrathin polyamide layers with satisfactory mechanical robustness. This paper provides a new perspective for fabricating efficient heavy metal ions filters.

Sloping land use affects the complexity of soil moisture and temperature changes in the loess hilly region of China

Various land use types have been implemented by the government in the loess hilly region of China to facilitate sustainable land use. Understanding the variability in soil moisture and temperature under various sloping land use types can aid the ecological restoration and sustainable utilization of sloping land resources. The objective of this study was to use approximate entropy (ApEn) to reveal the variations in soil moisture and temperature under different land use types, because ApEn only requires a short data series to obtain robust estimates, with a strong anti-interference ability. An experiment was conducted with four typical land use scenarios (i.e., soybean sloping field, maize terraced field, jujube orchard, and grassland) over two consecutive plant growing seasons (2014 and 2015), and the time series of soil moisture and temperature within different soil depth layers of each land use type were measured in both seasons. The results showed that the changing amplitude, degree of variation, and active layer of soil moisture in the 0–160 cm soil depth layer, as well as the changing amplitude and degree of variation of soil temperature in the 0–100 cm soil layer increased in the jujube orchard over the two growing seasons. The changing amplitude, degree of variation, and active layer of soil moisture all decreased in the maize terraced field, as did the changing amplitude and degree of variation of soil temperature. The ApEn of the soil moisture series was the lowest in the 0–160 cm soil layer in the maize terraced field, and the ApEn of the soil temperature series was the highest in the 0–100 cm layer in the jujube orchard in the two growing seasons. Finally, the jujube orchard soil moisture and temperature change process were more variable, whereas the changes in the maize terraced field were more stable, with a stable soil moisture and temperature. This work highlights the usefulness of ApEn for revealing soil moisture and temperature changes and to guide the management and development of sloping fields.

[Establishment of morphological reference values for the differential count of white blood cells in peripheral blood smear, as well as nucleated cells and megakaryocytes in bone marrow smear]

Objective: To establish the morphological reference values for the differential count of white blood cells in peripheral blood smear as well as nucleated cells and megakaryocytes in bone marrow smear. Methods: From April 2012 to June 2020, 4 221 healthy donors for hematopoietic stem cell transplantation in Hebei Yanda Lu Daopei Hospital were selected. The median age was 36 (3-72) years old, including 2 520 males and 1 701 females. They were divided into four groups according to age: children group, with age≤14 years old [n=334, 11 (3-14) years old], youth group, with age >14 years old and <45 years old [n=2 855, 33 (15-44) years old], middle-aged adult group, with age ≥45 years old and < 60 years old [n=929, 49 (45-59) years old], and older adult group, with age ≥60 years old [n=103, 62 (60-72) years old]. Gender subgroups were established in each age group. According to different hematopoietic characteristics, the children group were divided into two subgroups: children group 1 [n=48, 6 (3-7) years old] and children group 2 [n=286, 11 (8-14) years old]. According to the clinical routine, 100 white blood cells in peripheral blood, 200 nucleated cells in bone marrow, and cell numbers/4.5 cm² for megakaryocytes were classified and counted. The results of cell count in different age and gender groups were compared, and the reference values of morphological classification were established for different groups with statistical or clinical significance. Results: Due to the existence of statistically significant differences between children and adult groups and different gender subgroups in adults (all P<0.05), the reference values were established for children group and adult gender subgroups. The counts of segmented neutrophils and lymphocytes in peripheral blood were 46.65(43.97-49.32)% and 44.00(10.60-65.10)% in children group 1, 50.73(49.50-51.96)% and 39.55 (38.36-40.74)% in children group 2, and 57.00 (39.00-75.23) % and 33.00 (17.00-52.00) % in adult group, respectively. Bone marrow segmented neutrophils, orthochromatic erythroblasts, and mature lymphocytes were 11.54 (10.68-12.41)%, 14.20 (13.19-15.21)%, and 23.99 (22.06-25.92)% in children group 1, 12.50 (7.00-21.50)%, 15.00(9.50-25.50)%, and 21.02 (20.24-21.81)% in children group 2, 13.50 (7.50-21.00)%, 16.50 (10.50-26.00)%, and 15.50 (7.50-26.00)% in adult male group, and 14.50 (8.00-24.50)%, 14.50 (9.00-23.00)%, and 17.50 (8.50-29.00)% in adult female group, respectively. The myelopoiesis/erythropoiesis ratio in children group, adult male group and adult female group was 1.86∶1 (1.14∶1-3.23∶1), 1.96∶1 (1.12∶1-3.19∶1), 2.22∶1 (1.30∶1-3.69∶1), respectively. The numbers of granular megakaryocytes and thromocytogenic megakaryocytes were 138 (25-567) cells/4.5cm² and 86 (13-328) cells/4.5 cm² in children group, and 92 (13-338) cells/4.5 cm² and 38 (3-162) cells/4.5 cm² in adult group, respectively. Conclusion: The morphological reference values for the differential count of white blood cells in peripheral blood smear as well as nucleated cells and megakaryocytes in bone marrow smear are successfully established, which is helpful to improve the application of morphological examination in disease screening, diagnosis and monitoring.

Heavy metal ions and particulate pollutants can be effectively removed by a gravity-driven ceramic foam filter optimized by carbon nanotube implantation

It is of great significance to develop a new gravity-driven filter to remove water pollutants, but it is still challenging. Here, a novel and simple strategy is demonstrated to manufacture fly ash (FA) ceramic foams showing a three-dimensional interconnected porous structure, with multiwalled carbon nanotubes (MWCNTs) implanted by combining carbamate grafting and polydimethylsiloxane coating. The polydimethylsiloxane formed a physical coating on the carbamate group, generating an effective thermal insulating layer on the outer side of the entire MWCNT. The FA foam, which shows a sufficient adsorption capacity for Pb(II) (51.67 ± 1.17 mg g^-1) and Cd(II) (30.12 ± 0.37 mg g^-1) at pH = 5, T = 25 °C, has a 96.33%, 95.12%, 89.50% removal efficiency for Cd(II), Pb(II), and particulate pollutants, and exhibits excellent recycling performance. This paper provides new opportunities to fabricate gravity-driven filters with low energy consumption for wastewater treatment.

Deformable MR-CT image registration using an unsupervised, dual-channel network for neurosurgical guidance

PURPOSE

The accuracy of minimally invasive, intracranial neurosurgery can be challenged by deformation of brain tissue - e.g., up to 10 mm due to egress of cerebrospinal fluid during neuroendoscopic approach. We report an unsupervised, deep learning-based registration framework to resolve such deformations between preoperative MR and intraoperative CT with fast runtime for neurosurgical guidance.

METHOD

The framework incorporates subnetworks for MR and CT image synthesis with a dual-channel registration subnetwork (with synthesis uncertainty providing spatially varying weights on the dual-channel loss) to estimate a diffeomorphic deformation field from both the MR and CT channels. An end-to-end training is proposed that jointly optimizes both the synthesis and registration subnetworks. The proposed framework was investigated using three datasets: (1) paired MR/CT with simulated deformations; (2) paired MR/CT with real deformations; and (3) a neurosurgery dataset with real deformation. Two state-of-the-art methods (Symmetric Normalization and VoxelMorph) were implemented as a basis of comparison, and variations in the proposed dual-channel network were investigated, including single-channel registration, fusion without uncertainty weighting, and conventional sequential training of the synthesis and registration subnetworks.

RESULTS

The proposed method achieved: (1) Dice coefficient = 0.82±0.07 and TRE = 1.2 ± 0.6 mm on paired MR/CT with simulated deformations; (2) Dice coefficient = 0.83 ± 0.07 and TRE = 1.4 ± 0.7 mm on paired MR/CT with real deformations; and (3) Dice = 0.79 ± 0.13 and TRE = 1.6 ± 1.0 mm on the neurosurgery dataset with real deformations. The dual-channel registration with uncertainty weighting demonstrated superior performance (e.g., TRE = 1.2 ± 0.6 mm) compared to single-channel registration (TRE = 1.6 ± 1.0 mm, p < 0.05 for CT channel and TRE = 1.3 ± 0.7 mm for MR channel) and dual-channel registration without uncertainty weighting (TRE = 1.4 ± 0.8 mm, p < 0.05). End-to-end training of the synthesis and registration subnetworks also improved performance compared to the conventional sequential training strategy (TRE = 1.3 ± 0.6 mm). Registration runtime with the proposed network was ∼3 s.

CONCLUSION

The deformable registration framework based on dual-channel MR/CT registration with spatially varying weights and end-to-end training achieved geometric accuracy and runtime that was superior to state-of-the-art baseline methods and various ablations of the proposed network. The accuracy and runtime of the method may be compatible with the requirements of high-precision neurosurgery.

[Role of the ES-62 protein derived from Acanthocheilonema viteae in regulation of immune dysregulation diseases: a review]

ES-62 is a phosphorylcholine-containing, 62 kDa glycoprotein derived from the excretory-secretory product of Acanthocheilonema viteae, which is effective for the prevention and treatment of immune dysregulation diseases through triggering activation of immune cells, such as dendritic cells, mononuclear macrophages and regulatory B cells and mediating immune responses. Recently, the role of the ES-62 protein in the management of allergic, autoimmune and metabolic diseases has been paid much attention. This review summarizes the regulatory role of the ES-62 protein in immune dysregulation diseases and the underlying mechanisms, so as to provide insights into future experimental studies.

Deformable 3D-2D registration for high-precision guidance and verification of neuroelectrode placement

Purpose.Accurate neuroelectrode placement is essential to effective monitoring or stimulation of neurosurgery targets. This work presents and evaluates a method that combines deep learning and model-based deformable 3D-2D registration to guide and verify neuroelectrode placement using intraoperative imaging.Methods.The registration method consists of three stages: (1) detection of neuroelectrodes in a pair of fluoroscopy images using a deep learning approach; (2) determination of correspondence and initial 3D localization among neuroelectrode detections in the two projection images; and (3) deformable 3D-2D registration of neuroelectrodes according to a physical device model. The method was evaluated in phantom, cadaver, and clinical studies in terms of (a) the accuracy of neuroelectrode registration and (b) the quality of metal artifact reduction (MAR) in cone-beam CT (CBCT) in which the deformably registered neuroelectrode models are taken as input to the MAR.Results.The combined deep learning and model-based deformable 3D-2D registration approach achieved 0.2 ± 0.1 mm accuracy in cadaver studies and 0.6 ± 0.3 mm accuracy in clinical studies. The detection network and 3D correspondence provided initialization of 3D-2D registration within 2 mm, which facilitated end-to-end registration runtime within 10 s. Metal artifacts, quantified as the standard deviation in voxel values in tissue adjacent to neuroelectrodes, were reduced by 72% in phantom studies and by 60% in first clinical studies.Conclusions.The method combines the speed and generalizability of deep learning (for initialization) with the precision and reliability of physical model-based registration to achieve accurate deformable 3D-2D registration and MAR in functional neurosurgery. Accurate 3D-2D guidance from fluoroscopy could overcome limitations associated with deformation in conventional navigation, and improved MAR could improve CBCT verification of neuroelectrode placement.

[Analysis of components of proteins from Echinococcus granulosus cyst fluid]

OBJECTIVE

To analyze the components of proteins from Echinococcus granulosus cyst fluid using the shotgun method, and to identify the active components with potential regulatory effects for immune dysregulation diseases.

METHODS

The E. granulosus cyst fluid was collected aseptically from the hepatic cysts of patients with cystic echinococcosis, and characterized by liquid chromatography (LC) tandem mass spectrometry (MS/MS) following digestion with trypsin. The protein data were searched using the software MaxQuant version 1.6.1.0 and the cellular components, molecular functions, and biological processes of the identified proteins were analyzed using the Gene Ontology (GO) method.

RESULTS

The E. granulosus cyst fluid separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) had a relative molecular mass of 25 to 70 kDa. LS-MS/MS analysis identified 37 proteins, including 32 known proteins and 5 unknown proteins. At least 4 proteins were preliminarily found to exhibit potential regulatory effects for immune dysregulation diseases, including antigen B, glutathione-S-transferase (GST), thioredoxin peroxidase (TPX) and malate dehydrogenase (MDH). GO enrichment analysis showed that the identified proteins had 149 molecular functions and were involved in 341 biological processes.

CONCLUSIONS

E. granulosus cyst fluid has a variety of protein components, and four known proteins are preliminarily identified to be associated with immune dysregulation diseases.

Home blood pressure monitoring detects unrevealed hypertension in women with a history of preeclampsia: results of the BP-PRESELF study

Background/Introduction

The risk of cardiovascular disease more than doubles after hypertensive disorders of pregnancy. As early onset chronic hypertension contributes to cardiovascular risk, implementation of screening strategies, using home blood pressure monitoring (HBPM), may help to improve long-term cardiovascular health.

Purpose

We evaluated whether HBPM among women with a history of preeclampsia/HELLP syndrome is feasible for early detection and management of hypertension.

Methods

The Blood Pressure after PREeclampsia by SELF monitoring (BP-PRESELF) is a multicenter randomized controlled trial. We recruited 198 women with a mean age of 45 years, approximately 12 years after the index pregnancy. Participants were randomized to intervention group with HBPM for the duration of one year or the control group with 'usual care' (Figure 1). The primary outcome was feasibility of HBPM during 1 year of follow-up, defined as protocol adherence, protocol persistence and patient acceptance. Secondary outcomes were blood pressure levels and prevalence of hypertension.

Results

The baseline characteristics did not show statistically significant differences between groups, except for years since index pregnancy. Especially blood pressure levels were very similar at time of inclusion.

Protocol adherence decreased during the first 6 months, after which it stabilized (Figure 2A). Protocol persistence remained high throughout follow-up (Figure 2B). During the study period, 33 women (34%) in the intervention group were diagnosed with hypertension versus only 10 women (11%) in the control group. At 1-year follow-up, mean systolic blood pressure (SD) was 120.4 (11.6) mm Hg in the intervention group versus 126.1 (14.3) mm Hg in the control group, P=0.003. Mean diastolic blood pressure (SD) values were 77.2 (8.0) mm Hg versus 81.7 (9.4) mm Hg, P&lt;0.001, respectively. Adjusted systolic and diastolic differences (95% confidence interval) were −6.81 (−10.17, −3.45) and −4.93 (−7.26, −2.61) mm Hg, with 80% less hypertension at 1-year follow-up in the intervention group.

Conclusion(s)

HBPM appears to be feasible for follow-up of blood pressure in women after preeclampsia/HELLP syndrome, while it detected hypertension and reduced blood pressure levels after intervention in one-third of women in this group.

Funding Acknowledgement

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): INTERREG-V-A program Germany-The Netherlands “Zorg Verbindt”, co-financed by the European Union (EU), Ministry for Economy, Innovation, Digitalization and Energy of the Federal State of Nordrhein-Westfalen (Germany), and the Province of Gelderland (The Netherlands). CONSORT flowchartProtocol adherence (A) and persistence (B)