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Significant energy transition would be needed in China under the carbon neutrality target. Since it would have important impacts on water resource through increased usage, understanding the water demand under specific climate change targets could enable better policy-making for the energy transition. In order to quantitatively analyze the impacts, this study proposed a methodology that combines CO 2 emissions, energy transition, and water demand. An energy-water integrated assessment model was built, to simulate the future energy and CO 2 emissions pathways up to 2050 in China. The water demand of energy systems under both policy scenario (PS) and two mitigation scenarios (2C and 1.5C) are calculated. The key influencing factors of water demand are analysed in two low-water-demand mitigation scenarios (2C-LW and 1.5C-LW). The results showed that China's future energy system and CO 2 emissions pathways change significantly under mitigation scenarios. The timing of the CO 2 emissions peak advances from around 2030 under the PS scenario to between 2020 and 2025 in the mitigation scenarios. Near-zero emissions are achieved by 2050 under the 1.5C scenario. However, with no further water-saving measures, water consumption in energy sector would continue to increase under both the policy scenario and mitigation scenarios. This pressure is compounded by certain mitigation technologies, such as inland nuclear power, biomass energy, and CCS technologies. As such, the potential for water conservation in energy system under climate mitigation targets is studied. The results showed that water-saving measures can significantly reduce long-term water demand in the energy system.

In China, Energy transition was proposed in the “12th Five-Year Plan” and gained resilient support by “Energy Revolution” announced by President Xi Jinping in 2014. In Paris Agreement, there are targets set up for 2100 to be well below 2 °C, with ambitious target on 1.5 °C. China signed the agreement and will support the global target. In the meantime, large-scale actions were initiated in 2013 by the national action plan on air pollution control for the period from 2013 to 2017. None of these strategies has clear long-term target. In our studies, energy transition will be decided by the long-term target of CO2 emission reduction, air pollutant reduction, and energy security. This paper will present the analysis from IPAC model, by setting up reduction target for CO2 emission under the global 2 °C and 1.5 °C target. Energy transition, CO2 emission, and air pollutant reduction will be discussed based on these targets. For air pollutants, SO2, NOx, PM2.5, black carbon, and mercury will be included. From the results, there will be a significant energy transition by large-scale use of renewable energy, nuclear and the share of coal will be reduced to less than 20% in 2050 from 66% in 2015. Energy transition will also contribute to a drastic reduction in air pollutants.

We aim to investigate the functional profiles of perilesional gray matter (GM) in epileptic patients with focal cortical dysplasia (FCD) and to correlate these profiles with FCD II subtypes, surgical outcomes, and different antiseizure medications (ASMs) treatment response patterns. Nine patients with drug-responsive epilepsy and 30 patients with drug-resistant epilepsy (11 were histologically confirmed FCD type IIa, 19 were FCD type IIb) were included. Individual-specific perilesional GM and contralateral homotopic GM layer masks were generated. These masks underwent a two-voxel (2 mm) dilation from the FCD lesion and contralateral homotopic region, resulting in 10 GM layers (20 mm). Layer 1, the innermost, progressed to Layer 10, the outermost. Amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) analyses were conducted to assess the functional characteristics of ipsilateral perilesional GM and contralateral homotopic GM. Compared to the contralateral homotopic GM, a significant reduction of ALFF was detected at ipsilateral perilesional GM layer 1 to 6 in FCD type IIa (after Bonferroni correction  < 0.005, paired -test), whereas a significant decrease was observed at ipsilateral perilesional GM layer 1 to 2 in FCD type IIb (after Bonferroni correction  < 0.005, paired -test). Additionally, a significant decrease of the ReHo was detected at ipsilateral perilesional GM layer 1 compared to the CHRs in FCD type IIb. Notably, complete resection of functional perilesional GM alterations did not correlate with surgical outcomes. Compared to the contralateral homotopic GM, a decreased ALFF in the ipsilateral perilesional GM layer was detected in drug-responsive patients, whereas decreased ALFF in the ipsilateral perilesional GM layer 1-6 and decreased ReHo at ipsilateral perilesional GM layer 1 were observed in drug-resistant patients (after Bonferroni correction  < 0.005, paired -test). Our findings indicate distinct functional profiles of perilesional GM based on FCD histological subtypes and ASMs' response patterns. Importantly, our study illustrates that the identified functional alterations in perilesional GM may not provide sufficient evidence to determine the epileptogenic boundary required for surgical resection.

Background: Malformation of cortical development (MCD) is one of the most common causes of pharmacoresistant epilepsy. Improving the knowledge of antiseizure medications (ASMs) treatment response in epileptic patients with MCD is crucial for optimal treatment options, either pharmacological therapy or non-pharmacological intervention. Aim: To investigate the patterns of medical treatment outcome and the predictors for seizure freedom (SF) with ASM regimens in epilepsy caused by MCD. Methods: The epileptic patients with MCD were consecutively enrolled from March 2013 to June 2019. SF was defined as no seizures for at least 12 months or three times the longest pretreatment inter-seizure interval, whichever was longer. Outcomes were classified into three patterns: pattern A: patients achieved SF at one point and remained so throughout follow-up; pattern B: patients’ seizures fluctuated between periods of SF and relapse; pattern C: SF never attained. The terminal SF was defined if the patients remained SF at the last follow-up visit. Results: A total of 164 epileptic patients with MCD were included. Pattern A was observed in 22, pattern B in 42, and pattern C in 100 patients. SF was ever achieved in 64 (pattern A and B) patients. Twenty-nine patients had terminal SF after a median follow-up time of 4.3 years. With continuing ASM treatment, seizure relapse risk was very low after a 5-year seizure-free period. The pretreatment seizure frequency was the only independent predictor for pattern A and seizure relapse. Sodium channel blockers monotherapy (33.8%) was more effective than levetiracetam (4.5%) in rendering SF in the initial ASM regimen. Conclusion: Medical treatment can be successful in a minority of epileptic patients with MCD, and pretreatment seizure frequency helps to predict the treatment outcome. An unequal efficacy of ASMs in epilepsy caused by MCD suggests etiological evaluation is vital in the management of focal epilepsy.

Objective This study aims to evaluate the glymphatic system (GS) in different temporal lobe epilepsy (TLE) subtypes using diffusion tensor imaging analysis along the perivascular space (DTI‐ALPS) and to explore its correlation with clinical factors and memory performance. Methods The study encompassed 112 TLE patients with hippocampal sclerosis (TLE‐HS), 73 TLE patients with no lesions on magnetic resonance imaging (TLE‐NL), and 55 healthy controls. The DTI‐ALPS index was calculated based on 3.0T diffusion tensor image sequences, and the memory performance was assessed using the Wechsler Memory Scale‐Revised. The DTI‐ALPS index was compared among the three groups, and its relationships with clinical characteristics and memory performance were explored. Results TLE‐HS group showed a significantly lower DTI‐ALPS index compared with healthy controls in both hemispheres (ipsilateral: p < 0.001; contralateral: p = 0.002). By contrast, TLE‐NL group exhibited a reduced DTI‐ALPS index solely in the ipsilateral hemisphere (p < 0.001). Within TLE‐NL cohort, those with a history of focal to bilateral tonic–clonic seizures showed reduced DTI‐ALPS indices in both hemispheres (ipsilateral: p = 0.037; contralateral: p = 0.004). In the TLE‐HS group, DTI‐ALPS index positively correlated with memory performance (ps < 0.05). A multiple regression analysis indicated that the average DTI‐ALPS index was significantly associated with memory quotient (β = 0.309, p < 0.001; R2 = 0.226), independent of the ipsilateral hippocampal volume. Significance The patterns of reduced DTI‐ALPS index differed between TLE‐HS and TLE‐NL patients. The extent of GS impairment in TLE‐HS patients correlated with memory decline, suggesting its potential as a therapeutic target for memory enhancement. Plain Language Summary This study employed the DTI‐ALPS index, a neuroimaging marker, to assess glymphatic system function in distinct subtypes of temporal lobe epilepsy (TLE). Glymphatic impairment was observed in both TLE with hippocampal sclerosis (TLE‐HS) and nonlesional TLE (TLE‐NL), exhibiting distinct patterns. Notably, this dysfunction was associated with memory deficits, suggesting that targeting glymphatic clearance may represent a novel therapeutic strategy for memory improvement in epilepsy.

Objectives This study aims to investigate whether alterations in white matter topological networks are associated with focal to bilateral tonic–clonic seizures (FBTCS) in temporal lobe epilepsy (TLE). Additionally, we investigated the variables contributing to memory impairment in TLE. Methods This cross‐sectional study included 88 unilateral people with TLE (45 left/43 right), and 42 healthy controls. Graph theory analysis was employed to compare the FBTCS (+) group (n = 51) with the FBTCS (−) group (n = 37). The FBTCS (+) group was subcategorized into current‐FBTCS (n = 31) and remote‐FBTCS (n = 20), based on the history of FBTCS within 1 year or longer than 1 year before scanning, respectively. We evaluated the discriminatory power of topological network properties by receiver operating characteristic (ROC) analysis. Generalized linear models (GLMs) were employed to investigate variables associated with memory impairment in TLE. Results Global efficiency (Eg) was significantly reduced in the FBTCS (+) group, especially in the current‐FBTCS subgroup. Greater disruption of regional properties in the ipsilateral occipital and temporal association cortices was observed in the FBTCS (+) group. ROC analysis revealed that Eg, normalized characteristic shortest path length, and nodal efficiency of the ipsilateral middle temporal gyrus could distinguish between FBTCS (+) and FBTCS (−) groups. Additionally, GLMs linked the occurrence of current FBTCS with poorer verbal memory outcomes in TLE. Interpretation Our study suggests that abnormal networks could be the structural basis of seizure propagation in FBTCS. Strategies aimed at reducing the occurrence of FBTCS could potentially improve the memory outcomes in people with TLE.

Objectives Low‐grade tumors are the most common neoplasms inducing focal epilepsy; however, the short‐ and medium‐term efficacy of surgery in epilepsy patients with low‐grade tumors remains underappreciated. This study aims to summarize the clinical characteristics of epilepsy patients with low‐grade tumors and to identify factors associated with postsurgical seizure‐free outcomes. Methods We retrospectively reviewed consecutive patients with low‐grade tumors who underwent subsequent epilepsy surgery in our epilepsy center, between 2012 and 2018 with a minimum follow‐up of 1 year. Using Engel’s classification and Kaplan–Meier survival analysis, we assessed postoperative seizure freedom over time. Demographical, electroclinical, and other presurgical evaluations were then evaluated for association with postoperative seizure outcome. Results The cohort included a total of 132 patients: 79 males and 53 females. Among them, 110 (83.33%) were seizure‐free through their last follow‐up. The Engel class I outcomes were 90.15%, 87.76%, 85.53%, 82.46%, and 73.17% at the end of the 1st, 2nd, 3rd, 4th, and 5th postoperative years, respectively. Multivariate logistic analysis revealed that longer epilepsy duration (p < 0.001, OR 1.091, 95% CI 1.040–1.144) and incomplete resection (p = 0.009, OR 3.673, 95% CI 1.393–9.684) were independently associated with seizure recurrence through the last follow‐up. Conclusions Surgical treatment for seizure control in patients with low‐grade tumors provides excellent short‐ and median‐term outcomes.

Objectives Analysis of FDG‐PET imaging commonly shows that hypometabolism extends into extra‐epileptogenic zones (extra‐EZ). This study investigates the distribution patterns of hypometabolism in frontal lobe epilepsy (FLE) originating in different frontal regions. Methods Sixty‐four patients with FLE were grouped by EZ localization according to Brodmann areas (BAs): Group 1 (the frontal motor and premotor area), BAs 4, 6, and 8; Group 2 (the inferior frontal gyrus and opercular area), BAs 44, 45, and 47; Group 3 (the dorsal prefrontal area), BAs 9, 10, 11, and 46; and Group 4 (the medial frontal and anterior cingulate gyrus), BAs 32 and 24. Regions of extra‐EZ hypometabolism were statistically analyzed between FLE groups and healthy controls. Correlation analysis was performed to identify relationships between the intensity of hypometabolism and clinical characteristics. Results Significant hypometabolism in the ipsilateral (Groups 1 and 4) or bilateral (Groups 2 and 3) anterior insulae was found. Groups 1 and 4 presented with limited distribution of extra‐EZ hypometabolism, whereas Groups 2 and 3 showed widely distributed extra‐EZ hypometabolism in the rectus gyrus, cingulate gyrus, and other regions. Additionally, the intensity of hypometabolism was correlated with epilepsy duration in Groups 2 and 3. Conclusions All FLE groups showed hypometabolism in the anterior insula. In addition, distinct patterns of extra‐EZ hypometabolism were identified for each FLE group. This quantitative FDG‐PET analysis expanded our understanding of the topography of epileptic networks and can guide EZ localization in the future.

The energy transition towards achieving carbon neutrality is marked by the decarbonization of the power system and a high degree of electrification in end-use sectors. The decarbonization of the power system primarily relies on large-scale renewable energy, nuclear power, and fossil fuel-based power with carbon capture technologies. This structure of power supply introduces significant uncertainty in electricity supply. Due to the technological progress in end-use sectors and spatial reallocation of industries in China, the load curve and power supply curve is very different today. However, most studies’ analyses of future electricity systems are based on today’s load curve, which could be misleading when seeking to understand future electricity systems. Therefore, it is essential to thoroughly analyze changes in end-use load curves to better align electricity demand with supply. This paper analyzes the characteristics of electricity demand load under China’s future energy transition and economic transformation pathways using the Integrated Energy and Environment Policy Assessment model of China (IPAC). It examines the electricity and energy usage characteristics of various sectors in six typical regions, provides 24-h load curves for two representative days, and evaluates the effectiveness of demand-side response in selected provinces in 2050. The study reveals that, with the transition of the energy system and the industrial relocation during economic transformation, the load curves in China’s major regions by 2050 will differ notably from those of today, with distinct characteristics emerging across different regions. With the costs of solar photovoltaic (PV) and wind power declining in the future, the resulting electricity price will also differ significantly from today. Daytime electricity prices will be notably lower than those during the evening peak, as the decrease in solar PV and wind power output leads to a significant increase in electricity costs. This pricing structure is expected to drive a strong demand-side response. Demand-side response can significantly improve the alignment between load curves and power supply.

In the recent climate change negotiations it was declared that the increase in global temperature should be kept below 2°C by 2100, relative to pre-industrial levels. China's CO ₂ emissions from energy and cement processes already account for nearly 24% of global emissions, a trend that is expected to keep increasing. Thus the role of China in global GHG mitigation is crucial. A scenario analysis of China's CO ₂ emissions is presented here and the feasibility of China reaching a low-carbon scenario is discussed. The results suggest that recent and continued technological progress will make it possible for China to limit its CO ₂ emissions and for these emissions to peak before 2025 and therefore that the global 2°C target can be achieved. Policy relevance In signing the Copenhagen Accord, China agreed to the global 2°C target. Results from this article could be used to justify low-carbon development policies and negotiations. While many still doubt the feasibility of a low-carbon pathway to support the global 2°C target, the results suggest that such a pathway can be realistically achieved. This conclusion should increase confidence and guide the policy framework further to make possible China's low-carbon development. Related policies and measures, such as renewable energy development, energy efficiency, economic structure optimization, technology innovation, low-carbon investment, and carbon capture and storage (CCS) development, should be further enhanced. Furthermore, China can play a larger role in the international negotiations process. In the global context, the 2°C target could be reaffirmed and a global regime on an emissions mitigation protocol could be framed with countries’ emissions target up to 2050.