Summarizing the evidence for robotic-assisted bladder neck reconstruction: Systematic review of patency and incontinence outcomes

Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.

Effects of mesenchymal stem cell on dopaminergic neurons,motor and memory functions in animal models of Parkinson's disease:a systematic review and meta-analysis

Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.

Interplay between the glymphatic system and neurotoxic proteins in Parkinson’s disease and related disorders:current knowledge and future directions

Parkinson’s disease is a common neurodegenerative disorder that is associated with abnormal aggregation and accumulation of neurotoxic proteins,includingα-synuclein,amyloid-β,and tau,in addition to the impaired elimination of these neurotoxic protein.Atypical parkinsonism,which has the same clinical presentation and neuropathology as Parkinson’s disease,expands the disease landscape within the continuum of Parkinson’s disease and related disorders.The glymphatic system is a waste clearance system in the brain,which is responsible for eliminating the neurotoxic proteins from the interstitial fluid.Impairment of the glymphatic system has been proposed as a significant contributor to the development and progression of neurodegenerative disease,as it exacerbates the aggregation of neurotoxic proteins and deteriorates neuronal damage.Therefore,impairment of the glymphatic system could be considered as the final common pathway to neurodegeneration.Previous evidence has provided initial insights into the potential effect of the impaired glymphatic system on Parkinson’s disease and related disorders;however,many unanswered questions remain.This review aims to provide a comprehensive summary of the growing literature on the glymphatic system in Parkinson’s disease and related disorders.The focus of this review is on identifying the manifestations and mechanisms of interplay between the glymphatic system and neurotoxic proteins,including loss of polarization of aquaporin-4 in astrocytic endfeet,sleep and circadian rhythms,neuroinflammation,astrogliosis,and gliosis.This review further delves into the underlying pathophysiology of the glymphatic system in Parkinson’s disease and related disorders,and the potential implications of targeting the glymphatic system as a novel and promising therapeutic strategy.

Scene 3-D Reconstruction System in Scattering Medium

Research on neural radiance fields for novel view synthesis has experienced explosive growth with the development of new models and extensions.The NeRF(Neural Radiance Fields)algorithm,suitable for underwater scenes or scattering media,is also evolving.Existing underwater 3D reconstruction systems still face challenges such as long training times and low rendering efficiency.This paper proposes an improved underwater 3D reconstruction system to achieve rapid and high-quality 3D reconstruction.First,we enhance underwater videos captured by a monocular camera to correct the image quality degradation caused by the physical properties of the water medium and ensure consistency in enhancement across frames.Then,we perform keyframe selection to optimize resource usage and reduce the impact of dynamic objects on the reconstruction results.After pose estimation using COLMAP,the selected keyframes undergo 3D reconstruction using neural radiance fields(NeRF)based on multi-resolution hash encoding for model construction and rendering.In terms of image enhancement,our method has been optimized in certain scenarios,demonstrating effectiveness in image enhancement and better continuity between consecutive frames of the same data.In terms of 3D reconstruction,our method achieved a peak signal-to-noise ratio(PSNR)of 18.40 dB and a structural similarity(SSIM)of 0.6677,indicating a good balance between operational efficiency and reconstruction quality.

Simulation and experimental comparison of the performance of four-corner-readout plastic scintillator muon-detector system

Cosmic-ray muons are highly penetrating background-radiation particles found in natural environments.In this study,we develop and test a plastic scintillator muon detector based on machine-learning algorithms.The detector underwent muon position-resolution tests at the Institute of Modern Physics in Lanzhou using a multiwire drift chamber(MWDC)experimental platform.In the simulation,the same structural and performance parameters were maintained to ensure the reliability of the simulation results.The Gaussian process regression(GPR)algorithm was used as the position-reconstruction algorithm owing to its optimal performance.The results of the Time Difference of Arrival algorithm were incorporated as one of the features of the GPR model to reconstruct the muon hit positions.The accuracy of the position reconstruction was evaluated by comparing the experimental results with Geant4 simulation results.In the simulation,large-area plastic scintillator detectors achieved a position resolution better than 20 mm.In the experimental-platform tests,the position resolutions of the test detectors were 27.9 mm.We also analyzed factors affecting the position resolution,including the critical angle of the total internal reflection of the photomultiplier tubes and distribution of muons in the MWDC.Simulations were performed to image both large objects and objects with different atomic numbers.The results showed that the system could image high-and low-Z materials in the constructed model and distinguish objects with significant density differences.This study demonstrates the feasibility of the proposed system,thereby providing a new detector system for muon-imaging applications.

A review of the neurotransmitter system associated with cognitive function of the cerebellum in Parkinson's disease

The dichotomized brain system is a concept that was generalized from the‘dual syndrome hypothesis’to explain the heterogeneity of cognitive impairment,in which anterior and posterior brain systems are independent but partially overlap.The dopaminergic system acts on the anterior brain and is responsible for executive function,working memory,and planning.In contrast,the cholinergic system acts on the posterior brain and is responsible for semantic fluency and visuospatial function.Evidence from dopaminergic/cholinergic imaging or functional neuroimaging has shed significant insight relating to the involvement of the cerebellum in the cognitive process of patients with Parkinson’s disease.Previous research has reported evidence that the cerebellum receives both dopaminergic and cholinergic projections.However,whether these two neurotransmitter systems are associated with cognitive function has yet to be fully elucidated.Furthermore,the precise role of the cerebellum in patients with Parkinson’s disease and cognitive impairment remains unclear.Therefore,in this review,we summarize the cerebellar dopaminergic and cholinergic projections and their relationships with cognition,as reported by previous studies,and investigated the role of the cerebellum in patients with Parkinson’s disease and cognitive impairment,as determined by functional neuroimaging.Our findings will help us to understand the role of the cerebellum in the mechanisms underlying cognitive impairment in Parkinson’s disease.

Integrating GPT into the Journalism and Communication Industries:The Technological Logic,Ecosystem Reconstruction,and Ethical Chal enges

Generative AI,represented by GPT(Generative Pre-trained Transformer),is now leading the technological revolution and is reconstructing the journalism and communication industries'ecosystems because of its powerful generative capacity and diverse range of outputs.While GPT is busy revolutionizing and innovating the production of news content,working patterns,and operation modes,it has also given rise to ethical concerns in regard to news authenticity,data security,humanistic values,and other related aspects.Therefore,it is imperative to initiate strategies and approaches,such as establishing a mechanism for verifying information authenticity,enhancing data security and privacy regulations,and instituting an ethical supervision and governance framework for AI,in order to facilitate the systematic advancement of AI-based news production while reinstating public trust.

Duodenal Crohn’s disease:Case report and systematic review

BACKGROUND Inflammatory bowel disease,including ulcerative colitis,microscopic colitis,and Crohn’s disease(CD),has a global impact.This review focuses on duodenal CD(DCD),a rare subtype affecting the duodenum.DCD’s rarity and asymptomatic nature create diagnostic challenges,impacting prognosis and patient well-being.Delayed diagnosis can worsen DCD outcomes.AIM To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis.METHODS A systematic literature search,following the PRISMA statement,was conducted.Relevant studies were identified and analysed using specific Medical Subject Terms(MeSH)from PubMed/MEDLINE,American Journal of Gastroenterology,and the University of South Wales database.Data collection included information from radiology scans,endoscopy procedures,biopsies,and histopathology results.RESULTS The review considered 8 case reports and 1 observational study,involving 44 participants diagnosed with DCD,some of whom developed complications due to delayed diagnosis.Various diagnostic methods were employed,as there is no gold standard workup for DCD.Radiology scans[magnetic resonance imaging(MRI),computed tomography(CT),and upper gastrointestinal X-ray],endoscopy procedures(colonoscopy and esophagogastroduodenoscopy),biopsies,and clinical suspicions were utilized.CONCLUSION This review discusses DCD diagnosis challenges and the roles of CT,MRI,and fluoroscopy.It notes their limitations and compares findings with endoscopy and histopathology studies.Further research is needed to improve diagnosis,emphasizing scan interpretation,endoscopy procedures,and biopsies,especially in high-risk patients during routine endoscopy.

Physiological and pathological functions of circular RNAs in the nervous system

Circular RNAs(circRNAs)are a class of covalently closed single-stranded RNAs that are expressed during the development of specific cells and tissues.CircRNAs play crucial roles in physiological and pathological processes by sponging microRNAs,modulating gene transcription,controlling the activity of certain RNA-binding proteins,and producing functional peptides.A key focus of research at present is the functionality of circRNAs in the nervous system and several advances have emerged over the last 2 years.However,the precise role of circRNAs in the nervous system has yet to be comprehensively reviewed.In this review,we first summarize the recently described roles of circRNAs in brain development,maturity,and aging.Then,we focus on the involvement of circRNAs in various diseases of the central nervous system,such as brain cancer,chronic neurodegenerative diseases,acute injuries of the nervous system,and neuropathic pain.A better understanding of the functionality of circRNAs will help us to develop potential diagnostic,prognostic,and therapeutic strategies to treat diseases of the nervous system.

SphK1/S1P/S1PR2信号通路促进肌生成:运动改善骨骼肌健康的新视角

背景:近年来,运动改善骨骼肌的健康已成为学者们关注的一个重要研究内容,适宜的运动对骨骼肌具有积极的作用,其中在运动激活鞘氨醇激酶1(sphingosine kinase1,SphK1)/鞘氨醇-1-磷酸(sphingosine-1-phosphate,S1P)/鞘氨醇-1-磷酸受体2(sphingosine-1-phosphate receptor2,S1PR2)信号通路如何改善骨骼肌的健康,正受到科研人员的重视。目的:研究运动经SphK1/S1P/S1PR2信号通路如何改善骨骼肌的健康,探索治疗相关肌肉疾病的新方法,以改善人的骨骼肌健康。方法:检索Web of Science、PubMed、中国知网、万方和维普数据库从建库至今与文章主题相关的文献,以“signaling pathway,SphK1,S1P,S1PR2,skeletal muscle,satellite cell,myogenesis,exercise”为英文检索词,以“信号通路,SphK1,S1P,S1PR2,骨骼肌,卫星细胞,肌生成,运动”为中文检索词,最终纳入69篇文献进行分析。结果与结论:①SphK1/S1P/S1PR2信号通路是一个复杂的调控网络,通过SphK1催化产生的S1P,与S1PR2等受体的相互作用,触发下游信号转导过程,进而调控细胞、组织、器官和系统的多种生物学功能。②SphK1/S1P/S1PR2信号通路能调控卫星细胞增殖和成肌细胞分化,改善肌生成。③文章通过文献资料调研法分析了SphK1/S1P/S1PR2信号通路的生理基础以及运动对其影响的可能性。急性有氧运动可提高骨骼肌中SphK1的表达,人体和动物研究中已证实急性和长期运动均可提高骨骼肌中S1P水平,另外研究表明长期抗阻运动可提高S1PR2在骨骼肌中的表达,部分实验结果表明急性和长期运动对肌肉或者血液中S1P水平无显著影响,出现不同结果的原因可能是选择的研究对象、方式、强度及频率不同,而具体机制尚不明确。④研究认为,运动能够促进SphK1/S1P/S1PR2信号通路在骨骼肌中的表达,调控下游相关信号通路,并且针对这一信号通路的研究可能为骨骼肌疾病的治疗提供新的策略和方法,从而改善骨骼肌健康。⑤未来应深化对SphK1/S1P/S1PR2信号通路与骨骼肌健康关联的研究,进一步揭示其与卫星细胞、成肌细胞的调控关系及与上下游通路的相互作用,挖掘其临床应用价值,制定康复方案时考虑该通路变化,探索不同运动对该通路的影响机制,并将其作为潜在治疗靶点,结合人体肌肉模型提升研究深度和准确性。

Platelet-rich plasma for de Quervain’s tenosynovitis: A systematic review and meta-analysis

BACKGROUND Platelet-rich plasma(PRP)injection is used as an alternative non-operative management for de Quervain’s tenosynovitis(DQT)to regenerate tendon healing.AIM To assess and conclude the research-based study systematically to analyse the efficacy of PRP on DQT.METHODS This systematic review used the Cochrane Handbook for Systematic Reviews and the guideline of preferred reporting items for systematic review and metaanalysis.A systematic literature search was applied to 11 databases.The authors assessed the study quality and risk of bias of each included study.Results of the meta-analysis were presented using mean difference(MD)/standardized mean difference(SMD)and 95%condence interval(CI).RESULTS The authors evaluated 275 studies found in the literature search;12 studies met the criteria for this review,and then the study quality and risk of bias were assessed.Pooled analysis of data from two studies involving 194 subjects with DQT showed that,compared with conservative treatment,PRP injection was associated with a greater reduction in visual analog scale pain in one month and six months after treatment(MD:-0.67,P value<0.00001;MD:-1.16,P value<0.00001)and the increase of Mayo’s wrist score in one month and six months after treatment(SMD:3.72,P value<0.00001;SMD:4.44,P value<0.00001).CONCLUSION PRP can be used as an alternative non-operative treatment for DQT due to the tissue regenerative effect of PRP.

An Improved YOLOv5s-Based Smoke Detection System for Outdoor Parking Lots

In the rapidly evolving urban landscape,outdoor parking lots have become an indispensable part of the city’s transportation system.The growth of parking lots has raised the likelihood of spontaneous vehicle combus-tion,a significant safety hazard,making smoke detection an essential preventative step.However,the complex environment of outdoor parking lots presents additional challenges for smoke detection,which necessitates the development of more advanced and reliable smoke detection technologies.This paper addresses this concern and presents a novel smoke detection technique designed for the demanding environment of outdoor parking lots.First,we develop a novel dataset to fill the gap,as there is a lack of publicly available data.This dataset encompasses a wide range of smoke and fire scenarios,enhanced with data augmentation to ensure robustness against diverse outdoor conditions.Second,we utilize an optimized YOLOv5s model,integrated with the Squeeze-and-Excitation Network(SENet)attention mechanism,to significantly improve detection accuracy while maintaining real-time processing capabilities.Third,this paper implements an outdoor smoke detection system that is capable of accurately localizing and alerting in real time,enhancing the effectiveness and reliability of emergency response.Experiments show that the system has a high accuracy in terms of detecting smoke incidents in outdoor scenarios.

Navigating medial patellotibial ligament reconstruction:Clinical perspectives and surgical strategies

The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.

Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

Changes of China’s Status in the Global System and Its Influencing Factors:A Multiple Contact Networks Perspective

Clarifying China’s position in the global system is an important logical basis for developing national diplomacy.Although much research has been done on China’s development status,most studies have been based on country comparisons or institutional en-vironment.In today’s networked era in which the global economy,trade,personnel,and information are closely connected,studies on China’s global position and its status changes and influencing factors in multiple contact networks are still insufficient.In this study,from the perspective of diverse global contact networks,we constructed economic,cultural,and political influence indices to explore the changes and influencing factors on China’s status in the global system from 2005 to 2018.The results show that during the study period,China’s global influence in the fields of economic ties,cultural exchanges,and political contacts increased significantly,but its influ-ence in the fields of cultural exchanges and political contacts lagged far economic ties.The pattern of China’s economic influence on various economies around the world has shown a transformation from an‘upright pyramid’to an‘inverted pyramid’structure.The proportion of these economies in low-influence zones has decreased from more than 60%in 2005 to less than 20%in 2018.China’s cultural and political influence on various economies around the world has increased significantly;however,for the former,the percentage of high-influence areas is still less than 20%,whereas for the latter the percentage of these economies in medium-and high-influence areas is still less than 50%.Analyses such as a scatter plot matrix show that geographical proximity,economic globalization,close cooperation with developing countries,and a proactive and peaceful foreign policy are important factors in improving China’s status in the diverse global network system.

A holographic optical communication system based on RSA algorithm and quaternion function

A facile encryption way was successfully applied to the holographic optical encryption system with high speed,multidimensionality,and high capacity,which provided a better security solution for underwater communication.The reconstructed optical security system for information transmission was based on wavelengthλand focal length f that were keys to encryption and decryption.To finish the secure data transmission(λ,f)between sender and receiver,an extended Rivest-Shamir-Adleman(ERSA)algorithm for the encryption was achieved based on three-dimension quaternion function.Therein,the Pollard’s rho method was used for the evaluation and comparison of RSA and ERSA algorithms.The results demonstrate that the message encrypted by the ERSA algorithm has better security than that by RSA algorithm in the face of unpredictability and complexity of information transmission on the unsecure acoustic channel.

Overexpression of Kdm6b induces testicular differentiation in a temperature-dependent sex determination system

In reptiles,such as the red-eared slider turtle(Trachemys scripta elegans),gonadal sex determination is highly dependent on the environmental temperature during embryonic stages.This complex process,which leads to differentiation into either testes or ovaries,is governed by the finely tuned expression of upstream genes,notably the testis-promoting gene Dmrt1 and the ovary-promoting gene Foxl2.Recent studies have identified epigenetic regulation as a crucial factor in testis development,with the H3K27me3 demethylase KDM6B being essential for Dmrt1 expression in T.s.elegans.However,whether KDM6B alone can induce testicular differentiation remains unclear.In this study,we found that overexpression of Kdm6b in T.s.elegans embryos induced the male development pathway,accompanied by a rapid increase in the gonadal expression of Dmrt1 at 31°C,a temperature typically resulting in female development.Notably,this sex reversal could be entirely rescued by Dmrt1 knockdown.These findings demonstrate that Kdm6b is sufficient for commitment to the male pathway,underscoring its role as a critical epigenetic regulator in the sex determination of the red-eared slider turtle.

A Systematic Literature Review of the Impact of Climate Change on Menopause: Altering the Age, Severity of Symptoms and Long-Term Effects

Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature range—and women’s menopausal experiences. This study aims to interpret how these environmental factors influence the age of onset, severity of symptoms such as hot flushes and night sweats, and other long-term effects of menopause. Understanding these relationships addresses a significant gap in current knowledge and could guide future public health strategies. Methods: Through a comprehensive analysis of three cross-continental studies involving 1500 postmenopausal women from Spain, South American countries (Ecuador, Panama, Chile), various climates in Türkiye (Black Sea, Mediterranean, Continental), and the United Arab Emirates (UAE), this review evaluates diverse environmental impacts. Studies were selected based on their methodological rigor, geographical diversity, and focus on the unique and personal experiences of menopause. Data was collected via questionnaires and routine medical checkups, analyzing demographic, lifestyle, mood, symptom severity, and onset age variables. Results: Preliminary analysis indicates that 52.5% of participants from Spanish-speaking countries and the UAE reported vasomotor symptoms, with those in higher temperatures and lower altitudes experiencing exacerbated symptoms. Notably, Mediterranean climates were associated with an earlier menopause onset. Seasonal changes had minimal impact across all regions, suggesting lifestyle and other environmental factors play a more significant role. Conclusions: The findings highlight a clear link between climate-related geographical factors and the menopausal experience. Women in warmer, lower-altitude regions suffer more severe symptoms, while those in Mediterranean climates face earlier onset. The absence of significant seasonal variations across the studies underscores the predominance of lifestyle and environmental factors over purely climatic conditions. These insights pave the way for targeted interventions and support the need for further public health research into the complex interactions between climate change and menopause.

Fluid inclusion and H-O-S-Pb isotope systematics of the Chayong Cu-polymetallic deposit,Sanjiang Metallogenic Belt,Qinghai Province,China

The Chayong Cu-polymetallic deposit is a recently discovered Cu-polymetallic deposit hosted in the Sanjiang Metallogenic Belt within the Tibetan Plateau of China to the northeast of the North Qiangtang terrane.The ore body occurs in siltstone and is controlled by a northwest-trending fault structure.According to the associations,assemblages,and cutting relationships between ore veins,the hydrothermal mineralization period can be divided into three mineralization stages:(1)a molybdenite mineralization stage,(2)a Cu-polymetallic sulfide stage,and(3)a quartzcarbonate stage.Two types of fluid inclusions(FIs),namely,liquid and vapor-rich inclusions,are present in quartz as so ciated with sulfide minerals.Early-stage FIs are both iquid and vapor-rich,homogenized at temperatures ranging from 364.1 to 384.2℃,and have salinities ranging from0.70%to 9.60%NaCl equivalent(eqv).The middle-stage FIs are also both liquid-and vapor-rich,homogenized at temperatures ranging from 272.4 to 355.6℃,and have salinities ranging from 0.53%-17.10%NaCl eqv.The late-stage FIs are liquid,homogenized at temperatures ranging from 209.4to 255.3℃,and have salinities ranging from 0.35%-6.87%NaCl eqv.The samples from the deposit haveδ^(34)S values of-21.8‰to-19.2‰and-5.5‰to-6.0‰,suggesting that sulfur was derived from the host sediments and magmatic fluids,respectively.The metallic minerals within the deposit have^(206)Pb/^(204)Pb,^(207)Pb/^(204)Pb,and^(208)Pb/^(204)Pb values of 18.439-18.458,15.656-15.679,and 38.772-38.863,respectively,suggesting that the metals were derived from the upper crust and orogenic belts.The samples from the deposit haveδ^(18)O_(W)values of 2.99‰-7.99‰andδD_(W) values ranging from-84.4‰to-73.9‰,indicating that the pre-forming fluids were magmatic and mixed with minor amounts of meteoric water.The ore-forming fluid of the Chayong copper polymetallic deposit was a high-temperature,medium-to low-salinity H_(2)O-NaCl-CH_(4)-N_(2)±CO_(2)fluid system.The early high-temperature magmatic fluid,due to boiling,decreased in temperature,and via the mixing of meteoric water,gradually evolved towards the later-stage medium-to low-temperature and low-salinity fluid,causing nolybdenite mineralization and forming copper polymetallic sulfide veins and quartz carbonate veins.

Construction and application of a three-dimensional vascular variation-based nephrometry scoring system for completely endophytic renal tumors

Background:Completely endophytic renal tumors(CERT)pose significant challenges due to their anatomical complexity and loss of visual clues about tumor location.A facile scoring model based on three-dimensional(3D)reconstructed images will assist in better assessing tumor location and vascular variations.Methods:In this retrospective study,80 patients diagnosed with CERT were included.Forty cases underwent preoperative assessment using 3D reconstructed imaging(3D-Cohort),while the remaining 40 cases were assessed using two-dimensional imaging(2D-Cohort).Vascular variations were evaluated by ascertaining the presence of renal arteries>1,prehilar branching arteries,and arteries anterior to veins.The proposed scoring system,termed RAL,encompassed three critical components:(R)adius(maximal tumor diameter in cm),(A)rtery(occurrence of arterial variations),and(L)ocation relative to the polar line.Comparison of the RAL scoring system was made with established nephrometry scoring systems.Results:A total of 48(60%)patients exhibited at least one vascular variation.In the 2D-Cohort,patients with vascular variations experienced significantly prolonged operation time,increased bleeding volume,and extended warm ischemia time compared with those without vascular variations.Conversely,the presence of vascular vari-ations did not significantly affect operative parameters in the 3D-Cohort.Furthermore,the 2D-Cohort demon-strated a notable decline in both short-and long-term estimated glomerular filtration rate(eGFR)changes com-pared with the 3D-Cohort,a trend consistent across patients with warm ischemia time≥25 min and those with vascular variations.Notably,the 2D-Cohort exhibited a larger margin of normal renal tissue compared with the 3D-Cohort.Elevated RAL scores correlated with larger tumor size,prolonged operation time,extended warm is-chemia time,and substantial postoperative eGFR decrease.The RAL scoring system displayed superior predictive capabilities in assessing postoperative eGFR changes compared with conventional nephrometry scoring systems.Conclusions:Our proposed 3D vascular variation-based nephrometry scoring system offers heightened proficiency in preoperative assessment,precise prediction of surgical complexity,and more accurate evaluation of postoper-ative renal function in CERT patients.