Abstract: This study investigated the cytotoxicity, 15-hydroxyprostaglandin dehydrogenase (15-PGDH) inhibitory activity, prostaglandin (PG)E2 release, mRNA expression, collagen biosynthesis, and wound healing activity for evaluating the role of flavonoids obtained from Quercus mongolica bark (QMB-flavonoid) in enhancing wound healing. QMB-flavonoid inhibited 15-PGDH activity in a concentration-dependent manner, with a notable reduction at 7.0 μg/mL, and increased PGE2 release from 1,600 to 2,500 pg/mL between 5.0 and 7.0 μg/mL. Gene expression analysis showed a decrease in 15-PGDH, COX-1, and PGT, whereas MRP4 expression increased. Genes related to cell proliferation, such as KDR, were upregulated, with KDR showing a 5.1-fold increase. At 3.0 µg/mL, QMB-flavonoid promoted collagen synthesis by 142.7% with no cytotoxicity observed in fibroblasts up to that concentration. QMB flavonoids also demonstrated significant wound healing effect, showing a 199.3% growth rate and near-complete wound closure by day 15. The treated group exhibited better tissue regeneration and thinner epidermis than the control group. These results suggest that QMB-flavonoid have potential therapeutic applications in skin regeneration.

Abstract: Purpose: Hyperintense vessels (HV) observed on FLAIR MRI are thought to represent slow antegrade or retrograde flow in leptomeningeal vessels, which develop as collat-eral pathways in response to major intracranial artery stenosis or occlusion. HV is commonly seen in conditions like Moyamoya disease and symptomatic ICA/MCA steno-occlusion. The correlation between HV and cerebral hemodynamics, as well as the effect of STA-MCA bypass surgery on HV, remains poorly understood. This study aimed to investigate the relationship between HV on FLAIR and cerebral vascular he-modynamic status, as measured by SPECT, in patients with Moyamoya disease and symptomatic ICA/MCA occlusion. The secondary goal was to assess the impact of re-canalization through STA-MCA bypass surgery on the presence of HV. Methods: For-ty-nine patients with symptomatic ICA and MCA steno-occlusion, who underwent STA-MCA bypass surgery between 2015 and 2020, were retrospectively enrolled. Pre- and postoperative FLAIR MRI images were reviewed, and the presence of HV was classified as Negative (0), Minimal (1), or Positive (2). SPECT was used to measure cerebrovascular reserve (CVR) in regions with differing HV intensity. Follow-up FLAIR imaging was performed 3 to 14 months after surgery to evaluate changes in HV and correlate these with hemodynamic improvements assessed by SPECT. Result: HV was observed in 74% (36/49) of the affected hemispheres. SPECT revealed that regions with minimal or positive HV had significantly lower CVR compared to regions with no HV, indicating poorer hemodynamic status. After STA-MCA bypass surgery, HV de-creased or disappeared in 65% (32/49) of patients. Postoperative changes in HV corre-lated with improved CVR and perfusion, as observed in both SPECT and perfusion MRI. Conclusions: The presence of HV is associated with impaired cerebral hemody-namics in patients with Moyamoya disease or severe ICA/MCA steno-occlusion. HV-positive regions exhibit lower cerebrovascular reserve compared to HV-negative regions. STA-MCA bypass surgery improves hemodynamics, and the reduction or dis-appearance of HV can serve as a marker of vascular improvement following revascu-larization.

Abstract: This study examined the 6-month hospital readmission rate for Transition Care Program clients and its association with community goal attainment. This was a single-site retrospective cohort study of TCP clients admitted from 2014 to 2019. Goals were set at TCP entry, classified as home- or community-based, and mapped to the International Classification of Functioning and Disability. Hospital readmissions were tracked using QLD Health records. Of 1057 clients receiving TCP service, 747 (66.8% female and 33.2% male) client episodes were linked to a QLD Unique Record Number. Only 164 (22%) clients were readmitted to hospital. The mean exit Modified Barthel Index (MBI) and MBI change were significantly lower for readmitted clients (85.7 vs 90.5, p=0.001 and 11.5 vs 14.4, p=0.005). Clients who were not readmitted to hospital set and achieved a higher number of community-based goals (1.08 vs 0.8, p=0.01 and 0.8 vs 0.6, p=0.001). Utilising a logistic regression model, each additional community goal achieved was associated with a 30% reduction in risk of readmission to hospital (OR: 0.69, 95%CI: 0.5-0.8; p=0.002), adjusted for age, sex, MBI change, number of home goals achieved, hospital length of stay and number of comorbidities. Achieving community-based goals can reduce the risk of hospital readmission by 30% after adjusting for demographic and clinical variables.

Abstract: Background: Chronic otitis media (COM) with tympanic perforation sometimes requires tympanoplasty. Many factors can interfere with surgical success; however, the histological status of the remaining epithelium of the perforation has not been studied as a risk factor for surgical failure. Methods: Observational, longitudinal, analytical study in patients with COM, candidates for tympanoplasty who met the inclusion criteria between August and December 2024. Tympanoplasty was performed and the tympanic ring epithelium was sent for histological analysis. After 30 days, closure or non-closure of the perforation was determined and the results were collected. Descriptive and analytical statistics were performed according to the data distribution using the SPSS 26.0 statistical package. Results: Twenty subjects were included; 80% with tubal dysfunction, 60% central perforation, and 65% medium-sized. 13 were successful and 7 failed. Histopathological analysis revealed dystrophic calcification, chronic lymphocytic infiltrate, histiocytic infiltrate, fibrosis, loose keratin sheets, metaplasia, and spongiosis. The logistic regression model showed an OR of 7.3 for marginal perforation and 3.4 for the OPSS score. Of the patients with surgical failure, 57.4% had epithelial inflammation. Conclusions: Epithelial inflammation affected surgical success in more than 50%.

Abstract: Background: Multiple Chemical Sensitivity is a complex and disabling condition characterized by a range of non-specific symptoms triggered by low-level exposure to common environmental chemicals. It often leads to significant impairment in quality of life, psychological well-being, and daily functioning. Non-pharmacological approaches—such as lifestyle modifications and psychological interventions—are frequently used in clinical practice, but their effectiveness remains uncertain. Objective: To evaluate the effectiveness of lifestyle-based interventions in improving outcomes in adults with MCS. Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420251013537). Searches were performed in MEDLINE, Google Scholar, CINAHL, and ResearchGate from March to April, 2025. Eligible studies included adults (≥18 years) with a verified diagnosis of Multiple Chemical Sensitivity, reporting outcomes such as stress perception, anxiety, depressive symptoms, or quality of life. Methodological quality and risk of bias were assessed using PEDro, NIH, CEBMa, and RoB 2.0 tools. Results: Twelve studies (n = 378) were included. Cognitive and behavioral therapies consistently demonstrated reductions in symptom severity, maladaptive thought patterns, and functional limitations. Mindfulness-based stress reduction showed beneficial effects, while other mindfulness-based approaches were less conclusive. Exposure-based therapies helped improve chemical tolerance and reduce avoidance behaviors. Electromagnetic and biomedical interventions showed preliminary but limited evidence of effectiveness, and aromatherapy was well tolerated though minimally effective. Conclusions:Among lifestyle-based interventions, cognitive and behavioral therapies appear most effective for managing symptoms of Multiple Chemical Sensitivity. Nevertheless, heterogeneity in study design, intervention protocols, and outcome measures limits the generalizability of findings.

Abstract: Lung ultrasound (LUS) and thoracic ultrasound (TUS) are commonly used tools in acute care and anesthesia, enabling rapid, bedside assessment of pulmonary pathology and enhancing procedural safety. This scoping review synthesizes current evidence on the diagnostic and procedural applications of LUS and TUS across a wide range of clinical scenarios including pneumothorax, pulmonary edema, pneumonia, pleural effusion, and acute respiratory distress syndrome (ARDS). Emphasis is placed on the diagnostic performance of ultrasound compared to traditional modalities such as chest X-ray and CT. The review also evaluates emerging approaches such as anterior-only lung ultrasound for ARDS phenotyping, quantitative B-line analysis, and COVID-19 risk stratification using LUS scoring. In procedural contexts, we explore real-time guidance for central venous catheter placement, intubation confirmation, and thoracentesis. The review follows PRISMA-ScR guidelines and highlights current gaps in the literature while proposing future directions to expand ultrasound use in high-acuity environments. This comprehensive synthesis reinforces the versatility, safety, and diagnostic value of LUS and TUS in acute care and anesthesiology practice.

Abstract: Molecular imaging of α-synuclein (α-syn) pathology in Parkinson’s disease (PD) and related movement disorders is a clinical unmet need. The aim of this study was to discover and characterize in vitro a radioligand for imaging α-syn pathology. A library of 78 small molecules was developed and screened using recombinant α-syn fibrils and brain homogenates from Alzheimer´s disease (AD) donors. Selection criteria were: Ki_α-syn <30 nM, Ki_tau and Ki_A-β >200 nM. Three compounds, GMC-073 (K_iα-syn: 8 nM), GMC-098 (Ki_α-syn: 9.7 nM), and GMC-058 (Ki_α-syn: 22.5 nM) fulfilled the criteria and were radiolabelled with ³H. [³H]GMC-058 was the only compound with negligible binding in controls and was further evaluated using tissue microarrays, autoradiography on fresh-frozen brain slices and in vitro saturation binding assay on brain homogenates. [³H]GMC-058 binding co-localised with α-syn inclusions in Parkinson´s disease (PD) and multiple system atrophy (MSA), with dense A-β plaques in cerebral amyloid angiopathy and AD and with p-tau inclusions in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Specific binding was highest in PSP and CBD. In vitro K_D was highest in AD (5.4 nM), followed by PSP (41 nM) and CBD (75 nM). The K_D in MSA, PD and controls was >100 nM. [³H]GMC-058 is a novel radioligand displaying low affinity for aggregated α-syn in tissue, with an in vitro profile also suitable for detecting tau pathology in 4R tauopathies.

Abstract: Morbidity and mortality rates in intensive care unit (intensive care unit) reflect the severe health challenges faced by critically ill patients. Nutritional and immune status, as measured by the Prognostic Nutritional Index (prognostic nutritional index), are increasingly recognized as important predictors of intensive care unit outcomes. We aimed to compare prognostic nutritional index levels of survived and deceased subjects that treated in intensive care unit. This retrospective study examined the association between prognostic nutritional index and mortality among intensive care unit patients treated from June 2023 to June 2024. Prognostic nutritional index was calculated using serum albumin and lymphocyte levels, and patients were categorized into survived and deceased groups. Statistical analyses, including ROC and logistic regression, were used to evaluate prognostic nutritional index’s predictive capacity. We revealed that deceased patients had significantly lower prognostic nutritional index values, lower platelet counts, and higher C-reactive protein (C-reactive protein) and serum creatinine levels compared to survivors. Prognostic nutritional index was independently associated with mortality, with each unit decrease increasing mortality risk by 94%. These findings highlight prognostic nutritional index’s utility as a prognostic tool in intensive care unit settings, underscoring the need for nutritional assessments and targeted interventions to improve patient outcomes. Further research with larger cohorts is warranted to validate these findings and explore causative mechanisms.

Abstract: Alzheimer’s disease (AD) is a progressive neurological disorder that causes memory loss, cognitive decline, and behavioral changes. AD pathologies involve different factors, including damage of cholinergic neurons, extracellular deposition of β-amyloid (Aβ) into senile plaques, intracellular accumulation of hyperphosphorylated tau protein, microglia-related neuroinflammation, and oxidative stress. Several medications, such as cholinesterase inhibitors, N-Methyl-D-aspartate receptor antagonists, and immunotherapy drugs, are administered for AD treatment. Along with AD-related neurological disorders, behavioral and psychological symptoms of dementia (BPSD) are also prevalent in individuals with AD. Pharmacological treatments for BPSD include antipsychotics, memantine, and others. Yokukan-san (YKS) is a traditional Japanese Kampo medicine. YKS contains a blend of several herbs, including Uncaria uncis cum ramulus, Angelicae radix, Bupleurum radix, and others. It has been efficacious against BPSD; thus, it was officially approved for BPSD treatment in Japan. Recently, the anti-AD effects of YKS have attracted considerable attention. Uncaria uncis cum ramulus managed AD by reducing Aβ accumulation, decreasing abnormally hyperphosphorylated tau protein, and inhibiting acetylcholinesterase. Similarly, Angelicae radix has improved memory deficits in a rat AD model by reducing Aβ levels, promoting cholinergic function, and decreasing oxidative stress and neuroinflammation. Tetracyclines (i.e., minocycline and doxycycline) popularly exhibit anti-inflammatory effects by inhibiting microglia. Moreover, minocycline has reduced Aβ production and hyperphosphorylation of tau protein. Experimental AD models demonstrated that minocycline and doxycycline improved cognitive/learning, and memory deficits, respectively. Therefore, minocycline and doxycycline are efficacious against AD. Multidrug treatment is more effective than single-drug treatment because of the synergistic effects associated with the different mechanisms of action of involved drugs. In the absence of currently effective and low-priced treatments, YKS and tetracycline are proposed for AD treatment.

Abstract: Integrating artificial intelligence (AI) and mixed reality (MR) into orthopedic education has transformed learning. This review examines AI-powered platforms like Microsoft HoloLens, Apple Vision Pro, and HTC Vive Pro, which enhance anatomical visualization, surgical simulation, and clinical decision-making. These technologies improve spatial understanding of musculoskeletal structures, refine procedural skills with haptic feedback, and personalize learning through AI-driven adaptive algorithms. Generative AI tools like ChatGPT further support knowledge retention and provide evidence-based insights on orthopedic topics. AI-enabled platforms and generative AI tools help address challenges in standardizing orthopedic education. However, we still face many barriers that relate to standardizing data, algorithm evaluation, ethics, and the curriculum. AI is used in preoperative planning and predictive analytics in the postoperative period that bridges theory and practice. AI and MR are key to supporting innovation and scalability in orthopedic education. However, technological innovation relies on collaborative partnerships to develop equitable, evidence-informed practices that can be implemented in orthopedic education. For sustained impact, innovation must be aligned with pedagogical theories and principles. We believe that orthopedic medical educator's future critical role will be to enhance the next generation of competent clinicians.

Abstract: Phosphorus is one of the most abundant minerals in the body and plays a pivotal role in numerous cellular processes, including maintenance of skeletal health, integrity of phospholipid bilayers, cell signaling, and synthesis of nucleic acid and adenosine triphosphate (ATP). About 85% of total phosphate is deposited in bone as hydroxyapatite crystals, 14% is present in soft tissues as various organic phosphates, and the remaining 1% is found in extracellular space mainly as inorganic phosphate. The plasma inorganic phosphorus concentration is tightly maintained between 2.5 - 4.5 mg/dL by intertwined interactions between fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH) and vitamin D that tightly regulate the precise balance in the phosphorus trafficking across the gastrointestinal tract, kidneys and bones. Disruption of the tight hemostatic control of phosphorus balance can lead to altered cellular and organ functions that are associated with high morbidity and mortality. In the past three decades, there has been a steady increase in the prevalence of kidney failure (KF) population needing various kidney replacement therapies. The individuals with KF have unacceptably high mortality, and well over half of deaths are related to cardiovascular disease. Abnormal phosphorus metabolism is one of the major factors that is independently associated with vascular calcification and cardiovascular mortality in KF. While overt hyperphosphatemia is observed late during the progression of chronic kidney disease (CKD), a series of adaptive processes involving FGF-23, PTH and vitamin D occur in early stages of CKD attempting to enhance phosphate excretion and maintain plasma phosphorus level in the normal range. However, as CKD worsens, the ability to adequately eliminate phosphorus diminishes, eventually resulting in hyperphosphatemia, which is almost ubiquitous in individuals with KF. Notably, these hormonal imbalances and the associated adverse consequences are driven by the underlying hyperphosphatemic state in KF. Hence, it appears logical to strictly control serum phosphorus and its associated hormonal imbalance. Conventional dialysis is inadequate in removing phosphorus and most patients require dietary restrictions and pharmacologic interventions to manage hyperphosphatemia. Despite high phosphate content, plant-based diets are more efficient in controlling hyperphosphatemia as compared with animal-based diets. However, diet control comes with many challenges with adherence and may place patients at risk for inadequate protein intake and malnutrition that in turn may increase the risk of morbidity and mortality. Phosphate binders help to reduce phosphorus level but come with a sizable pill burden, have high financial cost, associated with poor adherence and psychosocial issues. Additionally, long-term use of binders may increase the risk of calcium, lanthanum or iron overload or promote gastrointestinal side effects that exacerbate malnutrition and affect quality of life. Given aforesaid challenges with phosphorus binders, novel therapies targeting small intestinal phosphate absorption pathways have been investigated. Recently, tenapanor, an agent that blocks paracellular absorption of phosphate via inhibition of enteric sodium-hydrogen-exchanger-3 (NHE3) was approved for the treatment of hyperphosphatemia in KF. While various clinical tools are now available to manage hyperphosphatemia, there is lack of convincing clinical data to demonstrate improvement in outcomes in KF with lowering of phosphorus level to near normal range. Conceivably, deleterious effects associated with hyperphosphatemia could be attributable to disruptions in phosphorus sensing mechanisms and hormonal imbalance thereof. Further exploration of mechanisms that precisely control phosphorus sensing and regulation may facilitate development of strategies to diminish the deleterious effects of phosphorus load and improve overall outcomes in KF.

Abstract: Background: Accurate diagnosis of IgE-mediated allergic diseases is crucial for effective management. This study compared the diagnostic performance of two multiplex allergy assays, AllergyChip and ALEX2, by measuring IgE reactivity to 31 inhalant allergens using serum samples from 90 participants. Methods: The qualitative analysis included calculating the Overall Percentage Agreement (OPA), Positive Percentage Agreement (PPA), and Negative Percentage Agreement (NPA) to assess test agreement. Cohen's kappa (k) quantified the strength of agreement. Receiver Operating Characteristic (ROC) analysis evaluated AllergyChip’s ability to differentiate positive and negative sIgE results. Spearman’s correlation coefficient (Rs) assessed agreement between sIgE classes, and Bland-Altman plots evaluated quantitative agreement. Results: AllergyChip showed substantial agreement with ALEX2, with an OPA of 88% and Cohen’s kappa of 0.792. AUC analysis demonstrated excellent discriminatory ability (AUC = 0.891). Spearman's correlation (Rs = 0.792) indicated significant agreement between the two assays. However, AllergyChip had lower PPA (below 70%) for 9 allergens, with particularly low rates for profilin allergens Phl p 12 (0%) and Bet v 2 (30%). Conclusions: AllergyChip performs well in detecting IgE to inhalant allergens and offers a viable alternative diagnostic tool. However, differences in sensitivity suggest that AllergyChip should complement, rather than replace, ALEX2, especially in cost-sensitive settings. Further studies are needed to confirm these findings and improve accuracy in multiplex allergy diagnostics.

Abstract: This study aimed to assess the clinical value of three-dimensional printed personalised vascular models (3DPPVM) in the arena of endovascular interventions. Four models which were 3D printed based CT images, including abdominal aorta aneurysm (AAA), carotid artery stenosis, coronary artery stenosis and renal artery stenosis were presented to clinicians for assessment of their clinical and educational value. Twenty-one clinicians from interventional radiology and vascular surgery specialties were invited to participate in the study. The clinicians comprised radiologists (n=6) and vascular surgeons (n=15); 38.1% had more than 8 years of experience; 38.1% between 3 and 8 years of experience and 23.8% had less than 3 years of experience. Of these participants, 66.7 % had not used a 3DPPVM prior to their participation. Over all the areas of experience and all four models, 75% of participants ranked the 3DPPVM models 7 out of 10 and above. The mean scores of the models across all the groups of participants were ranked from 3.2 to 4.3 out of 5. The AAA model was ranked the highest for realism and a low SD 0.89 indicating consistency amongst those participants. The carotid artery model was ranked the highest for accurately displaying anatomical structures at 4.3. All the 3DPPVM enhanced understanding of the disease demonstrated, with rankings between 3.8 and 3.95. All the models elucidated the intervention procedure required and the planning of vascular interventions, within rankings of 3.5 and 3.9. The AAA model was ranked well at 4.8 for enhancing pre-intervention simulation and interventional device selection. The highest rankings were observed in the qualified clinicians of 8 or more years of experience. The 3D printed vascular model’s potential was shown to be in education and training for clinicians and patients; and were correspondingly ranked as least limited in education and training.

Abstract: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system affecting over 2.8 million people around the world. Artificial intelligence (AI) is becoming increasingly utilized in many areas including patient care for MS. AI is revolutionizing the diagnosis and treatment of MS by enhancing the accuracy and efficiency of both processes. AI algorithms, particularly those based on machine learning, are being used to analyse medical imaging data, such as MRI scans, to detect early signs of MS, monitor disease progression and assess patient treatment response with greater precision. AI can help identify subtle changes in the brain and spinal cord that may be missed by human clinicians, leading to earlier diagnosis and more personalized treatment plans. Additionally, AI is being employed to predict disease outcomes which could allow clinicians to tailor therapies for individual patients based on their unique disease characteristics. In drug development, AI is accelerating the identification of potential therapeutic targets and the optimization of clinical trial designs, potentially leading to faster development of new treatments for MS. AI is also playing a critical role in MS fundamental research by promoting efficient analysis of vast amounts of single-cell data. Through these advancements, AI could improve the overall management of MS, offering more timely interventions and better patient outcomes. In this review we discuss these topics and whether the influence of AI on diagnosis, treatment and research of MS can change the future of this field.

Abstract: Background: Idiopathic inflammatory myopathies (IIM) also known as myositis are systemic autoimmune diseases characterized by chronic inflammation affecting the skin, muscles and internal organs. Besides traditional risk factors and immune-mediated myocarditis, continuous activity of the immune system increases cardiovascular diseases (CVD) risk resulting that cardiovascular events are leading causes of mortality in IIM pa-tients. Statins are the most widely used lipid lowering therapies, which reduce cardio-vascular risk, but the fear of muscular adverse events inhibit the frequency of use. Methods: Our aim was to assess the CVD risk in a myositis cohort using the SCORE2 prediction system, carotid artery Doppler ultrasound measurement and biomarkers; recom-mend individual lipid-lowering treatment; follow the efficacy and adverse events of ther-apy in a 6 months’ treatment period. Results: Study population (80 IIM patients) was a middle aged, female dominant myositis cohort with an average disease duration of 9 years and low median global disease activity. Based on the SCORE2 evaluation, 78.8% of patients had medium/high CVD risk as well as 73.13% had asymptomatic carotid plaque. After 6 months of adequate lipid-lowering therapy 37.5% of patients reached lower CVD risk category, the biomarker levels of atherosclerosis significantly decreased and no progression in carotid plaques have been de-tected. None of the patients reported muscular adverse event or IIM relapse. Conclusion: Our findings proved that CVD risk of patients with myositis is high, but carefully applied lipid-lowering treatment is the key to effective risk reduction. Risk strati-fication and recommendation of preventive treatment is the responsibility of treating physician.

Abstract: \textbf{Background:} Deep learning has revolutionized various fields of medical imaging, including radiology report generation. Automating radiology report generation can help alleviate radiologists' workload, reduce reporting inconsistencies, and enhance diagnostic accuracy. However, challenges such as data scarcity, model limitations, and clinical validation remain significant barriers to real-world implementation.\textbf{Objective:} This systematic review aims to synthesize existing research on deep learning-based radiology report generation, analyzing commonly used datasets, model architectures, evaluation metrics, and emerging trends.\textbf{Methods:} We conducted a comprehensive literature search across major scientific databases, selecting studies that applied deep learning techniques to generate radiology reports from medical images. Studies were categorized based on their methodologies, datasets, and evaluation approaches.\textbf{Results:} Our review of \textbf{356} studies reveals a shift from traditional CNN-RNN architectures to Transformer-based and multimodal models that incorporate both image and textual features. The most frequently used datasets include MIMIC-CXR and IU X-ray, while evaluation remains largely dependent on NLP metrics such as BLEU, ROUGE, and METEOR. Despite advancements, challenges persist in clinical accuracy, model interpretability, and real-world adoption.\textbf{Conclusion:} While deep learning has significantly advanced radiology report generation, critical issues such as data availability, evaluation standardization, and clinical integration must be addressed before widespread deployment. Future research should focus on developing knowledge-enhanced models, explainable AI techniques, and clinician-in-the-loop frameworks to ensure reliable and trustworthy AI-assisted radiology reporting.

Abstract: An electrocardiogram (ECG, or EKG) is a non-invasive recording of the heart’s electrical activity, captured via electrodes on the skin. Developed by Willem Einthoven in 1902, who later earned the 1924 Nobel Prize in Medicine, the ECG has become a fundamental tool in cardiac diagnostics. Physiologically, each heartbeat is driven by the coordinated depolarization and repolarization of cardiac muscle cells. The cardiac conduction system (including the sinoatrial node, atrioventricular node, bundle branches, and Purkinje fibers) orchestrates the orderly spread of electrical impulses through the atria and ventricles. The ECG tracings on paper or monitor represent the summation of these electrical currents over time, providing insight into heart rhythm, rate, and the integrity of myocardial tissue. Clinically, ECGs are prevalent in evaluating chest pain, palpitations, syncope, and numerous other cardiovascular presentations, and they are routinely used to screen for heart disease and monitor cardiac therapies. This paper provides an overview of ECG basics, interpretation of normal waveforms and intervals, and an in-depth review of various ECG abnormalities. We will discuss arrhythmias, conduction blocks, ischemic changes, electrolyte disturbances, and structural heart disease indications on ECG, describing their characteristic ECG features, clinical implications, pathophysiology, and common causes.

Abstract: Marker placement in a pathological node improves extirpation rates in breast cancer cases with limited axillary involvement. Our goal was to assess current indications for seed marked axillary lymph node dissection (SMALND). We conducted a descriptive observational study including 93 patients with cN1 breast cancer between January 2019 and December 2023. Seed placement was performed under ultrasound guidance days before the procedure. Intraoperative detection was achieved using a probe, and resection was confirmed radiologically. The primary indication was post neoadjuvant therapy (72 patients: 60 chemotherapy and 12 hormone therapy), followed by initial surgery (13), and single axillary recurrence (8). The extirpation rate of the marked axillary lymph node was 100%. In Target Axillary Dissection (TAD), the concordance rate between sentinel node and marked axillary node was 85%. In the 12 cases of initial surgery, axillary lymphadenectomy was avoided because the marked node matched the sentinel node and was the only one involved. The use of seeds has proven to be highly useful in axillary surgery, both in cases of negativization following neoadjuvant therapy and in those with low axillary involvement or single axillary recurrence.

Abstract: Introduction.Despite significant advancements in surgical techniques for reconstructing severely resorbed alveolar bone, achieving predictable regeneration remains a considerable challenge. Many conventional ridge augmentation methods require extended edentulous healing periods and multiple surgical interventions. This clinical study presents an innovative and simplified approach for advanced ridge augmentation using a wide-head tent-pole screw (WHTPS), designed to enhance procedural efficiency while ensuring reliable clinical outcomes. Material and Methods. Thirteen patients with severely vertically resorbed mandibular segments or completely edentulous alveolar ridges, each presenting with a minimum vertical bone defect of 5 mm or more, were included in this study. A single WHTPS was placed at the most severe bone defect site, followed by bone graft placement and coverage with a resorbable membrane. Postoperatively, a panoramic radiograph was taken, with an additional radiograph obtained on the day of WHTPS removal after a healing period of 3 to 6 months. Furthermore, a follow-up panoramic radiograph was taken after the final prosthesis placement, with an average follow-up of 5.5 months, to assess changes in the augmented alveolar bone. Patients were clinically monitored for a period ranging from 8 to 20 months, with an average duration of 13.9 months. Results. The average vertical bone gain immediately after surgery was 8.86 mm (SD: ±2.59 mm), while an average bone resorption of 1.49 mm (17.79%) was observed during the follow-up period. Conclusion. A single WHTPS effectively stabilized the graft material in cases of severe alveolar bone loss, preventing resorption and displacement. This technique simplified the surgical procedure while ensuring predictable vertical bone augmentation. Further clinical studies are required to validate its long-term effectiveness.

Abstract: Background: Silver-Russell Syndrome (SRS) is a genetic disorder characterized by prenatal and postnatal growth retardation. Affected individuals commonly present with low birth weight, intrauterine growth restriction, postnatal short stature, hemihypotrophy, characteristic facial features, and body asymmetry. Methods: This study included 24 Taiwanese children with SRS aged 2 years to 13 years and 3 months who were recruited at MacKay Memorial Hospital and other Taiwan hospitals between January 2013 and December 2024. Functional independence was assessed using the Functional Independence Measure for Children (WeeFIM) to evaluate self-care, mobility, and cognition domains. Results: The mean total WeeFIM score was 106.9 ± 23.2 (range: 54–126), with mean self-care, mobility, and cognition scores of 44.4 ± 13.8 (maximum 56), 32.4 ± 5.1 (maximum 35), and 30.2 ± 6.0 (maximum 35), respectively. The results of restricted cubic spline analysis revealed a clear positive linear correlation before school age (approximately 72 months), followed by a plateau (P for non-linearity < 0.05). Traceable molecular data were available for 13 participants, of whom nine (69%) had loss of methylation at chromosome 11p15 (11p15LOM), and four (31%) had maternal uniparental disomy of chromosome 7 (upd(7)mat). Of the 24 children, 46% required assistance with bathing, which was strongly correlated with self-care ability and body height. In contrast, most of the children had independence in mobility tasks such as walking and stair climbing. However, some required support in cognitive tasks, including problem-solving, comprehension, and expression. Overall, the included children reached a functional plateau later than the normative population, with the greatest delays in self-care and mobility domains. Conclusions: This study highlights that Taiwanese children with SRS require support in self-care and cognitive tasks. Functional independence in self-care and mobility domains was positively associated with body height. The WeeFIM questionnaire effectively identified strengths and limitations, emphasizing the need for individualized support in daily activities.