Contemporary strategies for dose optimization in pediatric congenital heart disease CT: size-specific acquisition and detector-level advances.

The weaving techniques of Nanjing Yunjin, which have been designated by UNESCO (the United Nations Educational, Scientific and Cultural Organization) as an Intangible Cultural Heritage, represent more than 1,600 years of silk - based civilization and are considered the summit of Chinese silk artistry; this piece examines the historical development of Yunjin techniques, meticulously dissects its central skills and cultural significance, centers on the present - day practices of inheritance and innovation, uncovers the process through which this "jewel among brocades" has evolved from an imperial treasure into a means of cultural creation, and offers a theoretical framework for the living continuation of intangible cultural heritage.

Spine magnetic resonance imaging is among the most frequently performed examinations in clinical radiology and places substantial demands on workflow efficiency and image quality. Over the past 20 years, acquisition times have been markedly reduced through a combination of optimized sequence parameters, advanced acceleration techniques, and modern image reconstruction methods.This article provides an overview of contemporary strategies for accelerating two-dimensional spine magnetic resonance imaging, with a focus on techniques that are robust and feasible in routine clinical practice. Classical parameter optimization, parallel imaging, compressed sensing, simultaneous multislice acquisition, and image reconstruction based on artificial intelligence are discussed with regard to their technical principles, advantages, and limitations.Particular emphasis is placed on practical protocol integration and a "how we do it" approach, illustrating how these methods can be combined to achieve substantial time savings while preserving diagnostic confidence. When applied judiciously, modern acceleration and reconstruction techniques enable efficient, high-quality spine magnetic resonance imaging and are particularly well suited for this high-volume clinical application.

Topical and systemic corticosteroids in the modern Management of Atopic Eczema: A scoping review.

The characterization of tumors as either "hot" or "cold" is determined by intrinsic properties of the cancer cells, the characteristics of the tumor immune landscape, the composition of the tumor microenvironment (TME), and underlying signaling mechanisms. These biological factors are critical in defining the clinical outcomes and therapeutic responses observed in cancer patients. The TME of glioblastoma exemplifies a case of "cold" TME, which significantly hinders antitumor immunity. This constitutes the predominant rationale underlying the ineffectiveness of immunotherapy. This review provides a thorough analysis of contemporary immunotherapeutic strategies that have been developed for the purpose of altering the immunological characteristics of tumors, with a view to achieving their effective elimination. The core mechanisms of action and future clinical applications of immune checkpoint inhibitors, adoptive cellular therapy, and oncolytic viruses (OV) are delineated. A combination of preclinical and clinical evidence suggests that OV-based combinations could be an effective treatment strategy for "cold" tumors.

Single-layer Endoscopic Repair of Anterior Skull Base Defects.

This study applies Critical Discourse Analysis (CDA) to examine the linguistic strategies employed by social media influencers on Instagram and their influence on consumer behavior. By analyzing a sample of posts from influencers in the fashion and fitness sectors, the research explores how language constructs persuasive narratives through lexical choices, framing, and engagement strategies. The study highlights the role of influencers in shaping consumer identities and reinforcing consumerist ideologies, driving followers’ purchasing decisions. Key findings show that influencers use emotional appeals, aspirational language, and direct calls to action to create a sense of community and influence consumer action. This research contributes to understanding how digital discourse on social media impacts brand perception and consumer behavior, offering valuable insights for marketers and communication scholars. The study underscores the power of language in shaping contemporary marketing strategies and calls for a deeper exploration of the power dynamics in influencer marketing.

Seed germination and early seedling development are critical determinants of crop establishment, stress tolerance, and yield stability, yet these stages remain insufficiently integrated into contemporary crop improvement strategies. Recent advances across genome editing, microbiome-assisted seed treatments, nanotechnology-enabled priming, and artificial intelligence-guided phenotyping have generated substantial but fragmented insights into early developmental regulation. This review synthesizes recent advances across early plant development research. It demonstrates that seemingly diverse technologies converge on a limited set of regulatory control nodes, including abscisic acid-gibberellin balance, redox homeostasis, and root system architectural plasticity. By integrating evidence from molecular, microbial, physicochemical, and computational studies, early plant ontogeny is presented as a tunable regulatory state governed by quantitative thresholds rather than as a strictly predetermined genetic process. Advances in deep learning, reinforcement learning, and high-throughput phenotyping further enable the modeling and optimization of early developmental trajectories across genotype by environment contexts. Together, these insights establish early development as a programmable target for crop improvement and provide a mechanistic foundation for designing integrated interventions that enhance developmental uniformity, stress resilience, and yield stability across diverse agroecological systems.

Periprosthetic humeral fractures are becoming an increasingly more relevant complication due to the growing number of shoulder arthroplasties being performed. The management of these fractures is complex and influenced by multiple factors. This article provides astructured overview of current classification systems, discusses therapeutic challenges and outlines contemporary treatment strategies for periprosthetic humeral fractures. Anarrative literature review was conducted focusing on the etiology, classification and treatment options of periprosthetic humeral fractures. Particular attention is given to the classification systems of Wright and Cofield and the classification system of Sanchez-SoteloPF with an emphasis on their relevance to surgical decision making. The management of periprosthetic humeral fractures requires an individualized approach. Nondisplaced fractures with astable implant can be treated conservatively, whereas displaced fractures or those associated with implant loosening typically necessitate surgical intervention. Surgical options include open reduction and internal fixation (ORIF), revision arthroplasty and, in selected cases, the use of custom-made implants. Early mobilization combined with interdisciplinary management is critical to achieving favorable functional outcomes. Periprosthetic humeral fractures continue to represent ademanding complication in shoulder surgery. Acomprehensive understanding of classification systems and modern treatment strategies is essential for accurate treatment planning and improved patient outcomes.

Background. The introduction of immune checkpoint inhibitors (ICIs) and targeted therapies (TTs) has fundamentally changed the clinical management of melanoma, significantly improving survival outcomes both in unresectable disease and in the adjuvant setting. At the same time, these therapeutic innovations have substantially increased healthcare expenditures, which raises the importance of pharmacoeconomic evaluation in clinical and policy decision-making. Objective: To analyze modern approaches to assessing the cost-effectiveness of pharmacotherapy using real-world data (RWD), to summarize international experience in their application, and to evaluate the prospects for implementing RWD-oriented pharmacoeconomic approaches in the healthcare system of the Russian Federation. Material and methods. Pharmacoeconomic studies published between 2010 and 2025 were analyzed using data from randomized clinical trials and real-world evidence. Key outcomes assessed included costs, effectiveness, and utility, such as quality-adjusted life years and incremental cost-effectiveness ratios. Results. In most international models, ICIs – particularly anti-рrogrammed cell death protein 1 (anti-PD-1) monotherapy – have more favorable cost-effectiveness profiles in the treatment of unresectable melanoma compared with TTs, whereas combination regimens are characterized by a substantially higher budget impact. The cost-effectiveness of adjuvant therapy largely depends on the risk of recurrence and the cost of subsequent treatment for disease progression. Several studies show the high economic value of preventive and screening interventions aimed at early melanoma detection. The review highlights the need for cautious extrapolation of international pharmacoeconomic data to the Russian setting, taking into account national pricing policies, reimbursement mechanisms, and the absence of a formally established willingness-to-pay threshold. Conclusion. The performed analysis of published studies shows that the use of RWD in pharmacoeconomic evaluations of pharmacotherapy allows refinement of model parameters and improves the robustness of economic conclusions; however, the applied approaches vary substantially in study design and data quality. The applicability of these approaches within the Russian healthcare system requires consideration of limitations related to the availability and structure of domestic RWD.

Myocardial infarction (MI) remains a major global health burden, driving substantial healthcare costs and long-term societal impact due to progressive heart failure and reduced quality of life. Conventional therapies improve survival but do not restore lost myocardial tissue. Stem cell–based cardiac regeneration represents a disruptive biomedical innovation situated at the intersection of biotechnology, translational medicine, and health systems transformation. This review examines contemporary regenerative strategies—including mesenchymal stromal cells, induced pluripotent stem cells, and cardiac progenitor cells—with emphasis on their underlying molecular mechanisms and technological advancements. Particular attention is given to exosome engineering, gene-modified stem cells, biomaterial-assisted delivery systems, hydrogel scaffolds, and tissue-engineered cardiac patches. Evidence from preclinical and clinical studies indicates functional improvements mediated predominantly through paracrine signaling, angiogenic stimulation, and immunomodulatory regulation rather than direct cardiomyocyte replacement. However, technological scalability, manufacturing standardization under GMP conditions, safety concerns, regulatory frameworks, and cost-effectiveness remain critical barriers to widespread implementation. The integration of regenerative cardiology with bioengineering, nanotechnology, and precision medicine may enable more sustainable and accessible therapeutic models. By situating stem cell–based cardiac repair within a broader innovation ecosystem, this review highlights both the transformative potential and the systemic challenges associated with next-generation cardiovascular therapies.

Injuries and diseases of the peripheral nervous system (PNS) often result in irreversible functional deficits. Current therapeutic approaches demonstrate limited efficacy, which has driven the development of regenerative medicine strategies. This review systematizes contemporary gene and cell therapy approaches aimed at PNS repair and regeneration. Key neurotrophic factors (NGF, BDNF, GDNF, VEGF, etc.) and the molecular mechanisms underlying their regenerative effects are discussed. Gene delivery strategies employing viral and plasmid vectors are analyzed, along with the therapeutic application of various cell populations, including Schwann cells, mesenchymal stromal cells, and derivatives of induced pluripotent stem cells. Particular attention is given to combined gene-cell-based approaches, which enable localized and sustained expression of therapeutic molecules. The integration of advances in genetic engineering, cell biology, and tissue engineering is shaping a new treatment paradigm focused on pathogenetic restoration of nerve tissue. These promising strategies pave the way toward achieving complete functional regeneration following PNS injuries.

Clonal haematopoiesis (CH) is an age-related condition increasingly recognised for its relevance in haematologic malignancies. In chronic lymphocytic leukaemia (CLL), its prevalence and clinical implications are gaining attention, particularly in the context of prolonged patient survival and the widespread adoption of targeted therapies. A comprehensive understanding of the biological and clinical significance of CH in CLL is therefore essential. This review synthesises current evidence on the biological basis, epidemiology and clinical impact of CH in CLL. Data from prospective clinical trials, real-world cohorts and translational studies were analysed to explore the associations between CH, genomic instability, immune dysregulation and inflammaging. Particular attention was given to the interaction between CH and contemporary therapeutic strategies, including Bruton tyrosine kinase (BTK) inhibitors and BCL2 inhibitors, and their potential influence on long-term outcomes. Available evidence indicates that CH is relatively frequent in patients with CLL and may contribute to disease biology through mechanisms involving genomic instability, chronic inflammation and immune system alterations. Emerging data suggest that CH can influence prognosis, treatment-related toxicities and cardiovascular risk, as well as predispose to therapy-related myeloid neoplasms. The interplay between CH and targeted agents may further modulate long-term outcomes, although the impact of CH on Richter transformation remains incompletely defined. CH represents a clinically relevant factor in the management of CLL in the era of targeted therapies. Its detection may have important implications for risk stratification, toxicity monitoring and survivorship care. Further prospective studies are needed to clarify its prognostic value and to integrate CH assessment into routine clinical practice and personalised treatment algorithms. Clonal haematopoiesis (CH) is common in patients with chronic lymphocytic leukaemia (CLL) and reflects age-related genomic and inflammatory remodeling of haematopoiesis. CH may influence prognosis, treatment-related toxicities, cardiovascular risk, and the development of therapy-related myeloid neoplasms. Targeted therapies, including BTK and BCL2 inhibitors, interact differently with CH compared with chemoimmunotherapy, potentially mitigating some adverse effects. Integrating CH assessment into CLL management may improve risk stratification and long-term survivorship strategies.

Two-dimensional (2D) metal monochalcogenides (MMCs) have emerged as a pivotal class of semiconductors, offering unique optoelectronic properties that bridge the gaps left by graphene and transition metal dichalcogenides. This review provides a comprehensive analysis of gallium-based MMCs, specifically GaS and GaSe, detailing their evolution from fundamental material physics to advanced device applications. We begin by elucidating the core sensing mechanisms-photoconductive, photogating, and photovoltaic effects-that govern light-matter interactions in 2D systems, followed by a rigorous definition of the figures-of-merit essential for evaluating photodetector performance. The article systematically surveys contemporary synthesis strategies, contrasting top-down exfoliation methods with bottom-up growth techniques such as chemical vapor deposition (CVD), physical vapor deposition (PVD), and pulsed laser deposition (PLD). A significant focus is placed on heterojunction engineering, highlighting how the integration of Ga-based MMCs into van der Waals heterostructures and 2D/3D interfaces can enhance carrier mobility, prolong photocarrier lifetimes, and enable self-powered operation. By synthesizing the current state of research, this work underscores the transformative potential of gallium-based MMCs in the development of next-generation, high-sensitivity multispectral photodetectors.

Nutritional disorders in early childhood remain a major global health concern, affecting physical growth, neurodevelopment, immune function, and long-term metabolic outcomes. Children under five years of age are particularly vulnerable due to rapid growth demands and increased susceptibility to environmental, infectious, and socio-economic factors. Both undernutrition (including wasting, stunting, and micronutrient deficiencies) and overnutrition (overweight and obesity) contribute significantly to pediatric morbidity worldwide. The aim of this study was to analyze the clinical patterns of nutritional disorders in children aged 6 months to 3 years and to evaluate contemporary correction strategies based on evidence-based nutritional and medical interventions. The study integrates current epidemiological data, clinical observations, and modern therapeutic recommendations, including individualized dietary planning, micronutrient supplementation, therapeutic feeding programs, probiotic support, and parental counseling. Recent evidence demonstrates that early identification through anthropometric screening and laboratory assessment significantly improves treatment outcomes. Modern correction strategies emphasize personalized nutrition plans tailored to age, metabolic needs, and comorbid conditions. Multidisciplinary management involving pediatricians, nutritionists, and caregivers has been shown to enhance recovery rates and prevent long-term developmental consequences. Early intervention is critical in minimizing irreversible growth impairment and cognitive deficits. Contemporary approaches combining nutritional therapy, education, and regular follow-up represent the most effective strategy in managing nutritional disorders in early childhood.

Enhancing the livelihood resilience of smallholder farmers has become a critical challenge in China’s contemporary agricultural development strategy. Agricultural machinery socialization services represent an important policy measure for facilitating smallholder farmers’ integration into modern agriculture and alleviating practical development constraints; however, as a substantial adjustment to farmer livelihood activities, such services may also disrupt smallholder farmers’ existing livelihood equilibria. Using survey data from smallholder farmers in the major corn-producing regions of Northeast China, this study examines the effects of agricultural machinery socialization services on smallholders’ livelihood resilience and explores the underlying mechanisms. The results show that both the breadth and depth of agricultural machinery socialization services significantly enhance smallholders’ livelihood resilience. These effects operate mainly through two pathways: an empowerment mechanism driven by farmland scale management and the professional division of labor in agriculture, and a capacity expansion mechanism driven by the extension and application of agricultural technologies and the development of social networks. Moreover, the influence of agricultural machinery socialization services on smallholders’ livelihood resilience is positively moderated by both internal perceived value and external policy incentives. Heterogeneity analysis further indicates that these services exert stronger effects on smallholder farmers’ buffering and learning capacities than on self-organizing capacity, with more pronounced impacts in plains areas than in hilly and mountainous regions. Accordingly, policy efforts should focus on the core needs of smallholder farmers by accelerating the development of a diversified, differentiated, and multi-tiered agricultural machinery socialization service system, expanding service coverage, improving service quality, and refining service mechanisms to promote sustained improvements in smallholders’ livelihood resilience.

Severe coronary artery calcification (CAC) remains a major challenge in percutaneous coronary intervention (PCI), driving stent under-expansion and higher rates of restenosis and adverse events. Balloon-based calcium modification remains central to lesion preparation, with the available tools ranging from high-pressure non-compliant balloons and ultra-high-pressure balloons to cutting, scoring, and intravascular lithotripsy (IVL) balloons. While traditional IVL has advanced the field by permitting circumferential fracture of deep calcium through acoustic shockwaves, important drawbacks persist, including problems in deliverability, energy distribution, and questionable efficacy in nodular or eccentric calcium. This review examines all contemporary balloon-based modification strategies and introduces the novel Hertz-contact IVL (HC-IVL), a new technology designed to transmit mechanical energy through direct contact rather than shockwave propagation. Based on Hertzian mechanics, this device may facilitate more focused energy delivery, improved lesion crossing, and enhanced calcium fracture in complex morphologies. A detailed comparison between HC-IVL and standard IVL is provided, along with a proposed algorithm for device selection. Taking into consideration the limitations of current tools, HC-IVL represents a promising mechanistic innovation in balloon-based calcium modification, warranting further validation in randomized, imaging-guided clinical studies.

<p><strong> </strong></p> <p>Abstract</p> <p><strong> </strong></p> <p>Background: Optimal myocardial protection remains challenging in emergency coronary revascularization, especially in patients with severely reduced left ventricular function. Contemporary cardioplegia strategies aim to limit ischemia–reperfusion injury and enhance postoperative ventricular recovery. The aim of this study was to compare operative parameters, early postoperative outcomes, and myocardial functional recovery between single-dose Del Nido cardioplegia and conventional blood cardioplegia in adults with left ventricular ejection fraction (LVEF) ≤40% undergoing emergency isolated coronary artery bypass grafting (CABG).</p> <p>Methods: This retrospective study included 150 consecutive patients with left ventricular ejection fraction (LVEF) ≤40% who underwent emergency isolated CABG between 2022 and 2024. Patients were assigned to either the Del Nido group (n=80) or the conventional blood cardioplegia group (n=70). Demographics, operative variables, postoperative complications, ventricular function changes, and short-term mortality were analyzed. Myocardial recovery was assessed using ΔEF (postoperative minus preoperative LVEF).  .</p> <p>Results: The Del Nido group demonstrated significantly shorter aortic cross-clamp and cardiopulmonary bypass times and required less intraoperative defibrillation. The incidence of postoperative atrial fibrillation was lower in the Del Nido group (18%) compared with conventional blood cardioplegia (29%). Improvement in ventricular function was greater with Del Nido (ΔEF +5.8±2.1%) than with blood cardioplegia (+3.2±2.4%). Rates of stroke, perioperative myocardial infarction, and early mortality were comparable between groups.</p> <p>Conclusion: Single-dose Del Nido cardioplegia provides effective and safe myocardial protection in emergency low-EF CABG, offering improved operative efficiency and superior early ventricular recovery without increasing perioperative complications.</p> <p><strong> </strong></p>

ABSTRACT Using policy and discourse analysis, as well as fieldwork across several island localities in Okinawa, I argue that Japan’s contemporary security strategy in Okinawa is not limited to exercising effective jurisdiction over territorial and maritime boundaries but also to incentivise the desirable movement of people and economic activity as a means of sustaining habitation of Japan’s remote border areas. In other words, internal migration governance is becoming an integral part of Japan’s security and sovereignty strategies. Although these policies are conceived as technocratic solutions, they are enacted upon border(is)lands that mark the geographic limits of the Japanese state, where colonial and post-colonial dynamics remain apparent. Using a multilevel approach, I juxtapose these dynamics with the agency of the local. At the national level, incentivising migration to Japan’s borderlands is framed as reinforcing the country’s sovereignty and security. At the local level, priorities are much more immediate – municipalities articulate their own narratives of local conditions and needs in implementing diverse policies, such as targeting specific categories of prospective migrants or creating strict selection criteria for limited housing in their attempts to strike a delicate balance between addressing labour deficits and maintaining social stability and a sense of local identity.

Abstract Craniosynostosis is a heterogeneous craniofacial disorder defined by premature fusion of one or more cranial sutures, resulting in abnormal skull growth and, in some cases, elevated intracranial pressure and neurodevelopmental compromise. Advances in pediatric neurosurgery, craniofacial surgery, and molecular genetics have substantially altered both the understanding and management of this condition. Endoscopic-assisted techniques have emerged as an alternative to traditional open cranial vault remodeling, particularly for early-presenting nonsyndromic cases, while open techniques remain essential for complex and syndromic craniosynostosis. Parallel progress in genetics has reframed craniosynostosis as a disorder of cranial suture biology, with defined molecular pathways influencing phenotype, progression, and outcome. This narrative review discusses contemporary surgical strategies, the timing of intervention in relation to neurocognitive development, challenges unique to syndromic craniosynostosis, and the expanding role of genetics and multidisciplinary care. The review aims to provide an integrated, clinically oriented perspective suitable for neurosurgical practice rather than a systematic comparison of outcomes.