Search Results (1,566)

Chagas disease, caused by Trypanosoma cruzi (T. cruzi), includes clinically relevant intestinal inflammation; however, the mechanisms associated with tissue injury remain incompletely understood. ArtinM is an immunomodulatory lectin with known effects on innate and adaptive immunity, although its intestinal role during acute T. cruzi infection remains unclear. This study investigated whether ArtinM modulates the intestinal inflammatory response during acute experimental T. cruzi infection. In vivo, BALB/c mice were allocated to Saline control, T. cruzi + Saline, and T. cruzi + ArtinM groups. Intestinal inflammatory infiltrate and tissue concentrations of TNF-α, IFN-γ, IL-12p40, and IL-10 were quantified. Acute infection markedly increased TNF-α, IFN-γ, IL-12p40, and inflammatory infiltrate, whereas ArtinM significantly attenuated these responses. TNF-α, IFN-γ, and IL-12p40 remained associated with group after adjustment for infiltrate, whereas IL-10 reached statistical significance only in the adjusted model and was therefore interpreted cautiously. In parallel, an exploratory analysis of a public murine intestinal scRNA-seq dataset (GSE319934; GSM9529706 and GSM9529707), derived from a chronic infection setting, was performed to provide pathway-level context for inflammatory mediators assessed in vivo. This transcriptomic analysis indicated that related inflammatory, innate immune, chemotactic, and adhesion-associated genes were detectable in intestinal single-cell data from T. cruzi infection. However, because this dataset was not temporally matched to the acute model, it was not interpreted as a phase-matched comparator, mechanistic validation, or temporal extension of the experimental findings. Together, the results support that ArtinM treatment is associated with attenuation of acute intestinal inflammatory outcomes in experimental T. cruzi infection. Because local intestinal parasite burden was not measured, these findings should be interpreted as evidence of inflammatory modulation rather than as direct evidence of local antiparasitic activity. The public scRNA-seq analysis provides only exploratory contextual information for related inflammatory pathways. Full article

Jiaodong Peninsula is one of the regions with the most abundant medium–low-temperature convective geothermal resources in the eastern coastal area of China. Analyzing geothermal fluid characteristics can help understand its hydrochemical discharge characteristics and renewal capacity, and these characteristics also exhibit distinct geochemical symmetry that reflects the genesis and evolution of geothermal systems. In this study, we conducted a water quality analysis of 15 natural hot spring geothermal fluids, as well as their adjacent bedrock and Quaternary water, in the Jiaodong Peninsula. We measured deuterium and oxygen isotopes, and the γ Na/γ Cl and γ SO₄/γ Cl ratios of geothermal fluids, focusing on the geochemical symmetry of these indicators to reveal the evolutionary rules of geothermal fluids. The hydrochemical types of geothermal fluids in the Jiaodong Peninsula included Cl–Na, Cl–Na·Ca, HCO₃·SO₄–Na, and SO₄·HCO₃–Na, with mineralization degrees of 0.45–7.68 g/L and pH values of 7.3–8.63. The geothermal fluid primarily originated from the infiltration recharge of atmospheric rainfall and had no hydraulic connection with the shallow Quaternary water and adjacent bedrock water near the geothermal field. The geothermal fluid in the study area had not yet reached water–rock equilibrium. For geothermal fields with higher γ Na/γ Cl and γ SO₄/γ Cl ratios, the corresponding geothermal fluid circulation depth was relatively shallow, indicating a poorly sealed hydrodynamic environment with strong renewal capacity, where the geothermal fluid is in a continuous supply–runoff–discharge process. The γ Na/γ Cl and γ SO₄/γ Cl ratios of some geothermal fields were close to those of seawater; this symmetric difference was caused by the large circulation depth and long residence period of the geothermal fluid, which had experienced a high degree of decarbonization. Our findings on the hydrochemical characteristics and geochemical symmetry of medium–low-temperature geothermal fluids in the Jiaodong Peninsula will help deepen the understanding of the formation and evolutionary mechanism of this type of geothermal resource. Full article

Background/Objectives: Despite the substantial clinical and socioeconomic burden of chronic low back pain (CLBP), objective diagnostic biomarkers remain limited. Structural alterations of the lumbosacral muscles, particularly muscle atrophy and fatty infiltration (FI), have been proposed as imaging correlates of chronic pain. This scoping review aimed to synthesize current evidence on these alterations in CLBP and characterize the imaging and segmentation methods used. Methods: The review was conducted in accordance with PRISMA-ScR guidelines and guided by the Population–Concept–Context framework. Population: adults with CLBP. Concept: MRI segmentation techniques are used to evaluate morphological soft-tissue changes. Context: clinical and research settings using MRI for CLBP evaluation. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was performed for studies published between January 2014 and October 2024. Results: Twelve observational studies met the inclusion criteria. Degenerative alterations were consistently observed in CLBP and were not reported in control groups. Muscle atrophy was reported in ten studies (multifidus [MF]: 9; erector spinae [ES]: 7; psoas major [PM]: 2; paraspinal muscles [PPM]: 1; and increased FI in all studies (MF: 9; ES: 5; PM: 2; PPM: 2). Considerable heterogeneity between studies was noted. Conclusions: Lumbosacral muscles assessment may provide useful objective information for a more objective characterization of CLBP. Degenerative alterations were reported in all examined muscles except QL, with the MF most consistently affected. Changes in ES and PM may be specific for CLBP. The frequent co-occurrence of muscle atrophy and FI suggests that their combined evaluation may provide complementary information. Full article

Breast cancer (BC) is associated with metabolic factors that may influence circulating lipids and apolipoproteins. We performed a cross-sectional observational study including 198 women with infiltrating ductal breast carcinoma and 78 cancer-free controls. In the analyzed data, the breast cancer cohort included 39 premenopausal and 44 postmenopausal women without neoadjuvant chemotherapy (NACT), and 35 premenopausal and 54 postmenopausal women exposed to NACT; controls included 63 premenopausal and 52 postmenopausal women. Serum ApoA1 and ApoB were measured by ELISA, and HDL and LDL cholesterol were measured by enzymatic methods. Analyses included two-way ANOVA, Tukey post hoc testing, false-discovery-rate correction, and multivariable linear models adjusted for age and BMI, with HC3 robust sensitivity analyses. In cancer patients, HDL was lower in women exposed to NACT (adjusted β= −8.16, 95% CI −12.61 to −3.71), and ApoA1 differed by menopausal status. Subtype-aware analyses in the available subset did not show independent molecular subtype effects after multiplicity correction. These findings support cross-sectional associations between menopausal status, treatment exposure, and lipid/apolipoprotein profiles, but do not establish causality or prognostic value. Prospective longitudinal studies are required. Full article

Additively manufactured cellular architectures frequently exhibit brittle failure under impact due to layer-induced stress concentrations. Through the programming of architectural and material design, specifically combining Fused Deposition Modeling (FDM) lattice topology with hyperelastic polyurea infiltration, this study achieves active control over the macroscopic transition from catastrophic structural fragmentation to stable progressive collapse. To evaluate this, auxetic and honeycomb specimens printed with ABS and glass-fiber-reinforced polyamide (PA-GF) were evaluated in unreinforced and polyurea-infiltrated states under quasi-static compression, three-point bending, and Charpy impact loading. Results show that the compressive response depends primarily on cellular topology; the pure auxetic (A-A) configuration provided the highest stiffness and energy absorption. Polyurea infiltration did not significantly alter elastic stiffness but increased post-yield stability, leading to a 96.6% elastic recovery in PA-GF A-A structures. In flexure, the base polymer governed stiffness, with ABS structures measuring 68% stiffer than PA-GF. Unreinforced ABS achieved 34% higher specific energy absorption (SEA) than PA-GF under compression, with the A-H topology maximizing SEA. Under dynamic impact, PA-GF absorbed an average of 70% more energy than ABS, and the H-A configuration recorded the highest impact resistance. The addition of polyurea shifted the failure mode from brittle fragmentation to stable elastomeric deformation, increasing absorbed impact energy by 52% for ABS and over 30% for PA-GF, preventing catastrophic structural failure. Integrating topological sequencing with elastomeric confinement provides a direct method to control energy dissipation and damage tolerance in 3D-printed cellular composites. Full article

Managed aquifer recharge (MAR) is increasingly being realized as an important approach to improve water security in arid and semi-arid environments where there is a low amount of surface water and high climatic variability. This paper introduces a unified approach to the process of locating appropriate MAR locations and estimating recharge potential in Central Kazakhstan through a multi-criteria analysis using geographic information systems (GIS) and hydrogeological field exploration, water balance modelling. Remote sensing datasets and evapotranspiration (ET) analyses were conducted for the 2014–2024 period, while field investigations, infiltration tests, and hydrochemical sampling were performed during the 2025 field campaign. The suitability testing was preliminarily performed in the Google Earth Engine (GEE; Google LLC, Mountain View, CA, USA) environment as a weighted overlay test with the combination of terrain, vegetation, hydrological, and land cover parameters. According to the suitability map obtained and patterns of activity in agricultural activities, eleven candidate sites were identified, out of which eight were found to be suitable after hydrochemical analysis. The Nesterov and Boldyrev techniques of field-based infiltration tests produced a range of 0.05 to 1.42 m/day of hydraulic conductivity. Water balance analysis shows that the total amount of water that could potentially be added to groundwater recharge is about 40.2 million m³/year and that the effective amount of water could be recharged is about 11.0 million m³/year, which is limited by the infiltration processes. This means that about 27 percent of the available water is added into ground water recharge, which is a significant boost to the original estimates. The assessment of the storage capacity of the aquifers indicates that at all locations, the pore space is much greater than the recharge volumes that have been calculated and, therefore, storage is not a limiting factor in the implementation of MAR. It is estimated that the potential MAR rates range between 174 and 5282 m³/day depending on local hydrogeological conditions. The suggested method offers a powerful and generalizable site selection and measurement framework of MAR in arid areas with limited data. The findings highlight the significance of combining remote sensing, field measurements, and process-based modeling to aid sustainable groundwater management and climate adaptation strategies. Full article

Background: Neoadjuvant partial breast irradiation using stereotactic body radiotherapy (SBRT) has emerged as a strategy to induce tumor and immune responses in early-stage, low-risk breast cancer. While prior studies have demonstrated encouraging response rates and evidence of immune modulation, the optimal radiotherapy regimen for immune priming remains unclear. SIGNAL 2.0 is a randomized phase II trial designed to compare the biological and immunological impact of a single-fraction versus three-fraction neoadjuvant SBRT. Materials and Methods: Sixty-one postmenopausal patients ≥ 50 years with unifocal, hormone positive, node-negative invasive ductal carcinoma < 3 cm were randomized 1:1 to receive either 21 Gy in one fraction or 30 Gy in three fractions, delivered to the tumor in the prone position. Core biopsies were collected pre-SBRT and 14–20 days post-SBRT at the time of surgery. Immune markers were assessed using tumor-infiltrating lymphocyte (TIL) scoring, NanoString nCounter PanCancer Immune Profiling, and NanoString GeoMx Digital Spatial Profiling (DSP). Results: Available tumor samples from 47 patients underwent paired tissue analysis. Three-fraction SBRT induced 200 differentially expressed genes, including enrichment of pathways related to adaptive immune activation, with significant increases in expression levels of macrophages, dendritic cells, neutrophils and CD8 T-cells. Proteomic profiling also identified a significant increase in the expression levels of neutrophils, Treg cells, macrophages, and NK cells in the tumor microenvironment of the samples from patients receiving the three-fraction regimen. Conclusions: Neoadjuvant SBRT induces measurable immune activation, with three-fraction regimens generating more extensive transcriptional, proteomic, and cellular immune changes than a single fraction. Three-fraction neoadjuvant SBRT may provide superior immune priming, providing a foundation for future trials integrating neoadjuvant radiotherapy with immunomodulatory therapies. Full article

Herein, we report a method to additively manufacture carbon fiber-reinforced siliconized silicon carbide composites. The process involves the pyrolysis of a 3D-printed carbon fiber-reinforced poly-ether-ether-ketone (PEEK) composite to produce a porous carbon fiber-reinforced carbon matrix composite preform, which is subsequently infiltrated with molten silicon to obtain a carbon fiber-reinforced siliconized silicon carbide composite. A key aspect of the method is limiting polymer melt flow during pyrolysis of PEEK, which is achieved by thermally annealing the 3D-printed carbon fiber-reinforced PEEK preform in air at a temperature below PEEK’s melting temperature. Rheological and differential scanning calorimetry (DSC) measurements demonstrate that the thermal annealing treatment altered the melting behavior of PEEK, while NMR and FTIR measurements provided a mechanistic explanation for the structural changes responsible for the behavior. It was also found that dimensional changes during pyrolysis were anisotropic with greater shrinkage in the stacking direction of the material. Full article

Small decentralized water supply systems are often sensitive to local pollution and require a clear understanding of recharge conditions and the hydrodynamics within the water resource catchment. This study develops a conceptual hydrogeological model for the Šmarna Gora area based on geological mapping, long-term monitoring of chemical parameters, and stable isotope analyses (δ¹⁸O, δ²H) of precipitation and groundwater. The study was initiated in response to rising pollutant concentrations in the drinking water. Estimates of transit time (TT) and mean residence time (MRT) were used to characterize recharge, mixing processes, and differences between the SG and ZAVRH wells, the existing and alternative water supply wells. Isotope data show that the aquifer is predominantly recharged during colder periods and that Mediterranean air masses have become an increasingly important source of precipitation, suggesting a shift in precipitation patterns. The results indicate that SG has longer TT (6–8 months) and MRT (up to 1–2 years). In contrast, ZAVRH shows shorter TT and MRT (4–6 months), and lower pollutant concentrations. The hydrogeological regime in the catchment of the ZAVRH well is characterized by a dynamic, fast-flowing system with limited storage and more intensive dilution of contaminants by infiltrating water, whereas the catchment of the SG well functions as a deeper and more buffered aquifer with prolonged groundwater residence and a more direct hydraulic linkage to the contaminant source. The findings distinguish two hydrogeological regimes and provide a basis for planning water supply solutions and protection measures. Full article

Background: Acrylamide (ACR), a toxic compound formed during high-temperature cooking of carbohydrate-rich foods, is known to induce multi-organ toxicity, including oxidative and inflammatory lung injury. N-Acetylcysteine (NAC), a precursor of glutathione (GSH), possesses potent antioxidant and anti-inflammatory properties that may counteract ACR-induced pulmonary damage. This study investigated the protective effects of NAC against ACR-mediated lung toxicity, with an emphasis on the GSK-3β/Nrf2/NF-κB signaling axis. Methods: Forty male Wistar rats were allocated into four groups: control, NAC (250 mg/kg/day), ACR (50 mg/kg/day), and NAC + ACR. After 11 days of treatment, lung tissues were examined histopathologically using H&E, PAS, and Masson’s trichrome stains. Oxidative stress biomarkers (MDA, SOD, GPx, CAT, GSH) were quantified biochemically. Immunohistochemistry and qRT PCR assessed expression of Nrf2, NF-κB, IL-1β, and Caspase 3, while ELISA measured TNF α, IL-6, Bax, Bcl 2, and GSK 3β. Results: ACR exposure resulted in severe lung injury characterized by alveolar wall edema, epithelial hyperplasia, leukocytic infiltration, goblet cell hyperplasia, and peribronchiolar collagen deposition. These pathological changes were accompanied by a marked increase in MDA, NF-κB, IL-1β, TNF α, IL-6, Bax, Caspase 3, and GSK 3β, together with significant reductions in antioxidant enzymes and Nrf2/HO 1/NQO1 expression. NAC co-administration significantly ameliorated ACR-induced lung damage, restoring normal histological architecture, reducing fibrosis, and normalizing goblet cell activity. NAC also reversed oxidative stress, enhanced Nrf2 and downstream antioxidant responses, suppressed NF-κB-mediated inflammation, and mitigated apoptosis. Notably, NAC downregulated ACR-induced GSK 3β activation, thereby contributing to balanced redox and inflammatory signaling. Conclusions: NAC confers significant protection against ACR-induced pulmonary toxicity through its antioxidant, anti-inflammatory, and anti-apoptotic activities. These effects are mediated, at least in part, by modulation of the GSK 3β/Nrf2/NF-κB pathway. NAC demonstrates promising therapeutic potential for preventing chemically induced lung injury. Full article

(1) Background: Innate lymphoid cells (ILCs) are potent cytokine producers that regulate local immune responses in tissues. Natural killer (NK) cells belong to group 1 ILCs and play an important role in tumor clearance and defense against intracellular pathogens. ILC2 and 3 have been implied in allergic responses and other chronic inflammatory diseases. The role of these cells in the pathogenesis of chronic rhinosinusitis (CRS) is not completely understood. There are changes in the cellular infiltrate in the mucosa of patients with CRS with and without polyps. The aim of this study was to characterize the number and phenotype of NK cells, ILC2s and ILC3s in patients with CRS. (2) Methods: Tissue samples were collected from patients with CRS with and without nasal polyps who were undergoing nasal sinus surgery as well as control patients who were undergoing surgery due to non-inflammatory reasons. Lymphocytes were isolated from the tissues using mechanical and enzymatic dissociation. Peripheral blood lymphocytes were obtained from the same patients. All cells were examined by multicolor flow cytometry. NK cells were analyzed for the distribution of CD56^dimCD16⁺ and CD56^brightCD16⁻ subsets and the expression of IL18Rα, CD16, CD57, GATA3, TCF1 and NKp44. In ILC2s, GATA3 and IL18Rα expression was determined, and ILC3s as well as NKp44⁺ and NKp44⁻ILC3 subsets were analyzed for the expression of IL18Rα. (3) Results: There were significantly fewer NK cells in the nasal polyps compared to the peripheral blood of patients with CRSwNP and tissues from CRSsNP patients, which both showed higher levels of TCF1 expression. Irrespective of the disease condition, NK cells in tissues showed lower CD16 expression and a lower frequency of the CD56^dimCD16⁺ subset compared to the peripheral blood mononuclear cells. Additionally, a smaller percentage of NK cells were terminally matured, as measured by CD16⁺ and CD57⁺ expression, in all examined nasal mucosa tissues. In the tissue ILC3s, we predominantly found cells from the NKp44⁻ subset in all groups. ILC3s from CRSsNP patients showed the highest frequencies of IL18Rα⁺ cells of all examined tissues. ILC2s from the polyps ofCRSwNP patients showed higher levels of GATA3 expression than their peripheral blood counterparts. (4) Conclusions: We found that tissue-resident NK cells in mucosa from the nose and sinuses are a more heterogenous and less mature population than those in peripheral blood. Expression of the examined markers in NK cells was similar among groups. NK cell frequency, both in blood and tissue from CRSsNP patients, was higher than in the other groups, indicating that these cells might play an important role in this phenotype. Changes in the IL18Rα expression of ILC3s suggest a potential role of IL18 signaling in CRS pathogenesis. Full article

As a result of long-term groundwater overexploitation, the thickness of the vadose zone in the NCP has significantly increased, leading to changes in moisture transport patterns and groundwater recharge processes. This research gathers data on soil water potential and moisture content by conducting in situ profile monitoring of a 30.4 m thick vadose zone. A 44.5 m geological borehole was drilled for the purpose of measuring the hydraulic parameters of undisturbed soil samples, collecting ³⁶Cl isotope tracer samples, and constructing a coupling model of the unsaturated–saturated zone with a depth of 47 m. The research objectives were to examine the moisture transport law and infiltration recharge mechanisms in deep vadose zones. Comprehensive analysis shows that the average infiltration velocity is 0.661–0.743 m/a and the average recharge intensity is 103.1–115.9 mm/a. The depth and silty clay play an important role in affecting the infiltration process. The characteristics of infiltration can be divided into three segments: rapid, slow, and stagnant. The residual pore gases in the clay strata have a certain inhibitory effect on moisture transport. The time required for precipitation infiltration is 75.14 years for a 44.5 m thick vadose zone; thereafter, new water replaces old water to continue recharging the aquifer. In recent years, the government has taken multiple actions to alleviate this continuous downward trend in groundwater levels, including river ecological flow replenishment and groundwater extraction reduction. Additionally, increased precipitation since 2021 has objectively halted the previous thickening trend of the vadose zone. It is recommended to further strengthen groundwater resource management and enhance groundwater-level monitoring and warning to prevent further declines. This research holds significant implications for the evaluation and sustainable management of groundwater resources in large-scale plains in semi-humid areas. Full article

Oral squamous cell carcinoma (OSCC) shows substantial immune and clinical heterogeneity that is not fully captured by conventional clinicopathologic risk factors. This systematic review synthesized primary studies evaluating immune biomarker signatures in OSCC identified through spatial transcriptomics, single-cell transcriptomics, and artificial intelligence (AI)-enabled pathology. PubMed/MEDLINE, Scopus, and Embase were searched without language or date restrictions. Eligible studies included original human OSCC investigations reporting immune-relevant biomarker outputs derived from spatial/single-cell transcriptomics or AI-enabled pathology. Nine studies met the inclusion criteria. Six used spatial and/or single-cell transcriptomic approaches, and three used AI-enabled pathology applied to histopathological whole-slide images. Functional meta-synthesis identified four interconnected domains: AI-derived tissue immune infiltration for prognostic stratification; T-cell states and tertiary lymphoid structure-associated antitumor immunity; spatial and metabolic immunosuppressive niches; and stromal–myeloid programs linked to T-cell exhaustion and resistance. Quantitative synthesis was considered but not performed because no group of studies was sufficiently comparable in biomarker construct, comparator, outcome, and effect measure. Clinical confidence remains limited by heterogeneity and prospective validation gaps. These findings suggest that emerging OSCC immune biomarkers may integrate tissue architecture, cellular states, and stromal–immune interactions; however, the current evidence remains exploratory and requires standardized, prospective validation before clinical translation can be considered. Full article

Land degradation and declining groundwater availability threaten the sustainability of rural livelihoods across semi-arid regions. This study evaluates the hydrological performance of contour-based trenches as a low-cost and replicable nature-based solution (Nbs) for soil restoration, runoff regulation, and potential distributed managed aquifer recharge (MAR) in Guerrero, Mexico. The structures were installed on 12% slopes and designed using a simplified water balance criterion based on trench storage capacity, runoff coefficient, and representative rainfall events. Each trench was constructed along contour lines with overflow notches and connecting micro-trenches to improve hydraulic continuity, reduce erosion, and enhance infiltration opportunities under degraded field conditions. After one year of field monitoring, the trenches reached an average filling efficiency of approximately 90% per effective rainfall event, with estimated infiltration rates ranging from 0.0069 to 0.011 L·s⁻¹. Soil moisture in the upper soil layer showed a relative increase of approximately 10–18% compared to adjacent untreated areas, while visible reductions in runoff velocity, sediment transport, and surface erosion were observed across the treated plot. Based on trench storage capacity, observed infiltration behavior, and assumed deep percolation fractions, the potential induced recharge was estimated between 216 and 360 m³·yr⁻¹ (43–72 mm·yr⁻¹). These values represent indicative plot-scale estimates rather than direct measurements of aquifer recharge, since no tracer studies or piezometric validation were performed. The results demonstrate that contour-based trenches contribute not only to infiltration enhancement and runoff control, but also to short-term soil restoration and improved water availability in rainfed agricultural systems. Their low-cost implementation, combined with community-based maintenance and adaptation to local environmental conditions, makes them a viable complementary strategy for strengthening decentralized water management, soil resilience, and climate adaptation in semi-arid rural landscapes. However, long-term effectiveness remains dependent on maintenance continuity, institutional support, and local governance conditions. Further multi-year monitoring and direct hydrogeological validation are recommended to improve the design and replicability of decentralized MAR systems. Full article

Background: Differentiation therapy is a cornerstone in treating hematologic malignancies, particularly acute myeloid leukemia (AML). Differentiation agents target molecular defects blocking myeloid differentiation. However, rapid differentiation can precipitate a life-threatening complication, differentiation syndrome (DS). DS manifests with fever, pulmonary infiltrates, pleural or pericardial effusions, hypotension, and organ dysfunction, often mimicking sepsis or infection. Early recognition in the emergency department (ED) is critical to mitigate morbidity and mortality. This review aims to provide emergency clinicians with practical strategies for the timely identification and management of DS in patients undergoing differentiation therapy. Discussion: Suspicion for DS should be heightened in patients with acute promyelocytic leukemia (M3 AML) who recently started induction chemotherapy, including all-trans retinoic acid or arsenic trioxide, and in those with non-M3 AML receiving differentiation agents (i.e., isocitrate dehydrogenase inhibitors, menin inhibitors, FMS-like tyrosine kinase 3 inhibitors). Imaging can identify pulmonary infiltrates, effusions, and other cardiopulmonary manifestations. Laboratory workups should include complete blood counts with differentials, serum chemistries, cardiac biomarkers, and sepsis panels to exclude infection. Electrocardiography is advised for patients on QT-prolonging agents. Management emphasizes prompt initiation of high-dose corticosteroids and supportive measures such as blood pressure support, intravascular volume optimization, and oxygen therapy or ventilatory support. Multidisciplinary coordination with oncology, hematology, and critical care teams is important to tailor plans and monitor complications. Conclusions: DS represents a diagnostic challenge in the ED due to its nonspecific presentation and mimicry of infection. A high index of suspicion, combined with targeted imaging, laboratory evaluation, and early corticosteroid therapy, can improve outcomes. Full article