Search Results (89)

FDO’s wide boiling range and complex composition hinder controlled synthesis of high-performance mesophase pitch. Here, FDO was separated into light, middle, and heavy narrow fractions by vacuum distillation. Multi-scale characterization traced molecular evolution and mesophase development. The light fraction consists of three-ring aromatics with short alkyl side chains and shows the lowest reactivity, yielding limited condensation and poor stacking with isotropic regions and dispersed spheres. The middle fraction contains four-ring aromatics with moderately extended chains, exhibiting enhanced reactivity and undergoing nucleation, growth, coalescence, and disintegration of mesophase spheres. However, insufficient volatiles restrict shear orientation, forming a mosaic texture. The heavy fraction has four-ring aromatics with the longest alkyl chains and the lowest substitution degree, giving the highest reactivity. During thermal cracking, long chains release abundant radicals and volatiles; directional escape generates shear, promoting rapid growth and ordered alignment of aromatic lamellae. At 440 °C for 12 h, this fraction yields high-quality mesophase pitch with small-domain texture, a low softening point (295 °C), and high anisotropic content (98.8%). The pitch shows excellent spinnability, and derived carbon fibers (tensile strength ~1.45 GPa, modulus ~151 GPa) outperform a commercial reference processed under identical conditions. This study reveals molecular-level regulation of mesophase evolution by narrow fraction structures. Full article

Background and Clinical Significance: Localized amyloidoma rarely affects the tongue base, a site far less commonly involved than the larynx. When it does occur at this location, the clinical and radiological presentation can closely mimic oropharyngeal malignancy, making it a genuine diagnostic pitfall for head and neck surgeons. Establishing the diagnosis demands histological proof, and ruling out systemic amyloidosis is an essential prerequisite. Case Presentation: An 80-year-old nonsmoking woman was evaluated for progressive dysphagia and globus sensation that had worsened over several years. Endoscopy revealed a firm, lobulated mass at the tongue base, centered on the glossotonsillar sulcus. Incisional biopsy under local anesthesia showed amyloid deposits. MRI demonstrated an avidly enhancing, well-circumscribed lesion without invasion of the deep neck spaces. A comprehensive systemic evaluation—including serum and urine protein electrophoresis with immunofixation, serum free light chains (κ/λ ratio 1.05), echocardiography, and bone marrow biopsy—yielded no evidence of systemic AL amyloidosis or plasma-cell dyscrasia. The mass was excised through transoral robotic surgery (TORS). Histopathology confirmed Congo red-positive, apple-green birefringent amyloid with lambda light-chain restriction; staining for AA amyloid and transthyretin was negative. The patient was diagnosed with primary localized lingual amyloidoma of the AL lambda type and remained symptom-free, with no endoscopic evidence of recurrence, at 12-month follow-up. Discussion: Amyloidoma deserves a place in the differential diagnosis of tongue base masses, particularly when the clinical picture does not fit squamous cell carcinoma. Congo red staining under polarized light, immunohistochemical light-chain typing, and a rigorous systemic workup are the cornerstones of diagnosis. Robotic-assisted transoral excision provides excellent access to the tongue base with low morbidity. Conclusions: This case underscores the need to consider amyloidoma when evaluating tongue base lesions, the central role of Congo red staining and light-chain typing, and the utility of TORS as an effective treatment option for selected symptomatic cases. Full article

Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease, with macrophages playing a critical role in its pathological remodeling. Our study aims to investigate the molecular basis of HCM by analyzing macrophage-related gene expression at the single-cell level. Utilizing published scRNA-seq datasets (GSE181764 and GSE161921), we identified macrophages as the key cell cluster most associated with HCM. Integration with bulk RNA-seq data (GSE249925) and differential expression analysis revealed three hub genes: ASPN (asporin), F13A1 (Coagulation Factor XIII A Chain), and SORBS2 (Sorbin and SH3 domain-containing protein 2). Immune infiltration analysis showed significant decreases in multiple immune cell subsets in HCM patients, including neutrophil and macrophages. Intercellular communication analysis revealed an approximately 50% reduction in total interactions in HCM, accompanied by markedly weakened macrophage signaling reception and loss of regulatory pathways. Single-cell validation confirmed that F13A1 expression was predominantly restricted to macrophage clusters and significantly downregulated in HCM macrophages, demonstrating strong macrophage specificity and diagnostic potential. Furthermore, a LASSO-based diagnostic model incorporating three genes (IGFBP4, FOS, CTSC) exhibited high predictive performance, with validated accuracy in both training and external validation sets. Collectively, our findings shed light on the mechanisms underlying macrophage dysfunction in HCM and offer novel insights into the cellular and molecular dynamics. Full article

The colonic epithelial barrier is a multilayered defense system comprising the mucus layer, intestinal epithelial cells (IECs), and the underlying lamina propria. These components collectively maintain mucosal homeostasis and restrict microbial translocation. Disruption of this barrier is a hallmark of chronic intestinal inflammation particularly in IBDs, and is primarily driven by pro-inflammatory cytokines, such as TNF-α, IFN-γ, IL-1β, and IL-6. TNF-α and IFN-γ synergistically induce epithelial cell apoptosis and tight junction disassembly through mechanisms involving TNFR2 upregulation, myosin light chain kinase (MLCK) activation, and adherens junction destabilization. IL-1β amplifies paracellular permeability via NF-κB-dependent MLCK induction and OCLN downregulation, while IL-6 promotes barrier leakiness by upregulating CLDN-2 and sustaining self-reinforcing inflammatory loops that maintain chronic inflammation and impede epithelial repair. This leads to persistent immune-cell infiltration, chronic tight junction remodeling, and failure of barrier replenishment. Consequently, leaky colon facilitates microbial and antigen translocation into the lamina propria, further activating immune cells and perpetuating pro-inflammatory signaling. This review synthesizes current evidence and studies on the cooperative and self-reinforcing roles of pro-inflammatory cytokines, providing insight into the mechanisms underlying chronic intestinal barrier dysfunction and highlighting the need for therapeutic strategies that simultaneously target multiple inflammatory axes to restore barrier integrity in inflammatory bowel disorders. Full article

Conventional therapies for rheumatoid arthritis (RA) are limited by poor selectivity, insufficient modulation of the oxidative inflammatory microenvironment, and systemic side effects. Oxidative stress and macrophage-driven immune dysregulation represent critical therapeutic targets. Cinnamaldehyde (CA) and arginine (Arg) possess antioxidant, anti-inflammatory, and anti-osteoclastogenic activities, but their poor solubility, instability, and lack of targeting restrict clinical application. Here, we report a pH-responsive cinnamaldehyde–arginine nanoprodrug (Arg-CA NPs), synthesized via Schiff base reaction, that spontaneously self-assembles into uniform nanoparticles capable of acid-triggered dual-drug release. Arg-CA NPs enhanced the solubility and stability of CA, exhibited excellent dispersibility and circulatory stability, and demonstrated intrinsic antioxidant and anti-inflammatory properties. Mechanistically, Arg-CA NPs attenuated intracellular ROS accumulation, preserved mitochondrial function, and reprogrammed macrophages toward an anti-inflammatory M2 phenotype by suppressing hypoxia-inducible factor-1α (HIF-1α), cyclooxygenase-2 (COX-2), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling. In an adjuvant-induced arthritis (AIA) rat model, Arg-CA NPs selectively accumulated in inflamed joints and significantly alleviated joint swelling, synovial inflammation, cartilage erosion, and bone destruction. These findings identify Arg-CA NPs as a promising redox-active nanoplatform for RA therapy by targeting oxidative stress and immune dysregulation. Full article

Botulinum neurotoxin injections are used off-label to treat chronic pain, but their efficacy is limited and paralytic effects restrict clinical utility in these applications. Here, we investigated whether combining the light chain and translocation domains of botulinum neurotoxin A (BoNT/A) with the GM1-binding B subunit of cholera toxin would be beneficial in silencing pain-associated sensory neurons. Chimeric ChoBot was assembled via a coiled-coil linking technology and was shown to retain the enzymatic activity of BoNT/A in vitro and in vivo. In cultured dorsal root ganglion neurons, ChoBot cleaved SNAP25 in a calcitonin gene-related peptide (CGRP)-rich subpopulation of sensory neurons, resulting in marked inhibition of CGRP release. ChoBot had a lesser effect on the compound muscle action potentials of the rat gastrocnemius muscle than BoNT/A following subcutaneous injections. In rat models of pain, including chemotherapy-induced peripheral neuropathy, intraplantar administration of ChoBot significantly attenuated mechanical allodynia. Immunohistochemical analysis confirmed SNAP25 cleavage in NF200- and CGRP-expressing sensory fibres in the epidermis following a single injection. ChoBot also mediated SNAP25 cleavage in human neuroblastoma cells in culture. Together, these findings indicate that ChoBot enables a silencing of pain-associated sensory pathways, providing a new strategy for the development of new long-lasting analgesics for chronic pain. Full article

Biobased hybrid semiconducting composites are attracting significant attention as sustainable alternatives to traditional inorganic photocatalysts for environmental remediation and energy-related applications. Recent research progress in biobased hybrid photocatalytic systems is critically reviewed to outline their design strategies, photocatalytic mechanisms, and environmental applications. These composites integrate bioderived polymers with metal oxide semiconductors, forming hybrid architectures that improve interfacial contact at the molecular level, enhance charge transfer efficiency, and impart higher structural flexibility. The polymer matrix not only provides mechanical adaptability and functional surface groups, but also serves as an environmentally friendly support that can modulate surface electronic states and influence the photoinduced electron–hole dynamics in the inorganic phase. By controlling the molecular interactions between the polymer chains and metal oxide surfaces, these hybrids can mitigate key limitations of conventional metal oxides, such as rapid electron–hole recombination and restricted visible-light absorption. This review first summarizes the fundamental electronic and structural properties of widely employed metal oxide semiconductors and highlights their intrinsic limitations in photocatalytic processes. It then examines the role of biopolymers from the perspective of molecular structure, charge transport pathways, and interfacial interaction mechanisms with the inorganic component. Various synthesis strategies—including sol–gel, hydrothermal, in situ nanoparticle generation, green synthesis, and surface functionalization—are discussed, with emphasis on their ability to tune the nanoscale morphology and interfacial chemistry of the hybrids. Applications of these biohybrid systems in dye degradation, pharmaceutical pollutant removal, heavy metal reduction, and antimicrobial photocatalysis are analyzed alongside mechanistic insights into charge separation efficiency and band alignment at the molecular interface. Furthermore, challenges related to long-term stability, reproducibility, scalability, and performance in real wastewater matrices are also addressed. Overall, this review provides a thorough discussion on the design principles, photocatalytic mechanism, and environmental applications of biobased hybrid semiconductors, while emphasizing future opportunities for the development of efficient and sustainable photocatalytic systems. Full article

Background: Plasma cell granuloma is generally considered a pseudotumor formed by reactive, polyclonal plasma cells. Although most cases can show polyclonal gammaglobulin production, quite a minority may exhibit monoclonal gammopathy, which mimics plasma cell neoplasms such as multiple myeloma or plasmacytoma. Because of this overlap, distinguishing reactive monoclonal proliferation from true malignancy is clinically essential. Case report: A 79-year-old man was presented with an anterior chest wall mass that had grown during investigation for fever of unknown origin. ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed a sternal bone mass (SUVmax 9.04), aortic uptake of bifurcation (SUVmax 7.08), and Th7/8 soft tissue mass (SUVmax 5.32). Results from the FDG-PET revealed infectious reactions. A chest wall biopsy revealed high degree proliferation of plasma cells. Hematologists suspected plasmacytoma. The pathologist did not diagnose plasmacytoma; thus, there remains a possibility of reactive granuloma lesion. Lastly, the patient’s vertebral soft tissue mass culture yielded Staphylococcus aureus. The patient was treated with antimicrobials and responded well. Discussion: In the presented case, FDG-PET revealed an aortic mass with an aortic aneurysm, a sternal mass, and a vertebral mass, as multiple lesions. The abscess lesions that initially resembled multiple plasmacytomas were identified as plasma cell granuloma. The final diagnosis required demonstrating biopsy and definitive monoclonality. Light-chain restriction or monoclonal protein should be considered in the clinical context. Ultimately, this case highlights the diagnostic value of FDG-PET and the importance of differentiating reactive plasma cell granuloma from true plasma cell neoplasm to guide appropriate management. In conclusion, a reactive plasma cell granuloma associated with infectious aortitis can exhibit monoclonal gammopathy, mimicking plasma cell neoplasm. Careful pathological and clinical evaluation is essential to avoid misdiagnosis and ensure proper treatment. Full article

Foods for special medical purposes play a critical role in clinical nutritional support, especially oil-in-water emulsions characterized as having high energy density, which could provide efficient energy for patients with insufficient intake or those requiring fluid restriction. The included oil types are the critical determinants of emulsion stability, which, in turn, governs digestive behavior, absorption efficiency, and ultimate bioavailability of the delivered nutrients. However, such emulsions face stability challenges during storage and application. In the present study, high-energy-density fat emulsions formulated with six typical oils, which contained 50% oil content, were prepared and systematically analyzed in terms of their particle size, zeta potential, microstructure, centrifugal stability, multiple light scattering, and rheological properties. The results indicated that oils with medium-chain fatty acids, due to their compact molecular structure and low viscosity, facilitated the formation of finer droplets and promoted the orderly arrangement of phospholipids at the interface of the emulsion system, leading to the formation of a dense, elastic interfacial layer and a gel network structure. Its marked shear-thinning characteristic and lowest frequency dependence contributed to desirable processing and storage stabilities. In contrast, long-chain triacylglycerols, especially those enriched with monounsaturated and saturated fatty acids, tended to form rigid but insufficiently elastic interfacial layers, which were unfavorable for resisting coalescence and phase separation induced by external forces. Highly unsaturated oils, on the contrary, exhibited medium levels for emulsion stability. Further analysis of the relationship between the physicochemical properties of oils and the characteristics of emulsions revealed that fatty acid species in the oil phase were the key determinants of emulsification behavior. It was therefore speculated that oils rich in medium-chain fatty acids with a moderate degree of unsaturation, especially including selected ω-3 and ω-6 fatty acids, could improve emulsion stability and fatty acid balance synchronously. This study provides a theoretical basis and technical support for the formulation design and stability control of high-energy-density fat emulsions. Full article

Mechanical recycling of polyethylene terephthalate (PET) is a key strategy for circular packaging applications; however, repeated thermo-mechanical processing leads to progressive polymer degradation. In this study, the effect of controlled repeated extrusion on the degradation behavior of bottle-grade PET was systematically investigated under laboratory conditions. Mechanical recycling was simulated using a co-rotating twin-screw extruder, where PET was subjected to up to four consecutive processing cycles corresponding to a cumulative residence time of 8 min. Progressive processing resulted in chain scission, reflected by a decrease in intrinsic viscosity from approximately 0.80 to 0.65 dL·g⁻¹ and a corresponding reduction in molecular weight. Melt flow rate increased accordingly, indicating a gradual loss of melt strength. Differential scanning calorimetry revealed that the glass transition and melting temperatures remained nearly unchanged, while the degree of crystallinity increased from approximately 23.0% to 29.5%, accompanied by changes in crystallization behavior. These structural changes led to reduced ductility, with elongation at break decreasing from about 84% to 60%. Optical analysis showed systematic material darkening, and a strong linear correlation between lightness (L*) and intrinsic viscosity was observed. By isolating intrinsic thermo-mechanical degradation effects under controlled processing conditions, this study enables a clearer definition of realistic reuse limits for mechanically recycled bottle-grade PET. The results indicate that bottle-grade PET retains properties compatible with demanding applications only after a limited number of thermo-mechanical processing cycles, whereas further processing restricts its usability to less demanding applications such as fibers, films, and non-food packaging. Full article

Background and Clinical Significance: Mantle cell lymphoma (MCL) frequently involves bone marrow, gastrointestinal tract, and hepatosplenomegaly, whereas pleural effusions are uncommon. Cases requiring invasive mechanical ventilation and thoracic drainage are rare. We report a case of MCL with persistent massive pleural effusions requiring invasive mechanical ventilation and bilateral continuous thoracic drainage. Case Presentation: A 71-year-old woman presented with dyspnea and was found to have bilateral pleural effusions and generalized lymphadenopathy. Shortly after admission, she developed acute respiratory failure due to pleural effusions and required invasive mechanical ventilation. Right-sided continuous thoracic drainage was initiated. Thereafter, more than 1 L of pleural fluid was drained each day. Flow cytometry of the pleural fluid showed CD5-positive B cells with kappa light-chain restriction. Bone marrow examination revealed abnormal lymphocyte infiltration. Cervical lymph node biopsy demonstrated diffuse proliferation of medium-sized, abnormal B lymphocytes with an immunophenotype of CD5⁺, CD19⁺, CD20⁺, cyclin D1⁺, SOX11⁺, and κ⁺, with a Ki-67 index of 20%, confirming MCL, stage IV. Immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was commenced under mechanical ventilation. Shortly thereafter, left-sided continuous thoracic drainage was also initiated. However, in response to immunochemotherapy, the bilateral pleural effusions gradually subsided, enabling extubation, and there was no reaccumulation after removal of both chest tubes. Furthermore, generalized lymphadenopathy regressed, and bone marrow examination revealed resolution of lymphoma infiltration, resulting in complete remission. Conclusions: De novo MCL complicated by persistent massive pleural effusions requiring invasive mechanical ventilation and bilateral continuous thoracic drainage is rare. A thorough diagnostic workup followed by prompt initiation of immunochemotherapy can arrest pleural output, enable extubation, and be lifesaving. Clinicians should recognize that MCL rarely presents with persistent massive pleural effusions. Full article

Amyloidosis is a group of disorders caused by extracellular deposition of insoluble fibrillar proteins, leading to progressive organ dysfunction. Cardiac amyloidosis is clinically significant, as myocardial infiltration results in restrictive cardiomyopathy, arrhythmias, and heart failure. The main subtypes are light-chain (AL) and transthyretin (ATTR) amyloidosis, while AA and isolated atrial amyloidosis (IAA) are less common. Accurate subtype identification is crucial for management and prognosis. Diagnosis requires a multimodal approach combining imaging and tissue-based techniques. Echocardiography is usually first-line, showing increased wall thickness, biatrial enlargement, and apical sparing. Cardiac magnetic resonance (CMR) provides superior tissue characterization through late gadolinium enhancement and elevated extracellular volume. Nuclear scintigraphy with 99mTc-labeled tracers enables non-invasive ATTR detection, while amyloid-specific PET tracers show potential for early diagnosis. Histochemical confirmation remains essential. Congo Red staining with apple-green birefringence under polarized light is the diagnostic gold standard, supported by Thioflavin T, PAS, and Alcian Blue stains. Immunohistochemistry and mass spectrometry aid amyloid typing, while electron microscopy provides ultrastructural confirmation. Integrating imaging, histochemical, immunohistochemical, and proteomic techniques enhances early recognition and precise classification, improving therapeutic strategies and patient outcomes. Full article

Paraneoplastic neurological syndromes (PNSs) are immune-mediated disorders caused by an antitumor response that cross-reacts with the nervous system, leading to severe and often irreversible neurological disability. Once considered exceedingly rare, PNSs are now increasingly recognized owing to the identification of novel neural autoantibodies, wider use of commercial testing, and the emergence of immune checkpoint inhibitor (ICI)-related neurotoxicity that phenotypically overlaps with classic PNS. In this narrative review, we performed a structured search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar, without date restrictions, to summarize contemporary advances in the epidemiology, pathogenesis, diagnosis, and management of PNS. Population-based data show rising incidence, largely reflecting improved ascertainment and expanding indications for ICIs. Pathogenetically, we distinguish T-cell-mediated syndromes associated with intracellular antigens from antibody-mediated disorders targeting neuronal surface proteins, integrating emerging concepts of molecular mimicry, tumor genetics, and HLA-linked susceptibility. The 2021 PNS-Care criteria are also reviewed, which replace earlier “classical/non-classical” definitions with risk-stratified phenotypes and antibodies, and demonstrate superior diagnostic performance while underscoring that “probable” and “definite” PNS should be managed with equal urgency. Newly described antibodies and methodological innovations such as PhIP-Seq, neurofilament light chain, and liquid biopsy are highlighted, which refine tumor search strategies and longitudinal monitoring. Management principles emphasize early tumor control, prompt immunotherapy, and a growing repertoire of targeted agents, alongside specific considerations for ICI-associated neurological syndromes. Remaining challenges include diagnostic delays, limited high-level evidence, and the paucity of validated biomarkers of disease activity. Future work should prioritize prospective, biomarker-driven trials and multidisciplinary pathways to shorten time to diagnosis and improve long-term outcomes in patients with PNS. Full article

Background: Renal impairment is a frequent and severe complication of multiple myeloma, most commonly caused by light-chain cast nephropathy. Therapeutic plasma exchange (TPE) has been proposed as an adjunctive approach to rapidly reduce circulating free light chains; however, its clinical benefit remains controversial. Methods: We retrospectively analyzed 71 patients treated between 2013 and 2023, of whom 30 received TPE in addition to anti-myeloma therapy and 41 received anti-myeloma therapy alone. Renal outcomes were assessed within a predefined early treatment window encompassing the first 4–6 cycles of therapy. Renal response was defined as a ≥50% reduction in serum creatinine and/or dialysis independence. Multivariable logistic regression and sensitivity analyses were performed to adjust for baseline imbalances, including renal function and anti-myeloma backbone therapy. Results: Although renal function improved significantly over time in both groups, renal response rates were comparable between patients treated with and without TPE (40% vs. 36.6%). In multivariable analysis, TPE was not independently associated with renal response. Importantly, in a sensitivity analyses restricted to patients receiving bortezomib-based regimens, the addition of TPE remained unassociated with improved renal outcomes. Conclusions: In this real-world cohort, adjunctive TPE did not confer a significant advantage in renal recovery or dialysis independence beyond contemporary anti-myeloma therapy. These findings indicate that renal recovery is predominantly driven by effective anti-myeloma treatment rather than extracorporeal light-chain removal. Full article

Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide and are strongly influenced by dietary habits. Beyond caloric intake, nutrients act as molecular signals that regulate cardiac metabolism, mitochondrial function, inflammation, and epigenetic remodeling. Objectives: This review aims to synthesize current evidence on how dietary patterns and specific nutritional interventions regulate cardiac metabolism and function through interconnected molecular and epigenetic mechanisms, highlighting their relevance for cardiovascular disease prevention. Methods: A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science, focusing on studies published between 2006 and 2025. Experimental, translational, and clinical studies addressing diet-induced modulation of cardiac metabolic pathways, oxidative and inflammatory signaling, epigenetic regulation, and gut microbiota-derived metabolites were included. Results: The analyzed literature consistently shows that unbalanced diets rich in saturated fats and refined carbohydrates impair cardiac metabolic flexibility by disrupting key nutrient-sensing pathways, including AMP-activated protein kinase (AMPK), proliferator-activated receptor alpha (PPARα), mammalian target of rapamycin (mTOR), and sirtuin 1/peroxisome proliferator-activated receptor gamma coactivator 1-alpha (SIRT1/PGC-1α), leading to mitochondrial dysfunction, oxidative stress, chronic inflammation, and maladaptive remodeling. In contrast, cardioprotective dietary patterns, such as caloric restriction (CR), intermittent fasting (IF), and Mediterranean and plant-based diets, enhance mitochondrial efficiency, redox balance, and metabolic adaptability. These effects are mediated by coordinated activation of AMPK-SIRT1 signaling, suppression of mTOR over-activation, modulation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2) pathways, and favorable epigenetic remodeling involving DNA methylation, histone modifications, and non-coding RNAs. Emerging evidence also highlights the central role of gut microbiota-derived metabolites, particularly short-chain fatty acids, in linking diet to epigenetic and metabolic regulation of cardiac function. Conclusions: Diet quality emerges as a key determinant of cardiac metabolic health, acting through integrated molecular, epigenetic, and microbiota-mediated mechanisms. Targeted nutritional strategies can induce long-lasting cardioprotective metabolic and epigenetic adaptations, supporting the concept of diet as a modifiable molecular intervention. These findings provide a mechanistic rationale for integrating personalized nutrition into cardiovascular prevention and precision cardiology, complementing standard pharmacological therapies. Full article