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Abstract The International Agency for Research on Cancer categorized nitrosamines as potential or probable human carcinogens. Hence, nitrosamine impurities should be controlled to minimize the cancer risk. Sustainable Development Goal 9 (SDG9: Industry, Innovation, and Infrastructure), Target 9.4 was realized by developing a simple and straightforward LC-APCI-MS/MS method for simultaneous determination of potential nitrosamines: N-nitroso dimethylamine, N-nitroso di isopropyl amine, N-nitroso isopropyl ethylamine and N-nitroso methyl aminopyridine (NDMA, NDIPA, NIPEA and NMAP) in Sitagliptin Phosphate Monohydrate API (STG-API), an antidiabetic medication for type-2 diabetes and validated as per ICH (Q2 R2) guidelines. As a part of SDG9 (Industry, Innovation, and Infrastructure), Target 9.4, greater adoption of clean and environmentally sound technologies is possible by using the current analytical method in view of (a) less consumption of solvents as it has a lower run time of 18 min (b) at-line sample collection (c) simple sample preparation (d) sample preparation process that does not require derivatization or sample extraction. The optimized LC method conditions are an Agilent Poroshell EC C18 column, a flow rate of 0.6 mL/min, an injection volume of 40 µL, a column oven temperature set at 50 °C, and a sample cooler temperature set at 6 °C. A gradient method was adopted using a mixture of mobile phases (Solvent A: 0.1% formic acid in water and Solvent B: a mixture of 50% Methanol and 50% Acetonitrile). The response was obtained with Multiple Reaction Monitoring (MRM) in APCI mode. The current method can quantify NDMA, NIPEA, NDIPA, and NMAP to a lower level of 74.19 ng/g, 19.62 ng/g, 20.36 ng/g, and 13.65 ng/g, respectively, which is less than 10% of the specified limits. Good linearity in the range of Limit of Quantitation (LOQ) to 150% of the specification limit was observed, with correlation coefficients higher than 0.996. The recoveries were over the range between 90.23 and 103.36%. Assessed the method’s eco-friendliness by greenness tools like the Modified Green Analytical Procedure Index (MoGAPI), ComplexMoGAPI, Analytical GREEnness (AGREE), and Analytical Eco-Scale, and found it to be eco-friendly. Graphical Abstract

Background Hyperbaric oxygen therapy (HBOT) has been proposed as a treatment for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but evidence remains limited. This study evaluated its clinical effectiveness and feasibility, as well as associated functional brain changes. Methods Thirty patients with ME/CFS (mean age 42.3 ± 11.7 years; 7 males, 23 females) received 40 HBOT sessions. Clinical outcomes were assessed at baseline, during treatment, and four weeks post-treatment. The primary outcome was change in the physical functioning subscale of the Short Form-36 Health Survey (SF-36 PF). Secondary outcomes included severity of core symptoms assessed via questionnaires, exercise capacity, handgrip strength, cognitive performance, orthostatic intolerance, and brain magnetic resonance imaging (MRI; volumetry and functional connectivity [FC]). Thirty age- and sex-matched healthy controls (mean age 42.3 ± 11.3 years; 7 males, 23 females) were included for MRI comparison. Results SF-36 PF significantly improved during HBOT compared with baseline (g = 0.71, p = 0.006). SF-36 pain (p = 0.002, g = 0.79) and Chalder Fatigue Scale also showed clinically meaningful reductions (p < 0.001, g = −0.87). Exercise capacity (g = 0.66), muscle strength (g = 0.40), and information processing speed (g = 0.52) improved significantly after treatment (all p < 0.05). Treatment adherence was high and tolerability was favorable, with no major adverse events reported. Functional MRI analyses revealed increased thalamic FC in ME/CFS patients compared to healthy controls in bilateral sensorimotor (p < 0.001, t = 5.65, FDR-corrected) and visuo-occipital regions (p < 0.001, t = 5.40, FDR-corrected) at baseline. Following HBOT, thalamic hyperconnectivity shifted toward patterns observed in healthy controls. Responders, defined as a ≥ 10 points increase in SF-36 PF, showed greater reductions in thalamic hyperconnectivity than non-responders (p < 0.001, t = −4.34 to −5.18, FDR-corrected). Conclusions HBOT was well tolerated and associated with significant improvements in physical functioning, fatigue, pain, and cognitive performance in ME/CFS. The post-treatment shift in thalamocortical connectivity toward healthy control patterns and its association with clinical response support the hypothesis that functional thalamic dysregulation contributes to ME/CFS pathophysiology and may be modulated by HBOT. This provides a network-level rationale for controlled trials to confirm therapeutic efficacy. Trial registration https://bit.ly/3Qfo2tX NCT06118138. Registered 01 November 2023 – Retrospectively registered, https://bit.ly/3Sv957M .

Brain tumor segmentation requires precise delineation of hierarchical structures from multi-sequence MRI. However, existing deep learning methods primarily rely on visual features, showing insufficient discriminative power in ambiguous boundary regions. Moreover, they lack explicit integration of medical domain knowledge such as anatomical semantics and geometric topology. We propose a knowledge-guided framework, Synchronized Tri-modal Prior Fusion (STPF), that explicitly integrates three heterogeneous knowledge priors: pathology-driven differential features (T1ce-T1, T2-FLAIR, T1/T2) encoding contrast patterns, unsupervised semantic descriptions transformed into voxel-level guidance via spatialization operators, and geometric constraints extracted through persistent homology analysis. A dual-level fusion architecture dynamically allocates prior weights at the voxel level based on confidence and at the sample level through hypernetwork-generated conditional vectors. Furthermore, nested output heads structurally ensure the hierarchical constraint ET $$\subseteq$$ TC $$\subseteq$$ WT. STPF achieves a mean Dice coefficient of 0.868 on the BraTS 2020 dataset, surpassing the best baseline by 2.6% points (3.09% relative improvement). Notably, five-fold cross-validation yields coefficients of variation between 0.23% and 0.33%, demonstrating stable performance. Additionally, ablation experiments show that removing topological and semantic priors leads to performance degradation of 2.8% and 3.5%, respectively. By explicitly integrating medical knowledge priors—anatomical semantics and geometric constraints—STPF improves segmentation accuracy in ambiguous boundary regions while demonstrating generalization capability and clinical deployment potential.

Background South Korea’s transformation from having no plastic and reconstructive surgery capability in 1945 to becoming the global leader in aesthetic procedures per capita represents one of medicine’s most remarkable national development stories. No comprehensive historical review tracing the specialty’s complete trajectory has been published. Main text This narrative review examines the origins, key figures, institutional developments, and evolutionary trajectory of plastic and reconstructive surgery in Korea from 1884 to 2026 through historiographical analysis of primary sources including society archives, founding surgeons’ memoirs, wartime medical records, and institutional histories. Western surgery in Korea originated on December 4, 1884, when Horace Allen treated the stab wounds of Min Young-ik following the Gapsin Coup, leading to the establishment of Korea’s first Western hospital. The Korean War catalyzed the specialty’s development; D. Ralph Millard Jr. developed his globally adopted rotation-advancement flap for cleft lip repair while operating on Korean children. Lew Jae-duk obtained American Board certification and founded the first plastic and reconstructive surgery department at Yonsei University in 1961. His disciples and independently trained pioneers subsequently established departments nationwide. The specialty evolved through five distinct phases: wartime introduction (1945–1960 s), institutional foundation (1966–1975), technical specialization (1975–1985), aesthetic emergence (1985–2000), and internationalization (2000–present). Conclusions By 2026, over 2,800 specialists had been certified and the Korean Society of Plastic and Reconstructive Surgeons had grown into the world’s third-largest national plastic surgery society. The trajectory from improvised wartime care to global prominence illustrates how historical contingency, individual initiative, and socioeconomic forces shape a specialty’s development, and the reconstructive mission that defined the specialty’s emergence continues to require careful stewardship by those who inherit it.