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At heterojunctions between mixed ionic and electronic conductors (MIECs), band alignment takes place in order to equilibrate electronic and ionic charge carriers. The bulk properties of such MIECs can be used to describe and understand the corresponding interfacial space charges. For ultrathin films in MIEC heterolayers, however, these interfacial effects may differ from those between bulk materials. In this work, the interfacial regions between SrTiO3 (STO) and the two MIECs (La, Sr)FeO3-δ (LSF) and (La, Sr)MnO3-δ (LSM) are considered. Stacks of LSF|LSM and LSM|LSF were deposited on STO single crystals, and the resulting space-charge regions in STO are characterized by means of impedance spectroscopy at 500 °C in the p(O2) range between 1 and 5 × 10-4 bar. By extracting the STO bulk and space-charge resistances from the impedance data, space-charge potentials are derived. Interestingly, even extremely thin LSM interlayers (0.5 nm) cause bulk-like LSM band bending beneath LSF top layers. STO space charges at LSF interlayers of the same thickness, however, are strongly affected by LSM top layers. A model is introduced to interpret the measured difference in critical thicknesses of LSF and LSM in terms of different accumulation- and depletion-layer thicknesses in MIECs.

COPD is a systemic disorder associated with cognitive impairment and affective dysfunction. However, the underlying neurobiological mechanisms remain unclear. This study examines brain reorganisation in patients with COPD and investigates potential neural mediators of cognitive and affective deficits. We enrolled 51 COPD patients and 50 age- and sex-matched healthy controls. All participants underwent high-resolution structural magnetic resonance imaging (MRI) and resting-state functional MRI. Comprehensive neuropsychological assessments for cognitive function (Montreal Cognitive Assessment (MoCA)) and affective symptoms (Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI)) were conducted. Voxel-wise analyses compared grey matter volume, fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity strength between groups. Mediation analysis was performed to explore causal pathways linking COPD, brain alterations and cognitive-affective dysfunction. COPD patients exhibited significant cognitive deficits (lower MoCA scores) compared with healthy controls, and greater affective symptom burden (higher BDI and STAI scores). Neuroimaging revealed no grey matter volume differences, but distinct functional abnormalities: increased fALFF in bilateral lingual gyri and decreased fALFF in the right inferior orbitofrontal and left middle occipital regions, alongside enhanced long-range functional connectivity strength in the right frontal and fusiform areas (cluster-level p<0.05, family-wise error-corrected). Functional connectivity between bilateral lingual gyri was strengthened in those with COPD and correlated with anxiety symptoms. Critically, mediation analysis demonstrated that increased fALFF in the left lingual gyrus and enhanced interhemispheric connectivity in the lingual region mediated COPD-related cognitive decline, suggesting compensatory mechanisms. COPD is associated with functional brain reorganisation, particularly in cognitive and emotional regions, without overt structural changes. The lingual gyrus emerges as a key compensatory hub, where heightened activity and connectivity may mediate cognitive impairment. These findings illuminate neuroprotective pathways in COPD and propose the lingual gyrus as a potential target for interventions aimed at preserving cognitive function.

Effectiveness of health systems is achieved through universal coverage, while efficiency is reached by minimizing the cost of delivery. This study presents a novel analysis for designing national health systems, considering workforce, equipment, global costs and accessibility in different geographical contexts. Designed to be a medium- and long-term strategic planning tool, our model offers a practical solution by assessing projected health infrastructure and resources and evaluates health requirements using data from the OECD, the World Bank, OpenStreetMap, and national health statistics. Applied to Brazil, Finland, and France, the analysis is in line with UN Sustainable Development Goal 3.8 and the WHO's Human Resources for Health strategy. The findings suggest that regions with dispersed populations, such as central-western Brazil and northern Finland, would benefit from small hospitals, clinics and health centers. Brazil should hire more health professionals, purchase more radiotherapy equipment and invest $7.95 billion in logistics to reduce patient travel times, particularly for the 1,222 municipalities most affected by low accessibility. Finland would benefit from additional hospital beds and CT scanners, while France could benefit from a more centralized health care model, with municipalities providing all levels of care. France should also invest more in nursing staff and mammography equipment.

Tumors are highly dynamic diseases characterized by significant heterogeneity. They consist of multiple cellular populations with distinct properties that respond differently to therapeutic pressure. This heterogeneity may arise from spatial variation across tumor regions (spatial heterogeneity) as well as from temporal changes during tumor evolution and treatment (temporal heterogeneity). As a consequence, drug-resistant subclones often emerge under therapy and contribute to treatment failure. Advances in single-cell and spatial multi-omics technologies enable precise quantification of tumor heterogeneity, supporting detailed investigation of how heterogeneity contributes to chemoresistance and informing the development of personalized therapeutic strategies. In this review, we summarize the evolutionary dynamics underlying the emergence of tumor drug resistance and examine the molecular mechanisms responsible for failure of targeted therapies. We highlight how advances in single-cell and spatial multi-omics have significantly improved our ability to elucidate these processes. We further suggest that addressing tumor drug resistance may require a shift from static, single-target approaches toward dynamic, biology-informed personalized strategies. Integrating high-resolution multi-omics monitoring with functional validation could enable identification of subclonal vulnerabilities, support adaptive treatment adjustment, and contribute to more durable clinical responses.

Emerging infectious diseases (EIDs) continue to pose recurrent challenges to global health systems. Nurses, as frontline healthcare professionals, play a pivotal role in early detection, infection control, and patient management. Mpox (monkeypox) outbreaks provide a real-world stress test for evaluating nurses' preparedness for EIDs. This study assessed Chinese nurses' knowledge and attitudes toward Mpox and examined training- and professional-related determinants of preparedness. A national online cross-sectional survey was conducted among nurses in China between January and March 2024 using convenience sampling. The questionnaire covered demographic characteristics, Mpox-related knowledge (27 items), and attitudes (7 items). Descriptive statistics, correlation analyses, and multivariable linear regression were performed. A total of 387 valid responses were analyzed. Respondents were recruited from 24 provincial-level administrative regions, although the sample was concentrated in Eastern China. Overall, 81.9% of nurses demonstrated good Mpox-related knowledge, and 97.4% showed positive attitudes. Knowledge scores were positively correlated with attitudes (p&#x202f;<&#x202f;0.001). Multivariable analysis revealed that professional title and receipt of Mpox-related workplace training were independently associated with higher knowledge scores (adjusted R 2&#x202f;=&#x202f;9.0%). Professional title was also a significant determinant of attitudes (adjusted R 2&#x202f;=&#x202f;3.9%). Chinese nurses exhibited generally high levels of knowledge and positive attitudes toward Mpox in the post-outbreak period, suggesting a high baseline awareness of EIDs. Workplace training and professional role differentiation appear central to preparedness. These findings highlight the importance of sustained, structured infectious disease education and leadership-oriented training to strengthen nursing preparedness for future EID threats.

New quality productive forces are increasingly recognized as essential drivers of high-quality development in health-related industries. In the context of TCM, the synergy between talent chain and supply chain may play a pivotal role in shaping firms' capacity to contribute to public health goals. This study investigates the impact of talent-supply chain synergy on new quality productive forces in leading TCM manufacturing enterprises, and examines the mediating role of innovation investment. It also explores how regional institutional contexts, such as TCM healthcare infrastructure, education systems, and policy environments, moderate this relationship. The study utilizes panel data from 75 publicly listed TCM manufacturers in China from 2015 to 2023. A stepwise regression is conducted to assess the effects of talent-supply chain synergy on new quality productive forces and the mediating role of innovation investment. In addition, heterogeneity across regional institutional contexts, including TCM healthcare infrastructure, education systems, and policy environments, is to examine the effects of dual-chain coupling coordination vary under different contextual conditions. The results indicate that: (1) the coupled synergy between the talent chain and the supply chain significantly enhances firms' new quality productive forces; (2) innovation investment plays a critical mediating role in linking dual-chain synergy to the development of new quality productive forces; and (3) the positive effects of dual-chain synergy are more pronounced in regions with stronger TCM healthcare infrastructure, more developed TCM education systems, and more favorable policy environments. This study offers theoretical insights into how dual-chain coordination contributes to the advancement of new quality productive forces and provides practical guidance for TCM enterprises in enhancing innovation investment and optimizing their alignment with regional institutional contexts.

Climate change has become a major health concern worldwide, while the policy response to these challenges exists in silos. In democracies, the media have the power to influence the policy agenda by highlighting certain issues and they act as a key platform for debating the political, social, and health implications of climate change. This research reveals how policy discourse is communicated to the public, directly influencing the political feasibility and social acceptance of climate-health policy actions. This research presents an analysis of media coverage of government approaches and solutions across the Global North (the United States and the United Kingdom) and the South (Pakistan and India). A quantitative content analysis of two newspapers from each country, from 2015 to 2024, was conducted to analyze the government's approach. Media coverage of climate and health reveals that inaction prevails across all selected countries, while sustainable policy responses are less emphasized. Denial of the climate-health connection is more prevalent in the Global North, particularly in the United States. After 2019, media coverage showed a reactive response to the issue. Media in all countries focused on government-led initiatives to manage health issues caused by climate change (47.4 %). Even the media in the Global South missed the opportunity to highlight global cooperation for climate-health action. These findings suggest that a country-specific anticipatory approach for integrating climate and health considerations into policy and communication across regions is needed to mitigate the health impacts of climate change.

Survival after head and neck cancer treatment has improved, shifting attention toward survivorship quality and post-treatment service gaps. Evidence from China that quantifies unmet supportive care needs using standardized instruments across multiple regions remains limited. We conducted a multicenter cross-sectional study in three tertiary hospitals in East, Middle, and Southwest China. Adults with histologically confirmed head and neck cancer were recruited during routine follow-up 3 to 24&#x202f;months after curative-intent treatment. Supportive care needs were assessed with the Supportive Care Needs Survey Short Form (SCNS-SF34) and the head and neck module (SCNS-HNC), and head and neck-related quality of life was measured with University of Washington Quality of Life version 4 (UW-QOL v4). The primary outcome was any moderate-to-high unmet need on SCNS-SF34. We reported overall and hospital-specific prevalence, domain-level burden, and correlates from mixed-effects logistic regression with hospital clustering interpreted cautiously because only three centers were included. Among 1,407 surveyed survivors, 1,239 questionnaires were valid for analysis (88.1%). Overall, 78.2% reported at least one moderate-to-high unmet need. Health system and information (34.2%) and psychological needs (31.2%) were the most prevalent SCNS-SF34 domains. Dry mouth or sticky saliva (54.6%) and swallowing difficulties (36.8%) were the leading head and neck-specific unmet needs. The median number of moderate-to-high SCNS-SF34 needs per patient was 3 (IQR 2 to 5). Lower UW-QOL composite score (per 10-point decrease: aOR 1.61), rural residence (aOR 1.25), monthly household income below 5,000 CNY (aOR 1.45), stage III to IV disease (aOR 1.25), and multimorbidity of at least two comorbidities (aOR 1.83) were associated with higher odds of unmet needs. In a hospital fixed-effect sensitivity model, the direction and magnitude of the main patient-level associations were materially unchanged. Unmet supportive care needs were common among Chinese head and neck cancer survivors in early survivorship, particularly in information, psychological, salivary, and swallowing domains. The observed associations suggest that routine needs screening and multidisciplinary follow-up pathways may help identify survivors who are more likely to report substantial unmet needs, especially in socioeconomically vulnerable groups. Any service-level interpretation should remain cautious because the evidence is observational and based on three tertiary centers.

Ricinus communis L., a medicinal plant widely distributed in tropical regions, is recognized not only for its use in traditional medicine but also for its antioxidant and other bioactive properties, which are largely associated with phenolamides. But the biosynthetic pathways of phenolamides in castor remain inadequately characterized. An integrated metabolomic and transcriptomic study was conducted to investigate the biosynthesis of phenolamides in root, stem, and leaf tissues at three time points (06:00, 12:00, and 18:00). The findings revealed that N-feruloyl putrescine was the predominant phenolamide, exhibiting peak accumulation in root tissues at 06:00. Integrated omics analysis and subsequent in vitro enzymatic assays led to the identification and functional characterization of two novel BAHD hydroxycinnamoyl transferase, RcHCT1 and RcHCT2. And RcHCT1 displayed broad substrate specificity, catalyzing the formation of N-feruloyl putrescine, N-caffeoyl putrescine, p-coumaroyl putrescine, N-caffeoyl serotonin, and N-feruloyl agmatine from the corresponding substrates: putrescine, serotonin, and agmatine. In contrast, RcHCT2 exhibited narrower catalytic activity, producing only N-feruloyl putrescine and N-caffeoyl serotonin from putrescine and serotonin. Expression of both genes was also highest in roots at 06:00. And subcellular localization of RcHCT1 and RcHCT2 indicates that both proteins were localized to both the nucleus and the cytoplasm. In addition, the active pockets of RcHCT1 and RcHCT2 binding to different substrates, as well as adjacent amino acid residues, were excavated through molecular docking models. In conclusion, these findings provide critical insights into the biosynthetic pathway of phenolamides in castor, opening new avenues for its utilization in the design of bioactive molecules.

Small and medium-sized enterprises (SMEs) play an important role in employment creation and local economic stability, yet they are highly vulnerable to disasters and operational disruptions. This study synthesises existing evidence on risk management frameworks used by SMEs in low- and middle-income countries and examines how these approaches contribute to disaster risk reduction and business continuity. A PRISMA-guided systematic review was conducted using major academic databases and selected grey literature covering the period 2000 to 2025. Eligible studies examined the application or adaptation of structured risk management approaches, including enterprise risk management, business continuity management and related frameworks in SME contexts. The search identified 2 640 records, of which 76 studies met the inclusion criteria. The findings indicate that simplified versions of internationally recognised frameworks, particularly ISO-aligned risk management, COSO-based enterprise risk management and business continuity toolkits, are most frequently adopted by SMEs. Across sectors and regions, these approaches are associated with improved preparedness, increased risk awareness and shorter recovery times following disruptions. However, evidence linking adoption to sustained financial performance or long-term resilience remains limited. The review also highlights important gaps in the evidence base, including limited use of causal research designs, reliance on self-reported measures and the underrepresentation of micro, informal and women-owned enterprises. Despite these limitations, the findings suggest that proportionate and context-sensitive practices can strengthen SME preparedness and recovery capacity. Policymakers and support institutions should promote accessible guidance, phased adoption pathways and practical continuity tools to better integrate SME resilience into local disaster risk reduction strategies.

This narrative review synthesizes recent empirical studies on the mental health impacts of wildfires on children and adolescents, with specific attention to how urbanization modifies risk, access, and recovery. It addresses a critical gap in the literature by examining spatial and infrastructural inequities in post-disaster mental health outcomes while identifying key gaps in this emerging research domain. Youth exposed to wildfires exhibit high rates of PTSD, depression, and anxiety, often persisting well beyond the acute event. Urbanization intensifies these risks by expanding the wildland-urban interface and stratifying access to care. Rural and peri-urban youth face the most significant disruption, from displacement to delayed service access, yet are the least likely to receive sustained, culturally responsive interventions. This review identified a limited evidence base: among studies published since June 2024 that explicitly examined youth mental health and urbanization in wildfire contexts, only three peer-reviewed empirical studies met inclusion criteria. Among the broader wildfire-youth literature, only one employed longitudinal tracking, none used systematic geospatial mapping, and few included Indigenous or marginalized populations. Intervention models such as telehealth, allied health services, and trauma-informed school support show promise but remain unevenly implemented. The psychological burden of wildfires on youth is enhanced by trauma exposure and spatial inequity. The scarcity of research explicitly addressing urbanization's role in youth wildfire mental health represents a critical gap. Urban planning and mental health policy must be integrated to ensure that services reach underserved regions. Future research should incorporate urban-rural typologies, geospatial analysis, cultural dimensions, and developmental trajectories to inform equitable, place-based interventions for wildfire-exposed youth.

Control of classical swine fever (CSF) in endemic regions relies heavily on vaccination of breeding herds. Optimizing vaccination strategies is essential for sustainable disease control covering pigs belonging to different categories. Data describing direct comparisons between the classical C-strain and recombinant DIVA-compatible vaccines in the context of gestational timing, maternal antibody transfer, and early postnatal virological outcomes remain very limited. This study evaluated how vaccination in the middle to late pregnancy periods (at 72&#x202f;days of gestation) with either the live attenuated C-strain or the recombinant FlagT4G vaccine influences early postnatal immunity and molecular detection profiles in piglets. Sow humoral responses induced by vaccination were assessed by E2-specific blocking ELISA and virus neutralization peroxidase-linked assay (NPLA), and piglets were monitored for the presence of maternally derived antibodies as well as vaccine-derived CSFV RNA. Vaccination at 72&#x202f;days of gestation resulted in limited and transient detection of vaccine-derived RNA in piglets, without showing any clinical signs. Both vaccines induced robust E2-specific binding antibody responses in sows; however, only FlagT4G elicited high-magnitude and broadly cross-neutralizing antibody titres. Interestingly, piglets born from C-strain-vaccinated sows presented E2-specific antibodies detectable by ELISA but neutralizing activity was low and declined rapidly. In contrast, piglets derived from FlagT4G-vaccinated sows displayed stronger, more homogeneous, and functionally relevant neutralizing responses that persisted through the early neonatal period. Notably, following vaccination at 72&#x202f;days of gestation, the gradual decline of maternally derived neutralizing titres coincided with the typical weaning age (approximately 28-35&#x202f;days), potentially facilitating timely piglet vaccination with reduced interference. In a second experiment it is shown that vaccination at 44&#x202f;days of gestation with FlagT4G consistently induced high neutralizing titres in sows and a highly efficient transfer of functional maternally derived immunity to piglets, without detectable vaccine RNA at birth. Overall, gestational timing and vaccine platform critically influenced the magnitude and functional quality of maternally derived immunity. Reliance solely on ELISA-based E2 antibody detection may overestimate the presence of protective immunity, emphasizing that the quantitative and functional assessment of neutralizing responses is essential to optimize maternal immunization strategies and advance sustainable DIVA-compatible CSF control.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition marked by persistent and impairing patterns of inattention, hyperactivity, and impulsivity. Evidence from neurochemical, pharmacological, and genetic research supports the hypothesis that ADHD involves alterations in neurotransmission, primarily within dopaminergic and noradrenergic systems, with contributions from other neurotransmitter pathways and their interactions. Neuroimaging studies identify structural and functional differences in regions such as the frontal cortex and subcortical structures, although findings remain heterogeneous. Genomic research indicates a polygenic basis, with common and rare variants influencing synaptic transmission, neuronal development, regulatory pathways, and related biological processes. These studies also point to shared genetic influences between ADHD and psychological, social, and somatic traits. Additional omics approaches have further expanded these insights, although larger and more integrative studies across multiple layers remain needed. Environmental factors not only influence the onset of ADHD but also shape its course and prognosis, with emerging evidence highlighting complex gene-environment correlations and interactions. Together, the heterogeneity of findings across neuroimaging, genomic, and multi-omics studies underscores the importance of integrative approaches that embrace diversity across populations, methodologies, and biological systems. The present review provides a comprehensive overview of ADHD's biological foundations, highlighting central nervous system mechanisms, their interplay with genetic and environmental factors, and recent advances from multi-omics research with translational potential. We also discuss key methodological considerations, emphasizing that the biological architecture of ADHD is complex, highly polygenic, and spans multiple levels of analysis.

Technological-based early warning systems (EWS) in rural Indonesia have shown limited long-term adoption because centralised, top-down mechanisms fail to incorporate the contextual triggers trusted by local communities, resulting in a disconnect in how warnings are understood, leading to inappropriate responses. Field evidence reinforces this problem; the usage of Information and Communication Technology (ICT)-based disaster information systems remained below three-quarters of users and the perceived benefits were also limited. At the same time, Local Indigenous Knowledge (LIK) has long played a critical role in disaster preparedness in rural communities. Local Indigenous Knowledge demonstrated universal adoption and was consistently considered more useful in preventing loss of life, fishing gear, catch and boats. Although prior studies have attempted to integrate LIK into disaster technologies, existing frameworks rely heavily on expert-driven knowledge extraction from qualitative interviews. This approach produces expert systems with unvalidated rules, limiting their credibility and scalability. To address this gap, this study proposes a socio-technical integration framework that systematically incorporates LIK into EWS. The framework was developed through a qualitative inquiry involving 17 in-depth interviews with fishermen and a focus group discussion (FGD) with eight fishermen community leaders from three coastal provinces of Indonesia, and its contextual foundation was further validated using 438 fishermen survey across the same regions. The framework introduces three stages: (1) LIK acquisition from community experience, (2) validation through empirical community consensus and scientific explanation and (3) structured integration into EWS. This staged community validation approach reduces dependence on tacit expert judgement and supports future integration with data-supported decision processes.

Water restriction and low soil fertility under semi-arid conditions, particularly in sandy soils prone to nutrient imbalance and sodium accumulation, limit the yield and fruit quality of sour passion fruit. The application of silicone (Si) and organic matter (OM) has been proposed as a strategy to mitigate these constraints by improving plant nutrition and ionic balance. This study evaluated the effects of Si and cattle manure on the nutritional status, yield, and fruit quality of sour passion fruit. A field experiment was conducted in a randomized block design in a 5 &#xd7; 2 factorial scheme, consisting of five Si doses (0, 27, 54, 81, and 108 g plant-1) combined with the presence or absence of cattle manure, with four replications and four plants per plot. Leaf macro- and micronutrients, sodium content, fruit yield, titratable acidity, and soluble solids were evaluated. A significant interaction between Si doses and cattle manure was observed, with the combined application enhancing plant nutrition and fruit production. Silicon increased leaf concentrations of P, Ca, B, Mo, and Si while reducing Na accumulation, whereas cattle manure enhanced leaf N, K, Mg, S, and Fe contents, although it also increased Na levels. In addition, Si improved fruit quality by increasing titratable acidity and soluble solids. The highest fruit yield (15.69 kg plant-1) was obtained with 108 g plant-1 of Si in the presence of cattle manure. However, the dose of 81 g plant-1 combined with cattle manure provided the best overall agronomic performance, ensuring a more balanced improvement in nutrient status, yield, and fruit quality. Overall, the integrated use of Si and cattle management is an effective strategy to improve nutrient uptake, ionic balance, and the performance of sour passion fruit cultivated under sandy semi-arid conditions. combined with cattle manure provided the best overall agronomic performance, ensuring a more balanced improvement in nutrient status, yield, and fruit quality.

Alcohol-related liver disease (ALD) remains a leading cause of preventable morbidity and mortality in Europe. Despite robust evidence that alcohol-related population-level policies delay use initiation and reduce associated harms, their implementation in Europe has been inconsistent and frequently undermined by alcohol industry interference, fragmented governance, and policy inertia. The burden of ALD as well as combined metabolic dysfunction and alcohol-associated liver disease (MetALD) has grown steadily, driven by increased alcohol intake, widespread metabolic risk factors, delayed diagnosis, and poor integration between primary care, substance use services, endocrinology, and hepatology. In this Series paper, we combine epidemiology, policy evaluations, and clinical evidence to examine these findings through the lenses of policy, system preparedness, education, and stigma. We highlight screening strategies for alcohol use and liver disease and describe models of multidisciplinary and digital care. Finally, we outline priorities for policy reform, stigma reduction, youth-focused prevention, and research on biomarkers, pharmacotherapies, and digital/artificial intelligence tools.

There is a wide range of differential diagnoses for paravertebral masses due to complex regional anatomy of the region. Positron emission tomography can help distinguish between benign and malignant lesions; malignant lesions usually have higher 18F fluorodeoxyglucose uptake. We report the case of a 70-year-old woman with a rare benign fluorodeoxyglucose-positron emission tomography avid lesion: mediastinal hibernoma.

The aim of this study was to explore the associations between an aspect of self-regulation (SR), effortful control (EC) and cortical brain structure in 5-year-old children. Efficient EC is a predictor of many attributes and important outcomes in life, such as social-emotional functioning, finance, psychiatric and somatic health. The early brain correlates of EC are not widely studied, and a better understanding of them would aid in understanding how self-regulatory capacities emerge over development. Participants (N&#x2009;=&#x2009;155) were a part of the FinnBrain Birth Cohort Study in Finland. T1-weighted brain magnetic resonance images were processed using FreeSurfer. The data were statistically analysed with a vertex-wise general linear model. At the age of 5&#x2009;years, EC was assessed via parental report using The Children's Behaviour Questionnaire. We found positive associations between EC and cortical volume in the left supramarginal region and in the right inferior temporal region. We also found positive associations between EC and surface area on the left hemisphere in the superior parietal region. We extended the previous literature by shedding light on early structural brain correlates of EC in a large sample of typically developing 5-year-olds. The main results differed significantly from previous findings in older children. The results were only present with questionnaire- and not task-based evaluation of EC. Both questionnaire and task-based evaluations are required to consider different aspects of EC and SR. In addition, longitudinal studies are needed to better understand the neural underpinnings of SR throughout development.

This case illustrates a rare presentation of premature junctional contractions arising from the atrioventricular nodal region, particularly the slow pathway, mediated by non-sustained reentrant activity. This mechanism does not result in sustained tachycardia but instead produces isolated echo beats.