Highlights

1. Incretin-based therapy for cardiovascular-kidney-metabolic health This leading-edge review explores how incretin-based therapies, especially GLP-1 receptor agonists like semaglutide, are revolutionizing the treatment of type 2 diabetes, obesity, and related organ damage. While initially valued for blood sugar control, these agents are now recognized for broader benefits, including significant reductions in major cardiovascular events, improved kidney health, and relief from heart failure symptoms. The article introduces the new cardiovascular-kidney-metabolic (CKM) syndrome framework, emphasizing the deep connections between diabetes, chronic kidney disease, and cardiovascular conditions. Supported by evidence from major clinical trials, the review highlights GLP-1 as a groundbreaking therapy with multi-organ benefits for both diabetic and non-diabetic patients. Specifically, GLP-1 receptor agonists have been shown to cut major adverse cardiovascular events by 14% and all-cause mortality by 18% in type 2 diabetes patients. Semaglutide, in particular, significantly reduces major renal events by 24% and can lead to a 12.4% reduction in body weight in obese individuals without diabetes. The review champions a move away from single-disease approaches towards integrated metabolic care, positioning incretins as vital modulators in comprehensive chronic disease prevention and treatment, beyond just glucose management.1 2. Air-transferred stroke thrombectomy between Kinmen and Taipei This study demonstrates the successful use of air transport to provide acute stroke care from remote areas, showing that acute ischemic stroke patients flown from Kinmen Hospital to Taipei Veterans General Hospital (TVGH) for endovascular thrombectomy (EVT) achieved clinical outcomes comparable to those treated directly at TVGH. Even with longer onset-to-puncture times, the air-transferred group had similar 90-day functional outcomes and reperfusion rates as patients presenting directly, highlighting that interfacility air transfer for EVT is a practical approach for rapid stroke intervention in geographically isolated settings. Key factors linked to better functional recovery included younger age, shorter door-to-puncture time, and lower initial National Institutes of Health Stroke Scale (NIHSS) scores.2 3. Retinal vessel density and preclinical CADASIL cognition This study unveils a novel link between ophthalmologic imaging and cognitive neurology, showing that increased parafoveal vessel density in the superficial retinal plexus correlates significantly with lower cognitive performance in asymptomatic carriers of the NOTCH3 p.R544C mutation. These findings suggest that retinal OCT angiography could serve as an early, non-invasive biomarker for cognitive impairment in cerebral small vessel disease, enabling earlier diagnosis and preventive intervention in CADASIL even before overt stroke or dementia. The research aimed to clarify the relationship between retinal microcirculation, brain white matter hyperintensities (WMH), and cognitive decline in individuals at the preclinical stage of CADASIL. Even with subtle MRI changes, higher macular vessel density was associated with poorer memory and attention scores, possibly indicating a compensatory blood flow increase in response to early microvascular damage, which may signal an early maladaptive process in the capillary plexus. Thus, a simple eye scan could offer crucial insights into early brain changes in at-risk individuals. In summary, both WMH burden and parafoveal vessel density in the superficial retinal plexus emerge as independent indicators of cognitive function in asymptomatic NOTCH3 p.R544C mutation carriers, underscoring their potential for risk stratification and early detection.3 4. Normative study of the Taiwanese version of the MoCA Drawing on data from over 2,300 community-dwelling adults aged 50–90 years, this study establishes robust, regression-based normative values for the Taiwanese version of the Montreal Cognitive Assessment (MoCA), adjusted for age, sex, and education level. MoCA performance was significantly influenced by demographic variables, with higher education and younger age associated with superior cognitive scores. The study proposes an updated cutoff for detecting early cognitive impairment tailored to the Taiwanese population and emphasizes the need for population-specific norms to enhance diagnostic accuracy. By incorporating demographic adjustments, these findings refine the interpretation of MoCA scores and help mitigate misclassification risks in culturally and educationally diverse settings.4 5. Comprehensive genomic profiling of triple-negative breast cancer This study offers crucial genomic insights into Taiwanese triple-negative breast cancer (TNBC) by using comprehensive genomic profiling (CGP) on 104 tumor samples, revealing frequent actionable alterations including PIK3CA (38%), BRCA2 (25%), PTEN (13%), BRCA1 (13%), ERBB2 (12%), and ERBB3 (11%). After stricter filtering, PIK3CA, PTEN, BRCA2, BRCA1, AKT1, and PALB2 remained the most common potentially targetable genes. Notably, 22.2% of samples were classified as tumor mutation burden (TMB)-high, with a higher occurrence in late-stage (36%) compared to early-stage (19%) cases. The successful application of CGP highlights its clinical viability and usefulness in analyzing both single-gene changes and multi-gene signatures like TMB. These findings establish a key genomic framework for Taiwanese TNBC, potentially guiding precision oncology and broadening treatment options for this high-risk patient group.5 CONFLICTS OF INTEREST Dr. Jong-Ling Fuh, an editorial board member at the Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article.

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