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Inclusion Criteria: * Women aged 18 and over * Having completed chemotherapy (intravenous) for breast cancer (any stage) less than 12 months prior to inclusion * Having a perceived cognitive complaint that appeared during or after (\< 3 months) chemotherapy treatments (no restriction on the care protocol used) and confirmed by a FACT-Cog score compatible with a subjective cognitive disorder (score \< 117 for patients aged 18 to 49; score \< 113 for patients aged 50 to 69; score \<105 for patients aged 70 and over) * Patient eligible for photobiomodulation sessions * Patient with sufficient command of the French language to complete the study questionnaries * Patient having given written consent to participate in the trial * Socially insured patient * Patient willing to comply with all study procedures and duration Exclusion Criteria: * Known cognitive disorders prior to chemotherapy treatment * Patients with psychiatric or psychobehavioral disorders incompatible with photobiomodulation sessions * Patients who, in the 12 months prior to inclusion or at the time of inclusion, have already received photobiomodulation treatment involving "whole body" therapy (photobiomodulation in a phototherapy booth). * Patient having previously received photobiomodulation with cortical stimulation (panel or helmet) with no time limit. * Patient taking or having received capecitabine * Patients taking part in a protocol involving a drug likely to affect cognitive performance (on the investigator's advice). * Patients suffering from claustrophobia * Patient unable to read and/or unable to complete a questionnaire, in the opinion of the investigator

Inclusion Criteria (Advanced Stage Cohort): Age ≥ 18 years; Histologically confirmed diagnosis of lung cancer (including both non-small cell lung cancer \[NSCLC\] and small cell lung cancer \[SCLC\]); Unresectable, locally advanced, metastatic, or recurrent disease classified as stage IIIB-IV according to the 8th edition of the AJCC TNM staging system; Eastern Cooperative Oncology Group (ECOG) performance status of 0-1; No prior systemic treatment (e.g., chemotherapy, anti-angiogenic therapy, targeted therapy, or immunotherapy); At least one measurable lesion as defined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1); Able to provide informed consent and voluntarily agree to participate in the study. Exclusion Criteria: Combined with other malignant tumors in the past 3 years; Concurrent acute or chronic psychiatric disorders; Current receiving anti-depressive or anti-anxiety therapy; Previous treatment with other clinical drug trials; Patients with symptomatic brain metastasis; Can't cooperate with psychological scale assessment; Inclusion Criteria (Early-Stage Surgical Cohort) Age ≥18 years; Pathologically diagnosed as non-small-cell lung cancer； Pathologically stage conformed as early stage of IA-IIIA Available for tumor tissue samples； Systematic treatments naive ( e. g., chemotherapy, anti-angiogenic drugs, targeted drugs, and immunotherapy ); Receiving radical surgery; Informed and agreed to participate in the study; Exclusion Criteria: Combined with other malignant tumors in the past 3 years; Concurrent acute or chronic psychiatric disorders; Current receiving anti-depressive or anti-anxiety therapy; Previous treatment with other clinical drug trials; Can't cooperate with psychological scale assessment; Inclusion Criteria (neoadjuvant therapy Cohort) Adults aged ≥18 years; Histologically confirmed diagnosis of non-small cell lung cancer \[NSCLC\]; Clinical stage IB-IIIB based on the 8th edition of the AJCC TNM staging system and deemed potentially resectable after neoadjuvant therapy; At least one measurable lesion can be evaluated according to the RECIST 1.1 standard; Planned to receive or currently receiving neoadjuvant systemic therapy (e.g., chemotherapy, targeted therapy, or immunotherapy) with curative intent; Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 prior to neoadjuvant treatment; No prior systemic treatment before the initiation of neoadjuvant therapy; Able to provide informed consent and voluntarily agree to participate in the study Exclusion Criteria: Combined with other malignant tumors in the past 3 years; Concurrent acute or chronic psychiatric disorders; Current receiving anti-depressive or anti-anxiety therapy; Previous treatment with other clinical drug trials; Can't cooperate with psychological scale assessment;

Inclusion Criteria: Youth between 9 to 25 years of age at inclusion, who are able to read and understand either French or English, with at least one parent or legal guardian available to consent for those under 18 years of age. Specific eligibility criteria: Help-seeking group: At least one help-seeking contact made with a primary care clinical service provider or agency (e.g, paediatric/family physician clinic, CLSC or Aire Ouverte) for a mental health concern (i.e., clinical needs). Non help-seeking group: At least one of the birth parents or siblings have received psychiatric care for a diagnosis of DMDs (i.e., family needs) OR Being in contact with community agencies that provide youth-centred social services for food, housing, social discrimination (e.g., racialized youth, LGBTQ2SIA+) (i.e., social needs) OR Having a diagnosed chronic physical illness that is expected to require treatment for \>12 months (e.g., diabetes, asthma to name a few) (i.e., physical health needs) Exclusion Criteria: * Due to the requirements of assessment procedures, youth who cannot communicate verbally due to known neurological conditions or intellectual disabilities will not be included. Youth who are already diagnosed with one of the DMDs by a physician and currently prescribed a treatment targeting the diagnosed condition (pharmacological or psychotherapeutic interventions), will not be eligible for inclusion. Importantly, no one will be excluded based on sex, gender, health insurance status, ethnicity, income status, ability to travel or living arrangements. If a participant initially approached through the referral pathways for non help-seeking individuals turns out to have had at least one help-seeking contact for a mental health concern (i.e., clinical needs), the participant will still be included but classified as part of the help-seeking group. We anticipate non help-seeking referrals to satisfy more than one criteria. Their occurrence and distribution will be recorded in detail as part of our assessment procedure.

Inclusion Criteria: * 1\. Chronic mental illness patients, 2. Mini-Mental State Examination (MMSE) ≥ 16 points, 3. Education level is junior high school graduates or above, 4. Appropriate oral expression ability, 5. Those who can complete the research consent form, 6. Those who are willing to participate in this study Exclusion Criteria: * 1\. Those with obvious risk of violence or suicide 2. People with cognitive impairment who have been diagnosed with mental retardation or autism

Inclusion Criteria: * Age≥18 years old; * Including but not limited to patients requiring TIPS for: acute esophageal/gastric variceal bleeding, portal hypertensive gastropathy, cirrhotic ascites, cirrhotic hydrothorax, hepatorenal syndrome, Budd-Chiari syndrome, atypical portal hypertension, portal vein thrombosis, prevention of recurrent esophageal/gastric variceal bleeding, or prevention of recurrent ectopic variceal bleeding; * Deemed by clinicians to require Transjugular Intrahepatic Portosystemic Shunt (TIPS) * Voluntarily signed informed consent form Exclusion Criteria: * Severe right heart failure, congestive heart failure (ejection fraction \<40%), or severe valvular heart disease; * Persistent severe pulmonary hypertension (mean pulmonary artery pressure \>45 mmHg) despite treatment; * Uncontrolled systemic infection or inflammation; * Hepatic encephalopathy stage III-IV; * Presence of cardiac pacemaker, metallic implants, or other conditions susceptible to electromagnetic interference; * Pregnancy or lactation; * Poor visualization of the portal venous system on ultrasound; * Investigator-determined unsuitability for study participation.

Inclusion Criteria: * Stage II-III breast cancer patients, excluding occult breast cancer, inflammatory breast cancer, metaplasia breast cancer * TNBC patients. TNBC was defined as ER \<= 10%, PR \<=10%, HER 0-1, or HER2 2+ and FISH negative. Exclusion Criteria: \-

Inclusion Criteria: * Female patients with newly diagnosed primary breast cancer, aged 18 to 70 years, confirmed by histopathology. * Willing to undergo breast-conserving surgery, concurrent silicone prosthesis breast reconstruction, or breast reconstruction with 3D-printed biodegradable material breast implants. * Having indications for subcutaneous glandectomy that preserves the nipples and areolas. * ECOG performance status score: 0-1. * If receiving neoadjuvant chemotherapy, the interval between chemotherapy completion and surgery is less than 8 weeks. * Good compliance with the planned treatment, ability to understand the study procedures, and willingness to sign the written informed consent form. Exclusion Criteria: * Age \> 70 years. * Newly diagnosed stage IV metastatic breast cancer. * Multicentric, extensive, or diffuse lesions; or inflammatory breast cancer. * Tumor invasion of the papillary areola complex. * Inability to accept/tolerate radiotherapy. * Breast cancer during pregnancy. * History of other malignant tumors within the past five years (except cured cervical carcinoma in situ and non-melanoma skin cancer). * Abnormal functions of vital organs (heart, lungs, liver, kidneys), poorly controlled diabetes, or other conditions that preclude surgery tolerance. * Patients deemed unsuitable for participation by the researchers.

Inclusion Criteria: * 18 years old or older * Healthy volunteers or semaglutide users Exclusion Criteria: * Bariatric surgery * Hiatal hernia * Impairment to give consent

Inclusion Criteria: 1. Aged ≥ 18 years old at the time of signing the informed consent form, regardless of gender; 2. Patient must meet one of the following pathological diagnoses and classifications: 2.1) For TNBC Cohort: -Histological/cytological confirmed of triple-negative breast cancer (TNBC) from the most recent pre-SKB264 biopsy/pathological report, with: HER2 negative: immunohistochemistry (IHC) of 0 or 1+; if is 2+ by IHC, negative HER2 expression must be confirmed by fluorescence in situ hybridization (FISH); Estrogen and progesterone receptor negative means that less than 1% of the cells express hormone receptors as indicated by IHC; -Locally advanced, recurrent, or metastatic disease (locally advanced disease should be confirmed by investigators as ineligible for curative resection); 2.2) For HR+/HER2- BC Cohort: -Histological/cytological confirmed of HR+/HER2- breast cancer from the most recent pre-SKB264 biopsy/pathological report, with: HER2 negative: IHC of 0 or 1+; if is 2+ by IHC, negative HER2 expression must be confirmed by FISH; HR positive: Hormone receptor-positive (HR, ER, or PR status) was defined as ≥1% expression by IHC.-Locally advanced, recurrent, or metastatic disease (locally advanced disease should be confirmed by investigators as ineligible for curative resection); 3. Plan to receive SKB264 monotherapy or combination therapy; 4. Prior treatment lines: -For TNBC Cohort: ≤2 lines of systemic antitumor therapy for unresectable locally advanced, recurrent, or metastatic disease; -For HR+/HER2- BC Cohort: ≤2 lines of systemic antitumor therapy (excluding endocrine therapy) for unresectable locally advanced, recurrent, or metastatic disease; 5. Voluntarily participate in the study, sign the informed consent form and demonstrate good compliance. Exclusion Criteria: 1. Patients with other malignancies, except cured basal or squamous cell skin cancer or in situ cancer of cervix; and patients with other malignancies must have a tumor-free period of at least 5 years; 2. Patients who are currently participating in other interventional clinical studies; 3. Known allergy to the investigational drug or any of its components; 4. Pregnant or lactating women; 5. Any situation that the researchers consider to interfere with the evaluation of the study drug or the safety of the subjects or the analysis of the study results, or any other situation that the researchers consider inappropriate to participate in this study.

Inclusion Criteria: * Clinician participants: Counselors will be included if they (a) provide school-based services; (b) have not previously received formal training in BRISC; and (c) are not actively receiving support to implement another intervention. * Youth participants: Students must meet eligibility criteria for BRISC including (a) being in grades 9-12 and 13 years or older (b) receiving school mental health services Exclusion Criteria: * Anyone not meeting inclusion criteria.

Inclusion Criteria: * Individuals with at least 365 days of continuous observation prior to the index date (defined as the date of first antihypertensive medication prescription), with no prior antihypertensive use during that period * At least one diagnosis of hypertension (ICD-10 codes I10-I13, I15) recorded within 180 days before the index date Exclusion Criteria (main cohort): * Any of the following occurring in the 365 days prior to the index date: Hospitalization (inpatient admission, including long-term care facility), transport-related trauma (ICD-10 codes V01-V99), Intentional self-harm (ICD-10 codes X60-X84, Y87), History of pathological fractures (e.g., M84.4, M90.7), Evidence of end-stage renal disease (ESRD), dialysis, kidney transplant, renal osteodystrophy

Inclusion Criteria: 1. To be aged between 18 and 65. 2. To meet the DSM-IV criteria for BPD. 3. To present a moderate depressive episode, defined as a MADRS score ≥ 20 (V1 and V3). 4. To be capable to consent to participate in the study. 5. To speak either French or English. 6. Participants must have a prescribing doctor or mental health professional responsible 7. To maintain a stable psychopharmacological and psychotherapeutic intervention. 8. To have access to internet an a smartphone. 9. To demonstrate proficiency in independently using a tDCS device. 10. To be able to pick up and return the remote tDCS device. Exclusion Criteria: \- 1. To have a history of Epilepsy. 2. To have a contraindication for tDCS Medical Devices. 3. To have a history of Cerebrovascular Surgery. 4. To present scalp Conditions Affecting tDCS Electrode Placement. 5. To have a history of bipolar disorder. 6. To present social or medical conditions limiting the autonomous use of remote tDCS. 7\. To be pregnant. 8. To be currently undergoing neuromodulation treatment. 9. To be currently using benzodiazepines.

Inclusion Criteria: * Patients with cataract and early-to-moderate pseudoexfoliative glaucoma (GPX) scheduled for isolated cataract surgery. * Reliable visual field, Humphrey 24-2, Sita-Fast, with typical glaucoma alterations, and with mean deviation ≤-12 dB. * OCT with ganglion cell alterations and fibers typical of glaucoma. * Typical glaucomatous neuropathy * Slit-lamp signs of pseudoexfoliation. * Open angle (2 to 4, according to Shaffer classification) determined by gonioscopy. * Untreated eye pressure \>21 mmHg and \<33 mmHg Exclusion Criteria: * Presence of other ophthalmological pathologies (except cataract or mild dry eye) * History of intraocular surgery in the last 12 months, history of trauma * History of laser trabeculoplasty (TLA or SLT) in the previous 12 months * Visual acuity below "finger count * Myopia ≥ 6 dioptres, hyperopia ≥ 5 dioptres * Iridocorneal angle closure (and angle-closure glaucoma), any other type of non-pseudoexfoliative glaucoma, iris neovascularization * Pachymetry \< 490 μm or \> 620 μm; or corneal pathology or other condition that makes accurate IOP measurements with flattening tonometry, ultrasonic pachymetry or specular microscopy impossible. * Presence of severe systemic pathologies

Key Inclusion Criteria: * Metastatic or locally advanced and unresectable solid tumor that has progressed on or after at least one available therapy. * Tumor harboring an activating PIK3CA mutation detected in either tumor tissue or ctDNA. * At least 1 measurable lesion or evaluable disease per RECIST v1.1. * An ECOG performance status score of 0 or 1. * Adequate organ function. Additional key inclusion criterion for Parts B and C: \- Confirmed metastatic or locally advanced HR+/HER2- breast cancer not amenable to surgical resection with curative intent and must have received at least 1 prior CDK4/6 inhibitor and at least 1 prior anti-estrogen therapy. Key Exclusion Criteria: * Has history (within ≤2 years before screening) of a solid tumor or hematological malignancy that is histologically distinct from the cancers being studied. * Has symptomatic brain or spinal metastases or a known or suspected history of untreated or uncontrolled central nervous system (CNS) involvement. * Has an established diagnosis of diabetes mellitus type 1 or has uncontrolled diabetes mellitus type 2. * Has received treatment with any local or systemic anticancer therapy or investigational anticancer agent within 14 days prior to start of treatment. * Has toxicities from previous anticancer therapies that have not resolved to baseline levels with the exception of alopecia and peripheral neuropathy. * Has had radiotherapy outside the target tumor lesions within 14 days prior to start of treatment.

Inclusion Criteria: * Male or female subjects, 45 years or older * Visually significant age-related cataract and requiring phacoemulsification cataract surgery, OR, pseudophakic and a minimum of six months since cataract surgery. * Intraocular pressure (IOP) at the Screening visit not exceeding 33 mmHg and at least 21 mmHg for unmedicated eyes or 16 mmHg if medicated (1 to 4 ocular hypotensive medications - fixed combinations count as the number of components), with a stable medication regimen for ≥2 months. * Diagnosed with mild to moderate primary open angle glaucoma (POAG). Diagnosis must include evidence of glaucomatous optic nerve damage or visual field defect consistent with glaucomatous optic nerve damage Exclusion Criteria: * Any of the following prior ocular procedures: * Laser trabeculoplasty ≤180 days prior to baseline * Durysta ≤12 months prior to baseline * Any implanted glaucoma device * Prior canaloplasty, goniotomy, trabeculotomy, trabeculectomy * Ciliary ablation including endoscopic cyclophotocoagulation (ECP), Cyclophotocoagulation or CPC (G probe), high intensity focused ultrasound (HIFU), ≤180 days prior to baseline * Retinal laser procedure ≤3 months prior to baseline * Any form of glaucoma other than POAG. * Use of topical ocular steroids. * Clinically significant concurrent ocular pathology or systemic medical condition which, in the Investigator's judgment, would either place the subject at increased risk of complications, contraindicate surgery, place the subject at risk of significant vision loss during the study period (e.g., wet age-related macular degeneration (AMD), corneal edema, Fuch's dystrophy, active intraocular infection or inflammation within 30 days prior to Screening Visit, etc.), or interfere with compliance to elements of the study protocol (e.g., returning to Investigator's office for follow-up visits). Dry AMD and Non- proliferative diabetic retinopathy are not excluded. * History of penetrating keratoplasty or another corneal transplant; corneal abnormality that would prevent reliable IOP measurement, e.g. keratoconus or abnormally thick (≥ 620 µM) or thin (≤ 480 µM) cornea. * Retrobulbar tumor, thyroid eye disease, Sturge-Weber Syndrome or any other type of condition that may cause elevated episcleral venous pressure. * BCVA of logMAR 0.4 (20/50) or worse in the study eye not due to cataract. * BCVA of logMAR 0.6 (20/80) or worse in the non-study eye not due to cataract.

Inclusion Criteria: * Females and males aged 18-70 years; * ECOG performance status 0-1; * Early-stage breast cancer, with postoperative pathology confirming invasive carcinoma, HR-positive and HER2-negative (In this study, HR-positive is defined as: ER-positive by IHC with \>10% tumor cells staining positive; HER2-negative defined as HER2 0-1+ by IHC or HER2++ with negative FISH result, without amplification); * Postoperative pathological stage pT2N0M0 and: Histological grade 3, or Histological grade 2 with Ki67 ≥ 20% or high-risk multigene assay results; * No prior neoadjuvant therapy received; * Good postoperative recovery, with randomization occurring no more than 8 weeks after surgery; * Normal function of major organs, meeting the following criteria: Hematological tests must meet: HB ≥90 g/L (no transfusion within 14 days); ANC ≥1.5×10⁹/L; PLT ≥100×10⁹/L; Biochemical tests must meet: TBIL ≤1.5×ULN (upper limit of normal); ALT and AST ≤3×ULN; serum Cr ≤1.5×ULN; * Contraception required for male participants and women of childbearing potential during treatment; * Participants voluntarily enroll in the study, sign informed consent, demonstrate good compliance, and cooperate with follow-up. Exclusion Criteria: * Bilateral breast cancer or carcinoma in situ (DCIS/LCIS); * Metastasis at any site; * Clinical or imaging suspicion of malignancy in the contralateral breast requiring biopsy (unless ruled out); * Prior neoadjuvant therapy, including chemotherapy, radiotherapy, or endocrine therapy; * Use of tamoxifen, raloxifene, or aromatase inhibitors (AIs) for breast cancer risk reduction ("chemoprevention") and/or osteoporosis treatment within the past 2 years; * History of other malignancies within the past 5 years (except basal cell carcinoma of the skin or carcinoma in situ of the cervix), including contralateral breast cancer; * Concurrent participation in another clinical trial; * Severe systemic diseases and/or uncontrolled infections that preclude study participation; * Severe cardiovascular or cerebrovascular events within 6 months before randomization (e.g., unstable angina, chronic heart failure, uncontrolled hypertension \>150/90 mmHg, myocardial infarction, or stroke); * Known hypersensitivity to the study drugs; * Men and women of childbearing potential unwilling to use contraception during treatment and for 8 weeks after treatment completion; * Pregnant or lactating women; * Positive pregnancy test before study drug administration (for women of childbearing potential); * Psychiatric disorders, cognitive impairment, or inability to comprehend the trial protocol, adverse effects, or comply with study procedures and follow-up (requires systematic evaluation before enrollment); * Individuals lacking personal freedom or legal capacity for independent civil conduct.

Inclusion Criteria: * Patient has ECOG performance status of 0-1 * One or more known primary oncogenic PIK3CA mutation(s) * Adult females, pre- and/or post-menopausal, and adult males. Pre-menopausal (and peri-menopausal) women can be enrolled if amenable to treatment with a gonadotropin-releasing hormone (GnRH) agonist. Patients are to have commenced treatment with a GnRH agonist at least 4 weeks prior to randomization and must be willing to continue on it for the duration of the study. * Histologically or cytologically confirmed diagnosis of HR+/HER2- locally advanced or metastatic breast cancer (ABC) with radiological or objective evidence of recurrence or progression; locally advanced disease must not be amenable to resection with curative intent * Measurable disease per RECIST v1.1 or evaluable bone-only disease. * Must have radiological evidence of progression on or after previous treatment for HR+/HER2- ABC with: 1. At least 1 and no more than 2 lines of endocrine therapy (ET) in the (neo)adjuvant setting with recurrence on or within 12 months of completion or in the ABC setting 2. 1 prior line of CDK4/6 inhibitor therapy in one of the following settings: 1. CDK4/6 inhibitor + ET in the ABC setting 2. CDK4/6 inhibitor therapy in the adjuvant setting if progression occurred during or within 12 months of completion of adjuvant CDK4/6 inhibitor with ET 3. Patients who progressed during or within 12 months of completion of adjuvant CDK4/6 inhibitor and after receiving CDK4/6 inhibitor therapy in the advanced setting are considered to have had \>1 prior line of CDK4/6 inhibitor and are not eligible Exclusion Criteria: * Prior treatment with any of the following: 1. CDK2 or selective CDK4 inhibitors or any investigational therapies targeting cyclin dependent kinases 2. PIK3, AKT, or mTOR inhibitors or any agent whose mechanism of action is the inhibit the PIK3/AKT/mTOR pathway 3. Immunotherapy 4. Antibody drug conjugates * Type 1 diabetes, or Type 2 diabetes requiring antihyperglycemic medication, or fasting plasma glucose ≥ 140 mg/dL, or glycosylated hemoglobin (HbA1c) ≥7.0% (≥ 53 mmol/mol). * Clinically significant, uncontrolled cardiovascular disease * Any factors that increase the risk of QTc prolongation or risk of arrhythmic events * Known active uncontrolled or symptomatic CNS metastases associated with progressive neurological symptoms or requiring ongoing corticosteroids or anticonvulsants for symptomatic control * Past medical history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis which required steroid treatment, or any evidence of clinically active interstitial lung disease * History of hypersensitivity to fulvestrant or drugs in a similar class as fulvestrant, RLY-2608, or capivasertib, including their excipients * Known activating AKT mutations, loss-of-function PTEN mutations, or loss of PTEN expression resulting in oncogenic pathway activation downstream of PI3K

Inclusion Criteria: 1. Women or men aged 18 to 89 years with stasis dermatitis secondary to venous hypertension 2. Agreement with the terms of the survey and signing of the informed consent form 3. Availability to make the necessary appointments for treatment and follow-up 4. Provide consent to avoid pregnancy during treatment 5. Have primary venous hypertension already treated (treatment of varicose veins of the lower limbs) by any of the available techniques Exclusion Criteria: 1. Men and women with CEAP 2 to 6, low mobility, no stasis dermatitis. 2. Peripheral arterial disease. 3. History of known allergy to the drugs used in this study 4. Presence of other types of dermatitis in the lower extremities, such as allergic stasis eczema. 5. Presence of comorbidities (such as diabetes mellitus, heart failure, respiratory failure, hypertension, hypothyroidism, or hyperthyroidism), pregnancy, breastfeeding, pulmonary hypertension, deep vein thrombosis (DVT), family history of DVT, known hypercoagulable states or thrombophilia, asthma, and migraine. 6. Anyone who does not agree with any of the search terms. \-

Inclusion Criteria: * Primary diagnosis of depression (DSM-5 criteria, American Psychiatric Association 2013). * Depressive symptoms assessed using MADR, BDI, or ZDR scales. * Ability to provide written informed consent. * Self-reported moderate-intensity leisure physical activity of less than 150 minutes per week. Exclusion Criteria: * Patients with severe psychopathology. * Medical contraindications to physical activity. * Orthopedic problems or other conditions limiting physical fitness assessment or currently pregnant. * Patients who underwent antibiotic/anti-inflammatory treatments in the last 3 months * Active gastrointestinal diseases * Autoimmune and/or chronic inflammatory disorders

Inclusion Criteria: * Diagnosed with type 2 diabetes mellitus and receiving medical treatment * Scheduled for isolated elective coronary artery bypass graft (CABG) surgery * American Society of Anesthesiologists (ASA) physical status class III or IV * Age between 40 and 85 years Exclusion Criteria: Emergency CABG surgery Reoperation (revision surgery) Left ventricular ejection fraction (LVEF) \< 40% History of cardiac arrest or cardiogenic shock Pregnancy Clinically significant peripheral arterial disease affecting the upper limbs Hepatic dysfunction (bilirubin \> 20 μmol/L or INR \> 2.0) Renal failure (eGFR \< 20 mL/min/1.73 m²) Ongoing treatment with glibenclamide or nicorandil (agents known to interfere with ischemic preconditioning mechanisms) Asthma