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关键词： early integration   palliative care   pediatric oncology   Phase 1 clinical trials  

摘要： Purpose Early-Phase clinical trials in pediatric oncology are designed to test drug safety and feasibility, offering minimal direct therapeutic benefit (5%-10%) while carrying a risk of toxicity, death, and worsened symptom burden. Pediatric palliative care (PPC) provides supportive care to patients and families enrolling in Phase 1 trials;however, oncologists inconsistently refer patients for PPC. This study aimed to explore potential benefits and ideal timepoints for integrating PPC for pediatric oncology patients participating in Phase 1 *** Semi-Structured qualitative interviews were conducted with parents of patients enrolling in Phase 1 trials at two academic cancer centers. Interviews were audio-recorded, transcribed, and analyzed using inductive content *** Parents of 31 patients were interviewed. Approximately 61% of parents (n = 19) were familiar with PPC, of whom a majority (68%, n = 13) defined PPC to mean end-of-life/hospice. Fewer than one third (30%, n = 9) described the evolution of this definition to include comfort, quality of life, and extra support. Most parents (97%, n = 30) supported early integration of PPC, with 87% (n = 27) identifying enrollment on a Phase 1 study as an ideal timepoint for PPC referral. Parents described PPC as helpful with symptom management, care coordination, and general support and advocated for clinicians to introduce PPC by emphasizing these *** Parents identified enrollment in a Phase 1 study as an ideal timepoint for PPC referral, highlighting benefits from PPC subspecialty support. Future research will assess the impact of the implementation of clinical interventions to promote PPC consultation in pediatric cancer Phase 1 trial populations.

关键词： Caputo derivative   cosine and sine family   control theory   controllability   Hilbert uniqueness method (HUM)   time-fractional systems  

摘要： The main purpose of this paper is to examine the controllability of linear time-fractional systems involving the Caputo fractional derivative of order 1

关键词： Curcumin   Platinum nanoparticles   Green synthesis   Antioxidant activity   Wound healing   Biocompatibility   Nanomedicine  

摘要： This study aimed to fabricate a curcumin@platinum nanohybrid (CUR@Pt NPs) through a green tea-based synthesis method and to evaluate its various functions, including antioxidant, burn-healing, and selective anticancer activities against PANC-1 pancreatic cancer cells. Green tea polyphenols served as natural reducing and stabilizing agents, facilitating an eco-friendly, single-step manufacturing process. Physicochemical characterization confirmed successful nanohybrid formation: a CUR@Pt band appeared at 457 nm in the UV-Vis spectrum, XRD displayed crystalline platinum peaks at 2 theta = 46.9 degrees, and 67.0 degrees, matching the (200), and (220) planes, respectively, and TEM images showed well-dispersed spherical nanoparticles with an average size of 50 nm. FTIR spectra showed shifts in O-H and C = O vibrational bands, indicating coordination between curcumin, tea polyphenols, and platinum. DLS analysis indicated a hydrodynamic diameter of 162.2 +/- 12.8 nm, with a zeta potential of - 5.6 mV. Antioxidant assessment using the DPPH assay revealed that CUR@Pt NPs had enhanced radical-scavenging activity with an IC50 of 17.58 ppm, compared to 22.45 ppm for free curcumin. In vivo burn-healing tests in mice demonstrated faster wound contraction, with the CUR@Pt group achieving significantly improved closure by day 14, along with increased re-epithelialization and dense collagen deposition similar to silver sulfadiazine (1%). Cytotoxicity assays showed selective anticancer effects against PANC-1 cells (IC50 = 89.4 mu g/mL), while normal NIH cells displayed higher tolerance (IC50 = 119.8 mu g/mL), indicating a favorable therapeutic index. In conclusion, CUR@Pt NPs are a promising, environmentally friendly nanoplatform that combines the complementary pharmacological effects of curcumin and platinum.

摘要： Background : Despite increasing global misuse of stimulant drugs, there is a paucity of literature regarding stimulant use among trauma patients. The primary aim of this study was to assess hospital mortality among patients with stimulant intoxication who presented to level 1 trauma centres in Canada and the United States. Secondary outcomes included emergency department mortality, hospital length of stay, and admission to the intensive care unit (ICU).Methods : This is a retrospective analysis of data from the Trauma Quality Improvement Program, including patients presenting emergently to participating level 1 trauma centres from January 2017 to December 2018. We included patients aged 19 to 88 years who had positive toxicology to stimulant drugs or negative toxicology to all drugs. We adjusted for patient demographic factors in the *** : We included 89 130 patients, with 10 017 patients (11.2%) having a positive screen for stimulants. The mean age in the stimulants cohort was 42.0 years, with a 75.9% male preponderance and mean Injury Severity Score of 9. The control cohort was older, with a mean age of 55 years, and a smaller proportion of males (63.0%, p < 0.001). We found no significant differences between emergency department mortality and length of stay in the ICU after we adjusted for confounders. Patients with stimulants in their system were predicted to spend 1.11 (95% confidence interval 1.09 to 1.13) times as many days in hospital as controls, after we accounted for *** : Stimulant misuse is a relevant issue in the trauma population, associated with increased hospital length of stay, but no significant difference in mortality. By addressing stimulant intoxication in trauma patients, health care providers can work toward improving patient outcomes and reducing the associated health care burden.

关键词： Diabetic neuropathy   Sudomotor dysfunction   Thermoregulatory sweat test   Type 1 diabetes mellitus   Dysautonomia  

摘要： Sudomotor dysfunction is a frequent and early sign of diabetic neuropathy. It is a disorder of the autonomic nervous system that involves small fibers and is usually underdiagnosed despite the impact it has on the patients' quality of life. Its study is recommended as a strategy for early detection as an indicator of dysautonomic dysfunction and management of later complications. Although it can be highly disabling, it often goes unnoticed, as it is considered less alarming than other dysautonomic symptoms. We present the case of a diabetic patient with sudomotor disfunction who underwent a comprehensive autonomic nervous system evaluation. Unlike most related studies, this case highlights a combination of compensatory hyperhidrosis and distal anhidrosis, underscoring the variability in clinical signs of sudomotor dysfunction. Additionally, it demonstrates the importance of autonomic testing in differential diagnosis and emphasizes the need for further research into its pathophysiological mechanisms and effective therapeutic strategies. (c) 2025 SEEN and SED. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： MIFE   phloem transport   radioisotope   salinity   sodium   SOS1   xylem transport  

摘要： The Na+/H+ antiporter SALT OVERLY SENSITIVE 1 (SOS1) is a key component of Na+ exclusion and plant salt tolerance. Although previous studies have suggested that SOS1 functions in both the root apex and mature root zone, their contributions remain unclear due to limited methodological resolution and originated mostly from transcriptional analysis. Here, we performed isotopic tracing techniques to visualize and quantify Na+ exclusion. Real-time imaging of shoot-applied 22Na+ showed that 22Na+ gradually disappeared from roots in wild-type (WT) plants, whereas it did not in sos1 mutants. To confirm that this reduction reflected active Na+ exclusion to the rhizosphere, we used the Microelectrode Ion Flux Estimation, which revealed significant Na+ efflux at the mature root zone of WT plants following shoot Na+ application, while no such efflux was observed at the root apex or in either root zone of sos1 mutants. Further quantification using a radioisotope-based method showed that approximately 90%-95% of Na+ derived from both the phloem and xylem was excluded from WT roots, primarily via SOS1, with the mature root zone identified as the major contributor. This study provides visual and quantitative evidence for the crucial contribution of SOS1 to Na+ exclusion in the mature root.

关键词： curve   moduli space   Frobenius splitting   parabolic bundles  

摘要： Let I be a finite set of P (1) over an algebraically closed field k of char ( k ) > 0 , and U (1)(P) , omega be the moduli space of semistable parabolic bundles of rank two and degree d on P-1 with parabolic structures determined by weights omega = { a( x) } (x is an element of I) . We prove that U (1)(P) (, omega) is F-split when | I | <= 6 , which partly answers a conjecture of Mehta and Ramadas for the genus zero case.

关键词： cerebral hemorrhage   diabetes   ischemic stroke   neuroprotection   smoking  

摘要： BACKGROUND:The potential protective effect of GLP-1RAs against nontraumatic subarachnoid hemorrhage (SAH) in individuals with intracranial aneurysms (IAs) remains unclear. Since GLP-1RAs (glucagon-like peptide-1 receptor agonists) have known anti-inflammatory and antihypertensive properties, we proposed to evaluate whether they reduce the risk of nontraumatic SAH in patients with IA with type 2 ***:We conducted a retrospective cohort study using the global TriNetX database, which spans over 90 health care organizations across North America, South America, Europe, and Asia, with the majority of data contributed by the United States. Analysis included data from January 2010 to January 2025. Patients with unruptured IAs and type 2 diabetes who received GLP-1RAs (n=2517) were compared with those who did not (n=23 431). Propensity score matching (1:1) was performed on 95 demographic and clinical variables, including smoking and hypertension. A subgroup and matched analysis excluded patients who had a history of IA treatment. The primary outcomes were nontraumatic SAH and all-cause mortality over a 5-year follow-up period. Hazard ratios (HRs) and 95% CIs were calculated, and a falsification analysis was performed to evaluate whether patients taking GLP-1RAs were receiving more medical ***:After matching, each cohort comprised 2275 patients. GLP-1RA use was associated with a significantly lower rate of nontraumatic SAH (HR, 0.66 [95% CI, 0.50-0.87]) and all-cause mortality (HR, 0.63 [95% CI, 0.52-0.76]). In the matched subgroup analysis of untreated patients, GLP-1RA use was similarly associated with reduced risk of nontraumatic SAH (HR, 0.68 [95% CI, 0.47-0.98]) and all-cause mortality (HR, 0.64 [95% CI, 0.53-0.77]). Falsification analysis confirmed the absence of confounding by indication and health care access ***:GLP-1RAs have a potential role in mitigating nontraumatic SAH and improving survival among patients with IA with type 2 dia