Proton Craniospinal Irradiation for Patients With Leptomeningeal Metastasis: A Randomized Clinical Trial.

Importance: Leptomeningeal metastasis (LM) is associated with limited survival and few treatment options. Photon involved-field radiotherapy (IFRT) is the most common radiotherapy treatment for patients with LM from solid tumors.

Objective: To assess whether proton craniospinal irradiation (pCSI) would result in superior central nervous system progression-free survival (CNS-PFS) compared with IFRT.

A phase 1/1b study of lenvatinib and cetuximab in patients with recurrent/metastatic head and neck squamous cell carcinoma.

Background: Despite overexpression of EGFR in head/neck squamous cell carcinoma (HNSCC), cetuximab monotherapy has limited benefit. Lenvatinib is a multi-targeted receptor tyrosine kinase inhibitor with activity against FGFRs1-4, involved in resistance to EGFR inhibition. We evaluated lenvatinib in combination with cetuximab in recurrent/metastatic (R/M) HNSCC.

In Situ Construction of a Dual-Component Hybrid Interfacial Layer for Stabilizing Zinc Anodes in Aqueous Zn-Ion Batteries.

Interfacial instability, particularly uncontrollable zinc deposition and water induced side reactions, severely compromises the cycling stability and lifespan of aqueous zinc-ion batteries (AZIBs), thereby hindering their commercialization. Herein, an in situ grown bilayer gradient hydrophobic artificial interface (ZFPB) is designed to achieve dendrite-free zinc deposition. In detail, the ion-conductive but electronically insulating ZnF outer layer facilitates the rapid migration of Zn.

Pathogenicity of spp. Against : Effects on Immune Enzyme Activities and Gene Expression Profile.

(1) Background: spp. are fungi known for producing cyclosporin A and their ability to infect insects. However, their pathogenicity against the lepidopteran pest has not been previously reported.

Phase I Dose Escalation Trial Combining Olaparib and Thoracic Radiation Therapy in Extensive-Stage Small Cell Lung Cancer.

Purpose: Patients with extensive-stage small cell lung cancer (ES-SCLC) are commonly treated with induction systemic therapy and consolidative thoracic radiation therapy (TRT). PARP inhibitors have demonstrated radiosensitization in preclinical lung cancer models. We performed an investigator-initiated, multi-institutional, single-arm, open label phase I study of concurrent olaparib with TRT.

The Experiences of Critical Care Nurses and Physicians Implementing Early Active Mobilisation on Patients With Mechanical Ventilation: A Qualitative Study.

Background: Early active mobilisation (EAM) of patients receiving mechanical ventilation can reduce complications caused by prolonged immobilisation. However, little is known about the experiences of intensive care unit (ICU) nurses and physicians implementing EAM.

Aim: This study aimed to explore the experiences of ICU nurses and physicians in implementing EAM for patients with mechanical ventilation.

Dendrobium officinale polysaccharide relieves hepatointestinal damage induced by chronic arsenic exposure in chickens by regulating gut microbiota.

Arsenic is a toxic substance that can enter the body through diet, and even skin contact. Dendrobium officinale polysaccharide (DOP) is one of the main active components of Dendrobium officinale, which has antioxidant and anti-inflammatory effects. To specify DOP's protective role against arsenic-induced hepatointestinal damage in chickens, this study explored the potential target and mechanism of DOP in intestinal barrier injury based on network pharmacological analysis.

Automated Midline Shift Detection in Head CT Using Localization and Symmetry Techniques Based on User-Selected Slice.

Background And Purpose: Midline shift (MLS) is an intracranial pathology characterized by the displacement of brain parenchyma across the skull's midsagittal axis, typically caused by mass effect from space-occupying lesions or traumatic brain injuries. Prompt detection of MLS is crucial, because delays in identification and intervention can negatively impact patient outcomes. The gap we have addressed in this work is the development of a deep learning algorithm that encompasses the full severity range from mild to severe cases of MLS.

Association between prognostic nutritional index and risk of moderate-to-severe basic activities of daily living dependence two years after hip fracture surgery in older adults.

Background: Hip fractures are a common and serious health concern in older adults. The ability to perform basic activities of daily living (BADL) is a key indicator of long-term functional status. This study aimed to evaluate the prognostic value of the Prognostic Nutritional Index (PNI) in identifying older patients at risk of moderate-to-severe BADL dependence two years after hip fracture surgery.

Cultivation and sequencing of microbiota members unveil the functional potential of yak gut microbiota.

The animal gut microbiota exhibits extensive taxonomic diversity, yet cultivated isolates and complete genomes from animal hosts remain scarce, hindering functional and ecological insights. We present a cultivated Yak () Fecal bacteria genome Reference (YFR), comprising 548 high-quality genomes based on aerobic and anaerobic cultivation. Notably, 216 strains represented novel taxa, classified into 29 species-level clusters spanning 4 phyla and 14 genera.

Randomized Clinical Trial of Geriatric Comanagement Versus Geriatric Assessment-Guided Supportive Care for Older Patients With Head and Neck Cancer.

Background: Geriatric assessment (GA) can be used to identify patient-specific deficits and facilitate interventions to improve patient outcomes. In this randomized pilot clinical trial, we hypothesized that geriatric assessment with or without geriatrician comanagement can reduce the risk of hospitalization for older adults with head and neck cancer receiving concurrent chemoradiotherapy (CRT).

Patients And Methods: Patients aged ≥65 years with newly diagnosed or postoperative mucosal head and neck squamous cell carcinomas were eligible for enrollment and received 6 to 7 weeks of CRT.

COPB2 facilitates EDEM3-mediated mannose trimming to sustain ER homeostasis in ovarian cancer.

Background: Ovarian cancer (OC) is a lethal gynecologic malignancy with limited therapeutic success due to late diagnosis and therapy resistance. Endoplasmic reticulum (ER) stress and ER-associated degradation (ERAD) are key to tumor adaptation, yet the mechanisms sustaining ER homeostasis in OC remain poorly defined.

Methods: We combined multi-omics analyses, tissue microarrays, and in vitro and in vivo models.

GHz fundamental mode-locking of a highly integrated Er-doped all-fiber ring laser.

High repetition rate ultrafast fiber lasers are essential for both scientific research and industrial applications. Here, we report the first, to the best of our knowledge, all-fiber ring laser with a fundamental repetition rate exceeding 1 GHz, by integrating all necessary functions into one single device with commercial active fiber pigtails. Low-threshold self-starting mode-locking is achieved by using a carbon nanotube (CNT) saturable absorber that directly deposits on the Er-doped fiber connector.

Development and clinical application of an automated machine learning-based delirium risk prediction model for emergency polytrauma patients.

Objective: To address the limitations of conventional delirium prediction models in emergency polytrauma care, this study developed an interpretable machine learning (ML) framework incorporating trauma-specific biomarkers and advanced optimization algorithms for risk stratification of delirium in emergency polytrauma patients.

Methods: This multi-center retrospective observational cohort study was conducted across six hospitals in the Ya'an region. A total of 956 polytrauma patients admitted between January 2020 and December 2024 were enrolled, complying with the American Association for the Surgery of Trauma (AAST) diagnostic criteria for polytrauma.

Problem-Based Learning and Case-Based Learning in Clinical Practical Teaching for Gynecology Residents: A Narrative Review.

Background: Gynecology residency training necessitates a robust educational framework to cultivate clinical competency, critical thinking, and problem-solving skills. Traditional lecture-based teaching methods are deficient in fostering active learning and clinical decision-making. Problem-based learning (PBL) and case-based learning (CBL) have emerged as learner-centered approaches that enhance medical education by integrating theoretical knowledge with clinical practice.

Association between albumin and short-term outcomes of unplanned early readmission emergency department patients: A retrospective cohort study.

Objective: This study was a post hoc analysis of data from a retrospective cohort population. The purpose of this study was to analyze the predictive value of albumin for the short-term survival of patients with unplanned early readmission to the emergency department (ED).

Methods: A total of 6,249 emergency patients were enrolled in this study, including 5,368 patients (85.

Development of Second Malignancies Following Chemotherapy With or Without Radiation Therapy for the Treatment of Locally Advanced Rectal Cancer.

Purpose: We sought to identify factors associated with second pelvic malignancies (SPM), as well as second nonpelvic malignancies (SNPM), after chemotherapy with or without radiation therapy (RT) for locally advanced rectal cancer (LARC).

Methods And Materials: Patients diagnosed with stage II-III LARC. Cumulative incidence of second malignancies was analyzed using a 2-year landmark analysis with death as a competing risk.

The influencing factors of neonatal extubation failure: A systematic review and meta-analysis.

Objective: To assess risk factors for extubation failure in mechanically ventilated neonatal patients in the neonatal intensive care unit.

Methods: We conducted a systematic review and meta-analysis of the literature. Data are reported as pooled odds ratios for categorical variables and mean differences for continuous variables.

ASIC1a Promotes nucleus pulposus derived stem cells apoptosis through modulation of SIRT3-dependent mitochondrial redox homeostasis in intervertebral disc degeneration.

The death of human nucleus pulposus derived stem cells (NPSCs) is a key factor affecting the endogenous repair capability and degeneration of intervertebral discs (IVD). ASIC1a is thought to be closely associated with cells destiny in IVD degeneration (IVDD). However, its physiological and pathological roles in human NPSCs are unclear.

Histone serotonylation promotes pancreatic cancer development via lipid metabolism remodeling.

Neurotransmitter serotonin (5-hydroxytryptamine [5-HT]) has emerged to play parallel roles in both neurobiology and oncology. Apart from receptor-mediated signaling transduction pattern, serotonin can be covalently integrated into histone (the post-translational modification known as histone serotonylation) and serve as an epigenetic mark associated with permissive gene expression. However, how histone serotonylation influences tumorigenesis is yet to be understood.

Laparoscopic treatment of triple ureteral with ureteral calculus: A case report.

Rationale: Ureteral triplication (UT) is a rare congenital urinary tract anomaly, with approximately 100 cases reported globally, arising from abnormal branching of the ureteric bud during embryogenesis.

Patient Concerns: A 48-year-old male presented with recurrent left flank and abdominal pain for 3 years, worsening over the past year, accompanied by gross hematuria and purulent urine, suggesting urinary tract infection and obstruction.

Diagnoses: Computed tomography urography and cystoscopy confirmed left-sided ureteral triplication, with 1 malformed ureter containing a calculus and proximally occluded, and another merging with the normal ureter.

The PARP1-EXD2 axis orchestrates R-loop resolution to safeguard genome stability.

R-loops, comprising an RNA-DNA hybrid and a displaced single-stranded DNA, are dynamic three-stranded nucleic acid structures that, when dysregulated, can disrupt transcription and replication, undermining genome integrity and contributing to human pathologies. Here we identify exonuclease 3'-5' domain-containing 2 (EXD2) as a pivotal R-loop resolvase. We demonstrate that EXD2, through direct interaction with poly(ADP-ribose) (PAR) polymers synthesized by R-loop-bound and activated PAR polymerase 1 (PARP1), is recruited to R-loops, where it undergoes acetylation by the acetyltransferase CREB-binding protein at K416.

Curcumin analog C1 activates autophagy through a TFEB-dependent mechanism to protect sensory hair cells from oxidative stress in C57BL/6 mice with age-related hearing loss.

Age-related hearing loss (AHL) is the primary cause of deafness in aging populations and lacks proven effective therapies. Protecting the survival and function of sensory outer hair cells (OHCs) represents a promising therapeutic strategy for AHL. Certain herbs have shown beneficial effects on OHCs, but a limited understanding of their mechanisms hinders their clinical application.

Prospective Evaluation of a Novel Unidirectional Permanent Device for Intraoperative Brachytherapy.

Purpose: The CivaSheet is a novel radiation delivery device consisting of unidirectionally shielded Pd-103 sources embedded in a bioabsorbable polymer sheet. This facilitates intraoperative placement of permanent brachytherapy seeds in a surgical tumor bed, while minimizing dose to overlying structures. No clinical trial data have yet been published for this device.

Biosynthesis of 5-hydroxymethyl-2-furancarboxylic acid from 5-hydroxymethylfurfural new whole-cell biocatalysts.

The selective oxidation of biomass-derived 5-hydroxymethylfurfural (HMF) to value-added furan compounds presents significant challenges due to the inherent high reactivity of HMF. In this study, two microorganisms were identified as whole-cell biocatalysts for the synthesis of 5-hydroxymethylfuroic acid (HMFCA) from HMF. The cells of sp.