prothrombin complex (Kanokad / Kaskadil)

Adolescents' positive and negative reactions to participation in trauma-focused research and their associations with PTSD and complex PTSD.

Zelviene Paulina P, Kairyte Agniete A, Pakeltytė Ema E, Kazlauskas Evaldas E

Background: Previous studies have investigated the levels of distress reported by children and adolescents while participating in trauma-focused research. However, the role of complex PTSD in responses to participation in trauma-focused research is unknown. The aim of the study was to investigate adolescents' positive and negative reactions to trauma-focused research and their associations with lifetime trauma exposure, PTSD, and complex PTSD.Methods: The sample comprised 834 school-based adolescents (40.9% boys), aged 13-18 years (M = 16.17, SD = 1.34) from the general population. Lifetime trauma exposure was measured using the Child and Adolescent Trauma Screen (CATS); PTSD and complex PTSD were measured with the Child and Adolescent version of the International Trauma Questionnaire (ITQ-CA). Positive and negative responses to research were measured with the short version of the Reactions to Research Participation Questionnaire for Children (RRPQ-C).Results: Most adolescents reported neutral or positive reactions to participation: 73.4% did not feel upset or sad, 81.4% did not regret participating, 34.3% reported being glad about participating, and 61.0% felt good about helping. 6.6% reported feeling upset. Lifetime trauma exposure was reported by 74.5% of participants (M = 2.18, SD = 2.18); 6.8% met criteria for PTSD, and 13.1% for complex PTSD. Lifetime trauma exposure, PTSD, and complex PTSD were associated with feeling upset or sad, as well as being glad to participate. PTSD increased the odds of negative reactions to research 2.07 times, and complex PTSD 5.78 times. On the other hand, 42.2% of those with complex PTSD reported being glad they had participated.Conclusions: Adolescents generally responded positively to participating in the study. However, complex PTSD was associated with a higher likelihood of research-related distress, highlighting the need for tailored safety and risk protocols for adolescents with complex PTSD.

EDA complex-enabled, substituent-controlled switch in anthranil reactivity for sequential access to azaaurones.

Tiwari Khushboo K, Singh Mayank M, Awasthi Annapurna A, Rajpoot Rudraa Singh RS et al.

A sequential protocol has been developed for the synthesis of azaaurones from readily available anthranils and olefins. The transformation proceeds via palladium-catalyzed C3-alkenylation of anthranils to afford C3-styrylanthranil intermediates, which subsequently undergo skeletal rearrangement in the presence of THIQ·HCl. Mechanistic studies suggest that THIQ·HCl forms an electron donor-acceptor (EDA) complex with the styrylanthranil intermediate, facilitating N-O bond cleavage and nitrene generation. The resulting nitrene undergoes cyclization to form an aziridine intermediate, which subsequently rearranges to afford the azaaurone. Notably, the compatibility of this protocol with biologically relevant styrene derivatives highlights its potential for the late-stage functionalization of complex molecules.

Beyond the Prescription - Integrating Addiction Counselors, Peer Support, and Clinical Teams in Complex Pain and Opioid Use Disorder.

Coffield Alexandra M AM, Oliver Jennifer B JB, Columbano Heather A HA, Galang Enrique E et al.

Phenotypic shift from active class IV lupus nephritis to lupus podocytopathy: a case report highlighting the treatment-altering role of repeat kidney biopsy.

Wang Zhifa Z, Deng Jinxiu J, Shen Jinfeng J, Jiang Hui H et al.

The underlying pathophysiological mechanisms of proteinuria relapse in lupus nephritis (LN) patients during immunological remission are complex, often involving non-immune complex-mediated podocyte injury. We report a 21-year-old male with class IV LN and thrombotic microangiopathy (TMA). After multi-target induction and maintenance therapy, the patient achieved complete clinical remission. During subsequent follow-up, he developed progressive nephrotic-range proteinuria while maintaining serological remission (persistently negative autoantibodies and normal complement levels). Intensification of conventional immunosuppressants was ineffective. A repeat kidney biopsy revealed significant resolution of immune complex deposits but prominent focal segmental glomerulosclerosis (FSGS)-like changes with extensive podocyte foot process effacement. The regimen was adjusted to a podocyte-targeted therapy centered on tacrolimus, resulting in a rapid and sustained reduction in proteinuria. This case suggests that in the clinico-serological dissociation phase of LN, repeat kidney biopsy is of significant clinical value for identifying pathological phenotypic shifts, avoiding excessive immunosuppression, and guiding precision medicine.