Title:  Case Report of a Giant Mediastinal Neurofibroma Misdiagnosed as Massive Pleural EffusionAuthors:  1. Hongqiang Chen1;2. DanYi Lin1 ;3. Zhizhong Zhou1*1 Fuzhou First General Hospital Affiliated to Fujian Medical University Fuzhou, CN 350000Corresponding Author:*Email: nb892366303@163.com ; Tel: +86-13959183699Conflict of Interest:  None declared.Funding:  NoAuthor Contributions: HC: wrote the manuscript, created the Figure, wrote the manuscript and treated the patient. ZZ: treated the patient, discussed the diagnosis and provided clinical comments. DL: wrote the manuscript and treated the patientEthics Statement: The requirement for informed consent was waived by the Ethics Committee due to the retrospective and anonymized nature of the data. But the written consent of the patient has been obtained before submitting the article, and the written and reserved consent is signed as requiredCase Report of a Giant Mediastinal Neurofibroma Misdiagnosed as Massive Pleural EffusionKey clinical message:  For thoracic hypodense lesions, ultrasound and contrast-enhanced CT differentiate tumors from effusions. Giant mediastinal tumors require preoperative vascular localization, optimal surgical access, and gradual decompression to prevent re-expansion complications.Keywords: Mediastinum; Nervous system neoplasms; Thoracic surgery; Video-assisted

The rapid expansion of cryptocurrency markets has introduced new challenges and opportunities in global taxation, particularly in the realm of Value-Added Tax (VAT). This paper investigates VAT registration and reporting obligations for crypto-based businesses, emphasizing jurisdictional variations and compliance complexities. Leveraging qualitative research and comparative analysis, we examine VAT frameworks in key regions, including the EU, UK, US, Australia, and Canada. The study proposes best practices and technological solutions, such as machine learning, to enhance VAT compliance and reporting efficiency.

Cancer is the second leading cause of death worldwide, with an estimated 27.5 million new cases projected by 2040. Disruptions in cell cycle control cause DNA replication errors to accumulate during cell growth, leading to genomic instability and tumor development. Proteins that regulate cell cycle progression and checkpoint mechanisms are crucial targets for cancer therapy. NIMA-related kinases (NEKs) are a family of serine/threonine kinases involved in regulating various aspects of the cell cycle and mitotic checkpoints in humans. Among these, NEK10 is the most divergent member and has been associated with both cancer and ciliopathies, a group of disorders caused by defects in cilia structure or function. Despite its biological significance and distinctive domain architecture, the structural details of NEK10 remain largely unknown. To address this gap, we employed computational modeling techniques to predict the complete structure of the NEK10 protein. Our analysis revealed a catalytic domain flanked by two coiled-coil domains, armadillo repeats (ARM repeats), an ATP binding site, two putative ubiquitin-associated (UBA) domains, and a PEST sequence known to regulate protein degradation. Furthermore, we mapped a comprehensive interactome of NEK10, uncovering previously unreported interactions with the cancer-related proteins MAP3K1 and HSPB1. MAP3K1, a serine/threonine kinase and E3 ubiquitin ligase frequently mutated in cancers, interacts with the catalytic region of NEK10. The interaction with HSPB1, a molecular chaperone associated with poor cancer prognosis, is mediated by NEK10’s ARM repeats. Our findings highlight a potential connection between NEK10, ciliogenesis, and cancer, suggesting an important role in cancer development and progression.

Access to public healthcare within British Columbia is inadequate and unequally distributed. This decreases physical and mental health outcomes for patients and their healthcare workers. B.C.’s five regional health authorities (RHAs) have failed over 50% of all performance targets set annually by the Ministry of Health, which has limited power due to the fragmented provincial system. Virtual care seemed like a prominent solution during the onset of the COVID- 19-induced lockdown, yet support has decreased since in-person activities resumed. However, Fraser Health is actively implementing new virtual care efforts integrated with predictive AI systems. Predictive AI has the potential to increase virtual care serviceability and provide a detailed schema of day-to-day operations, encouraging improvements towards performance targets that ultimately increase access to public healthcare. To achieve this potential, independent panels and analysis of previous new-technology scale-ups within established healthcare systems, such as eConsult, are advised.

Background: Liver cancer is a malignant tumor, and macrophages play a crucial role in its progression. Research on macrophages in liver cancer is increasing, however, the field still lacks comprehensive and objective bibliometric analyses. Method: A comprehensive bibliometric analysis was conducted on 4,664 papers related to macrophage research in liver cancer from 2015 to 2024, extracted from the Web of Science Core Collection using Biblioshiny, VOSviewer, Scimago Graphica, CiteSpace, and Microsoft Office Excel Professional Plus 2016. Visual analyses were performed on publication numbers, countries, institutions, collaborations, authors, journals, keywords, thematic trends, and cited references. Result: The study shows a rising research trend with increasing global publications annually. China led in publications and citations, and ” Frontiers in Immunology” had the most publications. Keyword analysis highlighted ”expression” as a core focus, with four main clusters identified. ”Mice” had high burst intensity from 2015 to 2018, while recent hotspots included ”single-cell”, ”neutrophil extracellular traps”, and ”atlas”. Conclusion: This paper elucidates the global landscape and ongoing trends of macrophage research in liver cancer, highlighting the increasing number of investigations. China and the United States are significant leaders, but international cooperation should be strengthened. Further research is needed on the heterogeneity of macrophage functions, their interactions with tumor cells, and combined immunotherapy.

Background. Pancreatic ductal adenocarcinoma (PDAC) has a high mortality rate despite treatment. This study compares the expression of C-Myc and p53 with clinicopathological, molecular, and prognostic factors in PDAC patients at the Fundación Santa Fe University Hospital in Bogotá. Methodology. This descriptive-analytical study included 95 PDAC patients, 55 of whom underwent surgical resection and 40 were only biopsied. Clinicopathological data was obtained from histological analyses and medical records. Expression of C-Myc and p53 was determined by immunohistochemistry. Statistical analysis was done using R-studio version 2023.12.1. Results. The study group consisted of 52 women (54.7%) and 43 men (45.3%), aged 41-89 years (M = 66.8). No significant associations were found between molecular marker expression and clinicopathological variables. However, patients with PDAC in the pancreas body or liver metastases had a higher likelihood of surviving less than 3 years. Among surgical patients (N = 54), 38 expressed C-Myc and 39 expressed p53. Aberrant p53 expression was linked to decreased disease-free survival in patients with a <3-year survival post diagnosis (t[23] = -2.42; p < .05). Similarly, higher C-Myc expression was seen in patients with postsurgical recurrence with a <3-year survival post diagnosis (t[21] = -2.28; p < .05). Conclusion. Targeted therapies for these genes may improve PDAC prognosis. Further research should investigate other biomarkers and their expression in neoplastic and preserved pancreatic tissue.

Space-air-ground integrated networks (SAGINs) are emerging as a fundamental architecture for 6G systems to enable massive connectivity, novel applications, extreme data rates, ultra-low latency, and multi-dimensional networking. The complex nature of SAGINs has driven researchers to explore classical machine learning (CML) as a powerful tool for modeling and optimizing these multi-layer networks. Although ML offers many benefits, it will suffer from exponential complexity for SAGIN design mainly due to high-dimensional data and problem spaces. Therefore, the NP-hard problems are challenging for CML to enable SAGINs efficiently. To address this critical challenge, we present a comprehensive survey examining the integration of quantum ML (QML) with SAGINs. We systematically evaluate quantum-enhanced SAGIN technologies through detailed performance metrics and create a new classification system for hybrid network architectures. We thoroughly examine key integration strategies and analyze major technical challenges, including how quantum states degrade in space, how to optimally distribute resources, and how to develop security protocols. We show how QML can solve the growing complexity of 6G networks by improving network capacity, intelligence, and security. The research also creates a comprehensive framework for quantum-enhanced SAGINs that researchers and industry professionals can use as a guide when developing next-generation communication systems. Our findings examine the transformative potential of QML in reshaping global communications infrastructure, which presents a structured approach to navigating the intricate challenges of advanced networking technologies and also provides a critical pathway for addressing the exponentially growing computational demands of future communication ecosystems.

We present a 8-page proof establishing that the Erd®sMoser equation 1 k + 2 k + • • • + (m − 1) k = m k admits only the trivial solution (k, m) = (1, 3), corresponding to 1 1 + 2 1 = 3 1. Our approach combines elementary number theory with a proof by contradiction, demonstrating the non-existence of non-trivial solutions. This result resolves the conjecture attributed to Erd®s and Moser Erd®s [1950s].

Riemann Hypothesis is a conjecture that states that all non trivial zeros of Riemann function are located on critical strip exactly on 1/2. This conjecture has been unsolved for over 160 years. In this proof that contains 294 pages, I will prove the conjecture of Riemann hypothesis using theorems and formulas that have never discovered before , I will also prove that there is and other function that is similar to Riemann Zeta Function and all its non trivial zeros lie exactly on critical strip-1/2 If mathematician like Ramanujan has found the sum of this infinite series : 1+2+3+4+5+6+7+…… =-1/12 , I will prove the value of this infinite product : (-2)*(-3)*(-5)*(-7)*(-11)*(-13)*(-17)*…………. = ? If the mathematician Euler has prove that 1/1 2 +1/2 2 +1/3 2 +1/4 2 +1/5 2 +….. =∏ 2 /6

In this study, the protective gas Ar of lead bismuth eutectic (LBE) operating environment and the substances such as Po、Pb、Bi、Po 2、Bi 2、PbPo produced during LBE operation were divided into three-atom group (Po 2-Po、Po 2-Pb、Po 2-Bi、Bi 2-Po、Bi 2-Pb、Bi 2-Bi、PbPo-Po、PbPo-Pb、PbPo-Bi) and four-atom group (Po 2-Po 2、Po 2-Bi 2、Po 2-PbPo、Bi 2-Bi 2、Bi 2-PbPo、PbPo-PbPo). The intermolecular interaction potential of each component was calculated respectively, and the Lennard-Jones (L-J) parameters of each component were obtained according to the relevant formula. Based on these L-J parameters, the transport properties such as binary diffusion coefficient, viscosity coefficient and thermal conductivity at high temperature were calculated. The results show that the well depth of each component of the three-atom group is much greater than that of the four-atom group, which results in the binary diffusion coefficient of each component of the three-atom group is much smaller than that of the four-atom group. In addition, it was found that the viscosity coefficient and thermal conductivity of the same substance seemed to have a fixed ratio, so we calculated the Prandtl number of Po 2 and Bi 2, and compared them with the Prandtl number of substances such as air, water and argon, and found that the thermal conductivity of Po 2 and Bi 2 was better than that of water and argon, but slightly lower than that of air. Finally, we calculate the rate constant of reaction PbPo+Po→Po 2+Pb in the temperature range of 400 K~2000 K at standard pressure(1.0 bar).

Aquaporins are water transporting channels, present in mammals, plants, bacteria, yeast, and amphibians facilitating the osmoregulation of water as well as some small solutes. Aquaporin Z (AqpZ), a water-selective aquaporin from E. coli strain, specifically transporting water by rejecting all other types of solutes and ions, has become a popular choice in biomimetic channels used for water filtration due to its efficiency and specificity. This study is focused on exploring effects of point mutations in/near the conserved Selectivity Filter (SF) of AqpZ, which are F208W, F208T, F208C, F208K, F43Y, F43S, F43A, F43D, R189T, H174T, T183S and T183S/F208W. Using all-atom MD simulations, we analyzed their impacts on conformational changes, structural stability, pore radius and the water permeability rate. The free energy profiles were calculated using PMF calculation and MM-GBSA methods to evaluate the structural integrity of the tetrameric assembly. While most single point mutations did not significantly alter the conformations of conserved residues but notable changes were observed in loop flexibility and arginine189 gate, disrupting the hydrophobicity of pore and the channel permeability. Among mutants, F208W increased the water permeability by 10 percent, while F43D resulted in a blocked channel leading to a loss of functionality and a double mutant T183S/F208W has the wildtype-like behavior and functional characteristics. The findings indicate that the improved channel’s permeability does not necessarily correlate with pore size but with the delicate balance of polar and hydrophobic interactions in the SF region. The study underscores the critical role of conserved residues in regulating the channel’s functionality.

Pseudohypoparathyroidism Type 1a: Delayed presentation

IntroductionCloacal exstrophy (CE) is an exceedingly rare and complex congenital defect that involves the exstrophy of the urinary, gastrointestinal, and genital organs, with an estimated incidence of less than 1 in 200,000 live births [1]. It is widely considered one of the most severe and complicated anomalies in pediatric urology and surgery, given the involvement of multiple organ systems [2]. Typically, CE is associated with other malformations, including myelomeningocele, imperforate anus, and omphalocele, and it poses significant challenges to both diagnosis and management [3]. The condition results from a failure in normal embryologic development of the cloaca, a structure that, during the early stages of gestation, separates into the urogenital sinus and the anorectal canal. When this separation process is disrupted before the fourth week of gestation, it leads to the manifestation of CE [4].Historically, the prognosis for children born with cloacal exstrophy was poor, with survival rates hindered by associated complications such as sepsis, short bowel syndrome, and renal failure [5]. However, advances in neonatal care, surgical techniques, and post-operative management have significantly improved survival rates in recent decades, with current survival rates ranging from 83% to 100% in some regions [6]. The complexity of CE requires a multidisciplinary approach, often involving pediatric surgeons, urologists, and other specialists to address the various associated defects [7]. Traditionally, the surgical management of CE was approached in multiple stages, beginning with the creation of an ileostomy, followed by bladder closure, abdominal wall repair, and other reconstructive procedures [8]. However, with the advent of improved techniques, primary repair strategies are now being explored and implemented with promising results in carefully selected cases [9].Despite these advancements, long-term outcomes remain variable, and many challenges still exist in achieving functional outcomes such as urinary and fecal continence, as well as addressing the cosmetic and psychological aspects of care [10]. The current treatment approach emphasizes individualized care, addressing the most life-threatening conditions initially while progressively managing the anatomical and functional restoration of affected organs [11]. This case report aims to highlight a successful example of primary repair for cloacal exstrophy, including the closure of the posterior bladder wall and the creation of an ileostomy, with an emphasis on the current progress and challenges in the management of this complex condition.

Title PageTitle: An Atypical Case of Takotsubo Cardiomyopathy in a Middle-Aged Male Triggered by Work-Related Stress Keywords: takotsubo cardiomyopathy; stress-induced cardiomyopathy; atypical presentation; work-related stress; transient left ventricular dysfunction; NSTEMI mimic; normal coronary angiography Authors: Dr. Bassim Albizreh,MD. Hamad Medical Corporation, Qatar Corresponding Author: Dr. Gagan Manoher, MD. ORCID#0009-0000-2229-6285 Email: Gmanoher@hamad.qa Dr. Fahmi Othman, MD. ORCID#0000-0002-4724-8850 Email: Fothman@hamad.qa All authors are affiliated with Hamad medical corporation

Grain spot disease in rice, caused by Curvularia lunata, poses a significant threat to rice production, leading to substantial yield losses. Aim of the study is to isolate, identify, and evaluate the pathogenicity of C. lunata from infected rice grains in Tamil Nadu, India. The pathogen was isolated using single hyphal tip and spore isolation techniques, followed by morphological and molecular identification. Colonies exhibited rapid growth on Potato Dextrose Agar (PDA), with distinct greyish-brown pigmentation. Light and scanning electron microscopy confirmed the characteristic conidial morphology of C. lunata. Molecular identification using ITS region sequencing confirmed the species identity, with the isolate showing 89% genetic homology to previously reported C. lunata strains. Pathogenicity tests confirmed the fungus as the causal organism of grain spot disease, as inoculated plants developed characteristic lesions, fulfilling Koch’s postulates. Growth analysis on different media revealed PDA as the most suitable for optimal mycelial development and sporulation. The findings emphasize the necessity of early detection and effective management strategies to mitigate C. lunata-induced grain spot disease in rice. Future research should focus on the genetic diversity of C. lunata isolates, host-pathogen interactions, and resistance breeding in rice. Additionally, exploring eco-friendly biocontrol agents and integrated disease management approaches could offer sustainable solutions. This research contributes to the understanding of C. lunata as an important rice pathogen and underscores the need for continued surveillance to prevent potential outbreaks in rice-growing regions worldwide.

Introduction: Respiratory distress syndrome (RDS) is often accompanied by low blood pressure and fluctuations in brain perfusion in premature infants. The present study aimed to assess the effectiveness and validity of concurrent cerebral and pulmonary near-infrared spectroscopy (NIRS) monitoring in the management of RDS. Methods: The study included 24 premature infants <34 weeks who were diagnosed with RDS (of the infants, 5 died [RDS non-survivors] and 19 survived [RDS survivors]) and 7 infants <34 weeks without RDS were enrolled. The infants were continuously monitored by cerebral and lung NIRS for the first 72 postnatal hours. Trends of regional pulmonary oxygen saturation (rSO 2L) and cerebral regional tissue oxygenation (rSO 2C) were analyzed. Additionally, rSO 2L values before and after surfactant treatment were compared. Results: In the RDS non-survivors, rSO 2C was significantly lower than that of the control group between the 14 th and 26 th postnatal hours, without any difference in the RDS survivors. Mean rSO 2C in the RDS non-survivors at this period was 66%±8.4. The rSO 2L values after surfactant treatment were significantly higher than that of the pre-administration values (p=0.04) in the RDS survivors, but no difference was observed in the RDS non-survivors. Conclusions: Concurrent cerebral and lung NIRS is a useful adjunct monitoring modality in RDS, especially in predicting short-term outcomes (notably in predicting mortality) and in the management of surfactant treatment and possibly other clinical interventions.

Understanding variability and trends in the near-surface diurnal air temperature range (DTR) remains unclear due to its complex interactions with antecedent radiative and hydrologic conditions. Here, we use a thermodynamic systems approach, and show that DTR primarily reflects changes in lower atmospheric heat storage, governed by diurnally constrained non-latent energy input from the surface into the atmospheric boundary layer. This approach predicts DTR across a range of climates, reproduces its day-to-day variations, and explains its decline with global warming. We show that in addition to strong controls exerted by radiation and cloud cover, DTR carries imprints of surface water stress during the water-limited evaporative regime. Our expression yields a mean reduction of 0.23°C in DTR per 1°C rise in temperatures, in response to changes in greenhouse gas forcings. Our findings imply that the first-order decline in DTR with global warming can be explained by increases in greenhouse gas forcings alone.

AbstractThe fast-moving field of data science is increasingly permeating into the health and care actuarial sciences. Given this context, the Institute and Faculty of Actuaries set out to form a “techniques in data science in health and care” working party. This working party was tasked to create a framework to assist health and care actuaries to determine what techniques are appropriate for their project. The framework presented here consists of an itemised checklist covering all aspects of health and care data analytics projects. Each itemised topic is covered by a summary providing guidance and relevant references for further reading. The framework blends relevant analytics elements from actuarial science, data science and epidemiology. We hope the framework will improve transparency, reproducibility, completeness and reporting of life and health data analytics projects.

Conventional satellite-based navigation systems do not provide required navigation performance and accuracy in indoor environments. This entails the development of indoor navigation systems that can either work independently or in conjunction with the satellite-based as well as on-board navigation systems. This paper discusses some of the existing indoor navigation systems before presenting a novel Acoustic Navigation and Guidance System (ANGuS). Echolocation exhibited by mammals like bats and dolphins as well as some visually impaired humans is discussed. Significant research efforts have focused on the dilution of precision for outdoor radio navigation systems, both terrestrial and satellite-based. However, indoor navigation systems pose considerably different challenges, which would potentially require a different approach from the techniques developed for outdoor navigation systems. One such approach would be how the issue of poor geometry is tackled for multistatic indoor navigation systems. Due to higher elevation angles, even a slight change in beacon arrangement indoors can significantly affect the geometry and consequently the position dilution of precision as well as the positioning error. An alternate positioning error estimation technique is proposed for high PDOP multistatic navigation systems, thus improving error budgeting and system design of indoor navigation systems. Experimental results of ANGuS, including static positioning tests, flight tests on an unmanned aerial platform, and ground tests on a tracked vehicle are discussed. A simulation case study looking at integration of on-board inertial measurement unit (IMU) with ANGuS is also discussed.

The pollen morphology of 13 Euphorbiaceae species and one Phyllanthaceae species native to forest fragments of Cerrado was investigated to contribute to expanding the morphological knowledge and characterizing species for the conservation of degraded areas. The pollen grains were acetolyzed, measured, and photographed using light microscopy (LM). To obtain more details of exine ornamentation, non-acetolyzed pollen grains of some species were observed using scanning electron microscopy (SEM). The qualitative data were described, a pollen key was presented, and descriptive and multivariate statistics analyzed the quantitative data. The pollen grains of Euphorbiaceae differ in polarity, size, amb, shape, number, and type of apertures (inaperturate, 3-colporate, 4-porate, or pantoporate), type of endoapertures (circular, lalongate, lolongate or endocingulate) and exine ornamentation (psilate, microreticulate, reticulate, or with Croton-pattern). Phyllanthus acuminatus Vahl. (Phyllanthaceae) presents pollen grains in monads, isopolar, medium, circular amb, oblate spheroidal, 3-diploporate, and exine pilate. The number and type of apertures, the morphology of the endoapertures, and the ornamentation of the exine were the essential data for distinguishing the studied species, in addition to the diameter measurements and the variations in the thickness of the exine layers being quantitative characters that characterize the analyzed taxa. These results define the palynology of species from native families within Cerrado forest fragments, which are a priority for conservation areas.

Defaunation of large-bodied animals threatens essential ecosystem functions, such as seed dispersal. However, the impact of this ‘downsizing’ of animal communities on plant-frugivore trait matching—the alignment of frugivory-related plant traits (e.g., fruit size) with frugivore traits (e.g., body mass)—remains poorly understood at macroecological scales. Here, we investigate how human disturbance and environmental conditions influence trait matching in plant-frugivore networks across the tropics. We compiled data on fruit size and frugivore body mass for 1,927 plant and 1,120 animal species and integrated these with 12,708 interaction records across 102 networks. Using fourth-corner analyses and structural equation models (SEMs), we assessed how human disturbance and environmental conditions affected trait matching strength across networks. SEMs revealed that these factors influenced trait matching strength through indirect pathways: human disturbance weakened trait matching by reducing the range of frugivore body masses within networks, whereas wet and productive ecosystems, where the proportion of fruit in frugivore diets is higher, supported stronger trait matching. Our synthesis shows that plant-frugivore trait matching is a widespread macroecological pattern that is weakened by human disturbance, particularly through the defaunation of large-bodied animals. Human activities are thereby decoupling the coevolved relationships between fruiting plants and their animal seed dispersers.

Background and Purpose: Astrocyte senescence plays a critical role in age-related cognitive decline and Alzheimer’s disease. This study investigated whether baicalein can delay astrocyte senescence and alleviate age-related cognitive decline. Meanwhile we explored the potential mechanisms by focusing on alterations in lipid metabolism. Experimental Approach: The anti-astrocyte senescence effects of baicalein were evaluated using SA-β-gal staining,cell cycle assay and so on. The molecular mechanisms underlying the effects of baicalein were elucidated by integrating transcriptomics and liquid chromatography-mass spectrometry (LC-MS) metabolomic approaches. The anti-senescence effects of key metabolites were verified in primary astrocytes. Subsequently, we confirmed the effects of baicalein on cognitive decline, astrocyte senescence, and key lipid metabolites levels in naturally aged mice model. Key Results: Our study demonstrate that baicalein protects against astrocyte injury and senescence. Transcriptomic - metabolomic integration reveals that lipid metabolism as a key pathway modulated by baicalein, with oxoglutaric and fumaric acid emerging as crucial metabolites. Also oxoglutaric and fumaric acid directly attenuate astrocyte senescence. In naturally aged mice, baicalein treatment significantly improved cognitive dysfunction, mitigated astrocyte senescence, and increased oxoglutaric acid levels. Collectively, these findings indicate that bacalein delays astrocyte senescence both in vitro and in vivo, and it may correlated with oxoglutaric and fumaric acid levels. Conclusion and Implications: This study demonstrates that baicalein effectively attenuates astrocyte senescence and ameliorates age-related cognitive dysfunction, likely through modulation of oxoglutaric and fumaric acid metabolism. Our work underscores the pivotal role of metabolic dysregulation in astrocyte senescence, revealing potential targets to combat age-associated neurological disorders.

Early phase trials, including phase II trials, play a direct role in the UK’s ambitions to lead in life sciences innovation, as outlined in its commitment to fast and efficient clinical research environments (Life Sciences Vision, UK Government, 2021). The analysis by Manfrin and colleagues of clinical trial submissions (Manfrin et al., 2025), clearly highlights the domination of commercial sponsors when it comes to early phase ATMPs (92.8% of submissions). Why is this? It is clear that commercial sponsors have and continue to be positioned as central stakeholders (Lord O’shaughnessy, 2025), (the data supports this, commercial sponsors represented 85.1% of the total submissions) and in turn justifies their significant integration into the UK government and regulatory infrastructures that shape the clinical trial landscape. Non-commercial sponsors are now firmly placed on the periphery, yet despite this they demonstrate remarkable resilience by submitting the greater number of phase II trials (37.3 v 26.6%). Their ability to conduct complex trials in these conditions is a remarkable achievement, underscoring both the importance and the potential of non-commercial research. Ultimately, a more inclusive and equitable regulatory system is needed—one that recognises and supports the efforts of non-commercial sponsors, enabling them to continue their vital contributions to the UK’s clinical research ecosystem, rather than keeping them on the outside. Mohammed Zubair, Ph. D Sponsor Representative The University of Manchester

Type I Enteropathy-Associated T-Cell Lymphoma as a complication of late diagnosis of Celiac Disease: A Case ReportRaja Alqandouz1, Abdelrahman I. Babiker2, Waad Ahmed2, Abdelkareem Alhyari3, Hussam Telfah3, Mohamed Lameir Mukhtar Hussein4, Ali Rahil11. Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar2. Department of Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar3. Department of Laboratory Medicine and Pathology, Anatomic Pathology Division, Hamad Medical Corporation, Doha, Qatar4. Department of Radiology, Hamad Medical Corporation (HMC), Doha, QatarCorrespondence: Raja Alqandouz (RAlqandouz@hamad.qa)