Background: Malignant Brenner tumor (MBT) is an exceptionally rare epithelial ovarian neoplasm, accounting for less than 1% of malignant ovarian tumors. No prospective data exist, and systemic therapy is extrapolated from high-grade epithelial ovarian carcinoma. Case presentation: A 37-year-old woman presented with abdominal pain, bloating and altered bowel habit. CT showed a large sigmoid mass inseparable from the left ovary and multiple hepatic lesions; CA-125 was 797 U/mL. Image-guided liver biopsy showed poorly differentiated adenocarcinoma, and sigmoid biopsy showed undifferentiated carcinoma expressing p63 and GATA3, consistent with MBT of ovarian origin (FIGO stage IVB). After multidisciplinary review, palliative carboplatin (AUC 5) and paclitaxel (175 mg/m²) every 21 days were started. Nine days after cycle 2 she developed febrile neutropenia (ANC 0.22 × 10⁹/L) with hypotension and a lactate of 10 mmol/L, requiring 24 hours of intensive care; cultures were negative and she recovered with piperacillin–tazobactam and fluid resuscitation. Treatment resumed at reduced doses (carboplatin AUC 4, paclitaxel 150 mg/m²) with pegfilgrastim. CA-125 rose to 1,232 U/mL before cycle 2 and fell to 645 U/mL before cycle 3; CT after cycle 2 showed stable hepatic metastases and a mild response of the pelvic primary. Literature update: Following the PRISMA-based 2024 systematic review (115 cases, searched to 15 September 2023), a provisional update search identified four further patients with ovarian MBT meeting the review's diagnostic criteria, with five more awaiting full-text assessment. All included cases, and all pending cases with a reported stage, were stage I–II; none described stage IV disease or hepatic metastases. Conclusions: Diagnosing MBT on biopsy material alone is difficult and depends on integrating morphology and immunohistochemistry with exclusion of urothelial and colorectal primaries. Treatment evidence is limited to case reports, small series and registry data, and carboplatin–paclitaxel is the most commonly reported regimen. Genomic data suggest that MBT is usually microsatellite-stable without homologous recombination deficiency and frequently carries FGFR3 alterations, so comprehensive profiling is more informative than empirical PARP or checkpoint inhibition.

The African Court on Human and Peoples’ Rights was established to strengthen continental judicial protection of human rights. However, access to its jurisdiction remains partly dependent on State consent. This paper examines whether the conditional nature of individual standing under Articles 5(3) and 34(6) of the Court Protocol affects the distribution of procedural authority which is between States, rights-holders and the Court. And what this reveals about the Court’s democratic legitimacy twenty years after its establishment. The study employs doctrinal legal analysis, treaty interpretation, examination of the Court’s jurisprudence and institutional analysis. Although it had limited comparative reference where relevant. Reading the Court’s rules of access through the lens of coloniality and democratic legitimacy. The focus is on the connection between the substantive rights and the ability to bring a case before the Court at the continental level. The study shows that the Protocol does acknowledge that individuals are subjects of rights, but denies them the same and autonomous path to the Court in countries that do not accept or have withdrawn their declarations of Article 34(6). Although indirect access through the African Commission provides an alternative route, but referral remains institutionally controlled. It does not place the individual in the same procedural position as a direct applicant. The study therefore identifies a persistent State-centred distribution of procedural authority that can weaken the participatory dimension of the Court’s legitimacy. It recommends stronger Commission referrals, greater acceptance of direct jurisdiction, safeguards for proceedings affected by withdrawal, and clearer limits around the use of State consent as a condition of individual access.

Background: Trastuzumab deruxtecan (T-DXd) is a HER2-directed antibody–drug conjugate (ADC) with substantial activity across HER2-expressing breast cancer. Interstitial lung disease (ILD)/pneumonitis is its most important adverse event of special interest and can be fatal. We report an early-onset, oxygen-requiring case and systematically review the incidence, timing, presentation, and management of T-DXd–associated ILD in breast cancer. Case presentation: A 47-year-old woman with de novo ER-negative, PR-negative, HER2-positive metastatic breast cancer (hepatic, pulmonary, and osseous metastases) and hepatic visceral crisis (total bilirubin 375 µmol/L) started T-DXd on 28 June 2026. After two cycles, bilirubin fell to 113 µmol/L and then normalised, with multisite radiological response. Approximately 5 weeks after the first dose she developed dyspnoea, non-productive cough, low-grade fever, tachycardia, and hypoxaemia (SpO₂ ≈88% on room air). CT pulmonary angiography excluded embolism and showed new bilateral ground-glass and consolidative opacities with interlobular septal thickening, while pulmonary metastases were regressing. Bronchoalveolar lavage (BAL) was negative for malignancy, fungi, and Pneumocystis jirovecii. Grade 3 T-DXd–associated ILD was diagnosed; T-DXd was permanently discontinued and prednisolone (≈1 mg/kg/day) plus empirical piperacillin–tazobactam and supplemental oxygen were started, with clinical stabilisation. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, and major oncology congress proceedings to 31 October 2026 for prospective trials of T-DXd in breast cancer reporting ILD incidence and for case reports/series of T-DXd–associated ILD. Incidence was pooled with a DerSimonian–Laird random-effects model on the logit scale. Results: Eight prospective trials (3,341 T-DXd-treated patients) were pooled. Any-grade drug-related ILD occurred in 12.1% (95% CI 10.7–13.6; I² = 39%) and grade 5 ILD in 0.8% (95% CI 0.5–1.5). In metastatic disease the pooled incidence was 12.7% (11.4–14.0; I² = 0%); in HER2-positive metastatic disease, 13.1% (11.4–15.0). Case reports (7 patients) and national post-marketing data showed an organising-pneumonia–predominant imaging pattern, onset ranging from 2 to 9 cycles, frequent prolonged corticosteroid dependence, and use of cyclophosphamide, infliximab, mycophenolate, or tacrolimus in steroid-refractory cases. Conclusions: Roughly one in eight breast cancer patients receiving T-DXd develops ILD, and about 1% die of it. Onset can be early, and ILD can emerge during an excellent tumour response—discordant radiology (regressing nodules with new diffuse opacities) is a useful diagnostic clue. Structured respiratory surveillance, low threshold for CT, prompt exclusion of infection, permanent discontinuation for grade ≥2 events, and grade-appropriate corticosteroids remain central. Keywords: Trastuzumab deruxtecan; interstitial lung disease; pneumonitis; HER2-positive breast cancer; antibody–drug conjugate; visceral crisis; systematic review; meta-analysis.

This work offers a detailed examination of the corrosion inhibiting action of an aqueous extract derived from Eichhornia crassipes (water hyacinth), employed in conjunction with zinc oxide (ZnO) nanoparticles, as a hybrid green formulation for mild steel exposed to 1.0 M HCl. The study confronts two interrelated objectives: reducing metallic deterioration in highly acidic media and repurposing an invasive aquatic weed into a usable material resource. A series of electrochemical measurements, including impedance spectroscopy and potentiodynamic polarization, were carried out over a range of extract to nanoparticle ratios. The optimal composition 0.5 g of plant extract combined with 0.1 g of ZnO yielded a maximum efficiency of 55.73%, a value substantially higher than that recorded for either constituent alone, thus confirming a cooperative enhancement effect. Polarization data further revealed that the combined system acts as a mixed inhibitor, moderating both anodic metal dissolution and cathodic hydrogen discharge. Microscopic and spectroscopic surface analyses (SEM–EDX) provided clear evidence of a dense and well adhered film covering the steel substrate, which curtailed both localized pitting and widespread surface loss. The presence of naturally occurring phytochemicals tentatively identified as flavonoids, tannins, and phenolics together with the inherent surface activity of ZnO nanoparticles, appears to facilitate improved adsorption and prolonged film resilience. This chemical interplay forms the basis for the observed rise in protective performance. Beyond the laboratory findings, the study underscores the practical viability of transforming an ecological nuisance into an inexpensive, non-hazardous inhibitor, positioning it as a plausible substitute for conventional but hazardous compounds such as chromates and synthetic organic inhibitors. In a broader context, the results support the principles of waste valorization and resource cycling, while pointing toward future work on nanoparticle surface modification and improved extraction protocols.

Founded in London in 1717 by artisans and small merchants, the Grand Lodge was rapidly taken over from 1721 by aristocrats and the landed gentry, who transformed it into an instrument of elite socialization and networking. Critics argue that Freemasonry operates as a club of mutual favors, using members' positions in politics, the judiciary, and the economy to benefit fellow Masons, acting as a state within a state whose secret rituals and lodge oaths take precedence over national laws and democratic scrutiny. The text reproduces material from a 1939 Training Bulletin of the National Socialist Party and the German Labor Front. That material, whose contents include contributions by Dr. Goebbels and Mussolini, asserts that the Jew, seeking to tear down racial and civic barriers, employs Freemasonry, which has fallen entirely under his dominion, as an instrument to ensnare governing circles and the upper strata of the political and economic bourgeoisie through Masonic threads. The reader is invited to assess this material and form an independent, well-founded opinion.

Based on James Phelan’s theory of unreliable narration, this paper analyzes Kazuo Ishiguro’s Never Let Me Go from three dimensions: fact, ethics and knowledge. Centering on Kathy’s misreporting, underreporting, misjudgment, under judgment, misinterpretation and under interpretation, the study explores technological violence, subject disintegration and cognitive confinement behind her retrospective narration. The clone protagonist beautifies memories and adopts institutional discourse to gloss over organ exploitation and surveillance, failing to recognize the systematic oppression embedded in Hailsham. She identifies with the donation system and misjudges self-value, while distorted cognition keeps her from comprehending interpersonal intimacy and the instrumentalized nature of cloned bodies. Her futile pursuit of prototypes further exposes the existential confusion of clones stripped of subjectivity. The novel reveals how power disciplines and deprives marginal lives, and reflects on bioethics and technological development. It also indicates that unilateral narratives constructed by technological systems may mislead public cognition, highlighting the importance of critical awareness and ethical norms for scientific progress.

Pharmacovigilance, Materiovigilance, and Haemovigilance together form the backbone of healthcare safety monitoring in India, yet their coverage in undergraduate curriculum remains inconsistent. This prospective cross-sectional study assessed the impact of a short structured educational session on knowledge, attitude, and practice of all three vigilance systems among 200 final-year medical and paramedical students at a tertiary care teaching hospital in Raichur, Karnataka. A validated pre-test/post-test questionnaire was administered before and after a 15-minute seminar; data were analyzed by the Wilcoxon Signed-Rank Test and Chisquare test (SPSS v20.0). The cohort was 56% female, with a mean age of 22.21 ± 1.87 years; pharmacy students made up 79% of participants. Haemovigilance showed the clearest benefit: knowledge improved significantly (p = 0.033) and practice improved highly significantly (p = 0.0002). Pharmacovigilance knowledge edged upward but did not reach significance (p = 0.052), while attitude fell sharply (p = 0.0001). In Materiovigilance, both knowledge (p = 0.035) and attitude (p = 0.032) declined significantly after the session, though all four practice items improved on Chi-square analysis. The declines in attitude scores likely reflect critical recalibration rather than genuine disengagement. A single short seminar can shift knowledge and practice in selected domains, but is insufficient for attitude change across all three. Regular, multi-session, curriculum-integrated vigilance training is needed to build the reporting culture that patient safety requires.