Photothermal therapy offers a promising alternative for treating infected wounds while mitigating antibiotic overuse. However, the limited near-infrared (NIR) photothermal conversion efficiency of polymeric materials hinders their clinical translation. Herein, we report the synthesis of Mn-chelated mesoporous poly(L-DOPA) nanoparticles (Mn-mDOPA) via polymerization-induced self-assembly, where the surfactant/oil ratio and Mn loading are precisely tuned to optimize mesoporosity and photothermal performance. The resulting Mn-mDOPA nanoparticles exhibit enlarged mesopores (≈28-39 nm) and a high specific surface area (up to 75.4 m[2]·g[-] [1]), enabling superior light absorption and heat generation, as confirmed by COMSOL simulations demonstrating a surface-area-dependent photothermal conversion effect. These structural features endow Mn-mDOPA with efficient NIR-triggered bacterial eradication (99.9% for S. aureus and 99.7% for E. coli) and substantial dark antibacterial activity (> 90%), attributed to the synergistic effects of hyperthermia and mesopore-mediated bacterial disruption. Moreover, the abundant catechol groups impart potent ROS scavenging capacity, alleviating oxidative stress and protecting wound-related cells. In a S. aureus-infected wound model, Mn-mDOPA effectively suppresses inflammation, promotes angiogenesis, and accelerates wound closure. Collectively, these results highlight Mn-mDOPA as a multifunctional, antibiotic-free nanoplatform that integrates enhanced photothermal conversion, intrinsic antibacterial activity, and antioxidant protection, providing a highly promising strategy for localized infection control and wound regeneration.

Bacterial biofilms present a major challenge to antibacterial therapy due to their dense extracellular polymeric substance (EPS) matrix, which limits nanoparticle penetration and reduces drug efficacy. Here, we report a pH-responsive, surface charge-adaptive multifunctional nanosystem (DA-L@DTTB/Bro) for efficient in vivo treatment of biofilm-associated infections. The nanosystem integrates pH-triggered charge adaptation, in situ self-aggregation, photothermal responsiveness, enzymatic EPS degradation, and NIR-II imaging. Cationic phospholipid AGPDP, together with cholesterol and thermosensitive DPPC, self-assembled into liposomes encapsulating bromelain in the hydrophilic core and an NIR-II-emissive photothermal agent (DTTB) in the hydrophobic layer. Surface modification with DA-functionalized chitosan (CS-DA) generates negatively charged nanoparticles for prolonged circulation. At acidic infection sites, DA hydrolysis restores the cationic surface, enhancing biofilm penetration, while residual CS-DA induces self-aggregation to improve retention. NIR irradiation triggers DTTB-mediated hyperthermia, directly killing bacteria and disassembling liposomes to release bromelain, which degrades EPSs and facilitates biofilm dispersion. The nanosystem eradicates methicillin-resistant Staphylococcus aureus biofilms in vitro with 99.99% efficiency, enables high-contrast NIR-II imaging, persists at abscess sites in vivo, and accelerates wound healing. Furthermore, it demonstrates effective therapeutic activity against biofilm-associated infections in deep pulmonary tissues. This study presents a versatile intravenous strategy for targeted, synergistic therapy against biofilm-associated infections in vivo.

Respiratory distress and tumor progression in malignant tracheal stenosis are both life-threatening. Anticancer drug-releasing tracheal stents achieve long-term localized chemotherapy to the tracheal tumor while dilating the airway; however, they cannot directly kill metastases. Furthermore, the anti-inflammatory stage during the chronic inflammatory response caused by stent placement reduces the effectiveness of stent-mediated chemotherapy. In this study, we propose a paclitaxel (PTX), resiquimod (R848) and Fe3O4 nanoparticles co-loaded tracheal stent (PTX/R848 stent), which exhibited self-expansion performance, magnetocaloric effect, and sustained co-release of PTX and R848, for local chemotherapy, magnetic hyperthermia (MH) and immunomodulation to enhance systemic immunity and antitumor effects synergistically. The PTX/R848 stent, in addition to relieving the stenosis, when combined with self-mediated MH, led to a decrease in HIF-1 levels and inflammatory responses, accompanied by increased macrophage infiltration in tumors. After 14 days of treatment, infiltrated macrophages were polarized from the anti-inflammatory M2 phenotype to the pro-inflammatory M1 phenotype, and the immune response to PTX- and MH-induced immunogenic cell death was promoted under the combined effects of released R848 and MH-mediated hypoxia alleviation. As a result, levels of effector T cells and pro-inflammatory cytokines (TNF-α, IFN-γ, IL-12) in both tumors and blood increased significantly, accompanied by promoted inhibition of both primary tumors and metastases, indicating the potentiation of systemic immunity and antitumor efficacy. Transcriptomic analysis also confirmed enrichment of immune-related pathways. In summary, the combined therapy mediated by the PTX/R848 stent achieves comprehensive and effective treatment of malignant tracheal stenosis and related metastases.

The performance of a multifunctional nanotheranostic depends on how its macromolecular assembly controls the loaded agents at the interface. Here, we report a bio-based nanoplatform (M8) built from an amphiphilic poly(lactide)-TPGS matrix and designed for colorectal cancer theranostics. Beyond efficient co-encapsulation (>85%), the controlled assembly of these segments gives a stepwise structural amplification of transverse relaxivity (r2), reaching 255.04 mM[-1]⋅s[-1] (r2/r1 = 455.84). This 3.4-fold gain at 7 T, higher than common clinical iron-oxide agents, comes from local magnetic field inhomogeneities and slower water-proton diffusion. Molecular crowding and homo-FRET first lower the NIR emission inside the core, but this turns into a fluorescence dequenching effect that reveals tumour accumulation in CT26 colorectal cancer models. The lipophilic PPIX, owing to its lipophilicity, is expected to localize preferentially toward the polymer shell, supporting interfacial ROS generation; together with magnetic hyperthermia and doxorubicin chemotherapy, the platform delivers a triggered multimodal cytotoxic response. Under combined laser and alternating magnetic field, the cytotoxicity increased 13-fold for M8 (IC50 from 12.31 to 0.95 µg/mL) and 29-fold for M4 (from 3.51 to 0.12 µg/mL), while normal Vero cells stayed largely unaffected (IC50 23-30 µg/mL), giving an in vitro therapeutic window above 30-fold. In CT26 tumour-bearing mice, M8 gave strong T2 signal darkening in the tumour, with 4.4- and 6-fold rises in the low- and high-signal pixel fractions, and NIR imaging confirmed tumour retention beyond 24 h. These results show how the colloidal structure links imaging and therapeutic performance, and offer a practical design route for colorectal cancer theranostics.

Extracorporeal cardiopulmonary resuscitation (ECPR) for pediatric cardiac arrest relies on enhanced resources and time-critical decision-making. We aimed to evaluate variations in systems and clinical practice among extracorporeal membrane oxygenation (ECMO) centers that offer ECPR for neonatal and pediatric patients using an online survey. Fifty-three ECMO centers participated, representing all five ELSO chapters. All centers had a similar understanding of the ECPR definition. The predominant intensive care unit (ICU) patient population was: cardiac (34%), mixed (51%), general (7.5%), neonatal (1%), and mixed adult and pediatric (6.5%). All centers activated ECPR teams within 10 minutes of starting conventional CPR. Thirty-four (64%) centers keep a primed circuit available for ECPR 24/7. Thirty-six (68%) centers have an institutional protocol on ECPR. The cardiac surgeon was the most common (94%) cannulator. Staffing levels varied during working hours compared to nights and weekends. Thirty-eight (71%) centers did not apply cooling measures during and after the initiation of ECPR. Oxygenation and CO2 strategy varied between centers upon ECMO flow commencement. Forty-two (81%) centers aimed to maintain normothermia and avoid hyperthermia. Twenty-three (44%) centers have guidelines on organ donation and neurodevelopmental follow-up. Conclusion-significant variations exist in systems and clinical practice among ECMO centers offering pediatric ECPR. Further research is needed to understand the reasons for these differences and their impacts on patient outcomes.

Pancreatic cancer remains highly refractory to conventional therapies owing to its immunosuppression of the tumor microenvironment (TME) and dense stromal structure. Nanomaterial-based strategies offer promising avenues for integrating multimodal treatment and modulating immunosuppressive TME. Here, we utilize MXene nanosheets as the photothermal substrate, loading chlorophyll e6 (Ce6) as the photosensitizer, and coating with a hybrid membrane that is derived from cancer cells and thylakoid vesicles, which can achieve dual-mode photothermal and photodynamic therapy (PTT/PDT) under near-infrared light irradiation. Notably, the thylakoid membrane component facilitates in situ oxygen generation, effectively alleviates the hypoxia of the tumor, and significantly boosts reactive oxygen species (ROS) production for enhanced PDT. In vitro and in vivo research exhibit potent tumor suppression, exhibiting a 90% inhibition rate, achieved via synergistic hyperthermia and oxidative stress, accompanied by significant immunogenic cell death (ICD), dendritic cell (DC) maturation, and cytotoxic T-cell infiltration. Moreover, the combination of this nanoplatform with αPD-1 therapy can not only inhibit primary pancreatic tumor progression but also elicit abscopal effects and systemic antitumor immunity. This multifunctional nanoplatform presents a highly promising nanomedicine strategy for overcoming pancreatic cancer's therapeutic challenges by synergistically integrating phototherapy and immunotherapy, with clinical translational potential.

The clinical imperative to treat maternal hyperthermia with acetaminophen is complicated by emerging evidence of the drug's association with neurodevelopmental disorders. This article examines this risk-benefit challenge and proposes a shift toward a more nuanced, indication-specific prescribing paradigm in pregnancy.

Review of the primary literature was used to develop six propositions regarding the nature of actions of heat stress on fertility of the bovine female. The first two propositions are that the reduction in fertility caused by heat stress is due to 1) negative effects on the competence of the oocyte to be fertilized and 2) support embryonic development and death of the embryo when exposed to elevated temperature. The third proposition is that it remains unclear whether damage to the spermatozoa occurs after deposition in the reproductive tract of a heat-stressed female. Fourth, the embryo acquires resistance to heat stress after activation of the embryonic genome. Fifth, heat stress after the first few days of pregnancy usually has only slight effects on embryonic or fetal survival. Sixth, the magnitude of effects of heat stress on fertility is related to the degree of hyperthermia experienced by the female. Thus, physiological and environmental factors that control ability of an animal to regulate its body temperature during heat stress are important determinants of the magnitude of the impact of heat stress on fertility.

Magnetic biointerfaces have emerged as powerful tools in neuroscience, enabling significant advances in both neural regeneration and neuromodulation. Magnetothermal neuromodulation using magnetic nanoparticles (MNPs) responsive to alternating magnetic fields (AMFs), offers a remote means of localized thermal stimulation of thermosensitive ion channels, which subsequently modulate neural activity, but clinical translation is limited by poor spatial control and off-target nanoparticle distribution. Here, we introduce a magnetically responsive fibrin hydrogel that spatially confines polyethylene glycol-functionalized iron oxide nanoparticles and enables localized magnetothermal stimulation in three-dimensional (3D) neural constructs. Incorporation of MNPs (3-10 mg/mL) yielded hybrid hydrogels with tunable morphology, mechanical properties, and degradation kinetics while generating temperature increases under AMFs. The magnetic fibrin hydrogel supported dorsal root ganglion explant viability (>95%) and promoted neurite outgrowth within a 3D matrix. When adhered to spinal cord tissue ex vivo, the hydrogels produced localized and concentration-dependent heating, demonstrating efficient heat transfer to neural tissue. These results establish fibrin-based magnetic hydrogels as a biocompatible platform for spatially controlled magnetothermal neuromodulation and suggest their potential as implantable interfaces for minimally invasive bioelectronic therapies.

Malignant hyperthermia (MH) is a rare but life-threatening pharmacogenetic disorder triggered by volatile anesthetics and/or depolarizing muscle relaxants, resulting in a hypermetabolic crisis. We report a case of postoperative fulminant MH in a 26-year-old man who underwent general anesthesia with desflurane and rocuronium for mandibular fracture repair. Despite a history of multiple uneventful anesthetics, the patient developed acute hypercapnia, tachycardia, muscle rigidity, and rapid hyperthermia during emergence, following sugammadex administration. Initial treatment for presumed bronchospasm and postoperative shivering-including sevoflurane sedation, hyperventilation, and inhaled bronchodilators-proved ineffective. A clinical diagnosis of MH was made based on the progression of clinical findings, and treatment with intravenous dantrolene 100 mg, active cooling, and antipyretics was initiated. The patient responded well to intervention and recovered without sequelae. This case highlights the importance of considering MH even in the postoperative phase, particularly with the use of desflurane and potentially contributory agents such as sugammadex and ondansetron. Early clinical suspicion, rapid administration of dantrolene, and supportive measures are critical for favorable outcomes. Anesthesia providers must remain vigilant for MH at all perioperative stages and ensure that emergency protocols, appropriate drug stock, and staff readiness are in place.