Browse Articles

Trends and disparities in lung cancer and hypertension-related mortality in the United States, 1999–2023.

e23366 Background: Lung cancer remains a primary driver of mortality in the United States, frequently occurring alongside hypertension, which complicates clinical management and significantly worsens patient outcomes. This study aims to analyze and interpret annual mortality trends and disparities among adults in the United States from 1999 to 2023, for various demographic and geographic factors. Methods: The mortality data from the CDC WONDER multiple cause of death files for adults aged ≥25 years were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 100,000 through ICD 10 code: C34 (lung cancer) and ICD 10 code: I10-I15 (hypertension) stratified by year, gender, race/ethnicity, place of death, and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: From 1999 to 2023, a total of 274,113 deaths were attributed to lung cancer with coexisting hypertension, most occurring at the decedent’s home. The overall AAMR increased from 2.59 in 1999 to 6.05 in 2023 (AAPC: 3.33; 95% CI: 2.27 to 4.41), with the most significant increase observed during the initial years between 1999 and 2001 (APC: 19.43). Men had a higher AAMR than women (5.96 vs 3.92), but the rise in mortality was more pronounced in women compared to men (AAPC: 3.55 vs 3.05). Adults aged 65 years and above had the highest CMR (20.42), with an annual increase of 3.30% (p < 0.001). The highest AAMR was observed among non-Hispanic (NH) Blacks (7.27), while the lowest AAMR was noted among Hispanics or Latinos (2.46). Geographic disparities were evident, with the South having the highest AAMR (5.37) and the Northeast having the lowest (3.96). Non-metropolitan areas had higher AAMR (5.65 vs 4.45) and also showed a sharper increase in mortality than metropolitan areas (AAPC: 4.78 vs 3.12). At the state level, Oklahoma ranked the highest, falling within the top 90th percentile. Conclusions: Mortality related to lung cancer and hypertension has increased over the past two decades, with disproportionate burden among older adults, men, NH Black individuals, and those living in the Southern region and non-metropolitan areas. This underscores the need for targeted prevention strategies and promotion of equitable healthcare services for vulnerable populations. Average annual percent change (AAPC) of age-adjusted mortality rates for Lung Cancer and Hypertension in the United States, 1999 to 2023. Variable Deaths AAPC (95%CI) Overall 274,113 3.33 (2.27 to 4.41) Male 146,982 3.05 (2.06 to 4.05) Female 127,131 3.55 (2.27 to 4.86) Non-metropolitan areas 48,149 4.78 (3.32 to 6.27) Metropolitan areas 175,077 3.12 (2.04 to 4.21)

Pathologic complete response and association with survival benefit in hormone receptor–positive breast cancer BRCA carriers.

e12670 Background: In hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2–) breast cancer, the prognostic significance of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) is less consistent than in triple-negative or HER2-positive disease. BRCA1/2 pathogenic variant carriers demonstrate higher pCR rates to chemotherapy, even within HR+/HER2– tumors, suggesting potential differential chemosensitivity. We evaluated the association between pCR and long-term outcomes among BRCA carriers with HR+/HER2– breast cancer. Methods: We conducted a retrospective, single-institution cohort study of consecutive BRCA1/2 pathogenic variant carriers diagnosed between January 2000 and December 2024. Patients with HR+ (ER > 1%), HER2– stage I–III breast cancer who received NAC were included. The primary endpoint was pCR rate. Secondary endpoints included distant recurrence-free survival (DRFS) and locoregional recurrence. Survival outcomes were estimated using the Kaplan–Meier method and compared using the log-rank test. Results: Among 579 BRCA carriers with stage I–III breast cancer, 169 had HR+/HER2– disease; 49 received NAC and comprised the study cohort. Median age was 39.8 years (range, 24–61), and 27 patients (55%) had BRCA2 mutations. Most received anthracycline- and taxane-based NAC;3 received anthracycline-only NAC, followed by adjuvant a taxane-based therapy. Adjuvant systemic therapy included endocrine therapy in 43/49 patients, olaparib in 14 patients, and abemaciclib in five patients. Median follow-up time was 56.9 (range 7-193) months. The overall pCR rate was 22.4% (11/49), including 31.8% (7/22) among BRCA1 carriers and 14.8% (4/27) among BRCA2 carriers (Fisher’s exact p = 0.185). Among patients achieving pCR, one contralateral breast cancer event occurred, with no distant recurrences observed. In contrast, among patients without pCR, 13 of 38 (34.2%) developed distant recurrence, including one with synchronous local recurrence. Metastatic recurrence occurred in 2 of 12 patients (16.7%) with residual stage I disease compared with 11 of 26 patients (42.3%) with residual stage II–III disease. Ten deaths occurred during follow-up, nine attributable to metastatic breast cancer. Five-year DRFS was 100% in patients achieving pCR versus 61.9% in those without pCR (log-rank p = 0.037). Conclusions: Among BRCA carriers with HR+/HER2– breast cancer treated with NAC, pCR was associated with significantly improved distant recurrence-free survival whereas patients with residual disease—particularly those with residual stage II–III tumors—experienced a high risk of distant recurrence. These findings support pCR as a meaningful prognostic marker in this biologically distinct population and highlight the need for post-neoadjuvant risk-adapted strategies for patients with residual disease after NAC.

Epidemiological trends and burden of thyroid cancer mortality in South Asia: A retrospective analysis from 1990 to 2023 with advanced machine learning forecasting to 2050.

e18126 Background: Thyroid cancer mortality shows regional heterogeneity, with rising trends in many low- and middle-income settings including South Asia, potentially driven by improved detection, environmental exposures, and changing risk profiles. Methods: This study utilized age-standardized mortality rates (ASMR per 100,000) for thyroid cancer from the IHME Global Burden of Disease 2023 database, covering South Asia and its key countries (Bangladesh, Bhutan, India, Nepal, Pakistan) from 1990 to 2023, stratified by sex. Historical trends were quantified using estimated annual percentage change (EAPC) derived from log-linear regression of ASMR. Future mortality projections to 2050 were generated using autoregressive integrated moving average (ARIMA) time-series models fitted to historical data, yielding point forecasts and 95% prediction intervals (PI). Results: In South Asia (Both sexes), ASMR rose from 0.55 (1990) to 0.76 (2023), EAPC +0.93% (95% CI +0.84 to +1.02); males +1.20% (+1.09 to +1.31), females +0.69% (+0.59 to +0.80). Country patterns varied markedly: Bangladesh Both EAPC +0.65% (+0.42 to +0.87), ASMR 0.63 (1990) to 0.98 (2023), forecast 1.12 (0.50–1.75) by 2050; Bhutan Both +0.87% (+0.72 to +1.02), ASMR 0.56 (1990) to 0.81 (2023), forecast 1.02 (0.39–1.64) in 2050; India Both +1.01% (+0.89 to +1.14), ASMR 0.51 (1990) to 0.69 (2023), forecast 0.86 (0.69–1.03) in 2050; Nepal Both +0.20% (0.00 to +0.40), ASMR 0.43 (1990) to 0.57 (2023), forecast 0.52 (0.40–0.63) in 2050; Pakistan Both +0.81% (+0.71 to +0.90), ASMR 0.87 (1990) to 1.09 (2023), forecast 1.28 (1.09–1.46) in 2050. Sex disparities were evident: India males +1.35% (+1.20 to +1.49), Bangladesh males +1.03% (+0.94 to +1.12), Bhutan males +1.06% (+0.93 to +1.19). ARIMA projections indicate continued regional rise to 0.92 (0.80–1.04) by 2050, with Pakistan reaching 1.28, India 0.86, Bangladesh 1.12, Bhutan 1.02, and Nepal stabilizing near 0.52. Conclusions: Thyroid cancer mortality in South Asia increased steadily from 1990–2023 (EAPC +0.93%), with strongest rises in India, Bangladesh, and Bhutan, particularly among males. Projections to 2050 forecast further escalation across most subregions, highlighting the need for enhanced surveillance, risk factor research, early detection, and equitable treatment access. Location Sex EAPC Lower 95%CI Upper 95%CI Bangladesh Both 0.65 0.42 0.87 Bangladesh Female 0.30 -0.02 0.62 Bangladesh Male 1.03 0.94 1.12 Bhutan Both 0.87 0.72 1.02 Bhutan Female 0.79 0.61 0.97 Bhutan Male 1.06 0.93 1.19 India Both 1.01 0.89 1.14 India Female 0.75 0.62 0.88 India Male 1.35 1.20 1.49 Nepal Both 0.20 0.00 0.40 Nepal Female -0.16 -0.39 0.08 Nepal Male 0.74 0.55 0.93 Pakistan Both 0.81 0.71 0.90 Pakistan Female 0.73 0.60 0.86 Pakistan Male 0.64 0.55 0.73 South Asia Both 0.93 0.84 1.02 South Asia Female 0.69 0.59 0.80 South Asia Male 1.20 1.09 1.31

Elderly patients with extranodal MZL: Academic vs community care outcomes.

e13610 Background: Extranodal marginal zone lymphoma (EMZL) of mucosa-associated lymphoid tissue (MALT lymphoma) is the most common MZL subtype, typically affecting older adults and following an indolent course with a median survival > 10 years. Age ≥70 years is a key prognostic factor in MALT lymphoma and a component of the MALT-IPI, which incorporates age, stage, and LDH to stratify five-year event-free survival from ~70% to < 30%. Outcomes in older adults may be influenced by comorbidities and treatment setting, as Academic Cancer Programs (ACPs) offer greater diagnostic and therapeutic resources than Community Cancer Programs (CCPs). We evaluated institutional differences in treatment patterns and survival among elderly patients with extranodal MZL. Methods: We performed a retrospective cohort study using the National Cancer Database (NCDB), identifying patients aged ≥75 years diagnosed with extranodal MZL between 2004 and 2022. Patients were categorized by treatment facility type as ACP or CCP. Demographic, socioeconomic, clinical, and treatment characteristics were compared between cohorts. Overall survival (OS) was estimated using Kaplan–Meier methods and compared across facility types. Early mortality at 30 and 90 days and median OS were assessed by treatment setting. Results: Of 23,693 patients with extranodal MZL, 12,735 (54%) were treated at ACP and 10,958 (46%) at CCP. Patients at ACP were slightly younger (median age 80 vs 81 years; p < 0.001) and more racially diverse (Black 7% vs 4%; p < 0.001). CCP served communities with lower income and education (all p < 0.001) and had a higher comorbidity burden (Charlson-Deyo score ≥1: 31% vs 27%; p < 0.001). Medicare coverage was slightly higher at CCP (90% vs 88%). Treatment patterns differed by setting. Active surveillance was more frequent at ACPs (12% vs 10%; p < 0.001), while no treatment was more common at CCPs (13% vs 11%; p < 0.001). Systemic therapy initiation occurred earlier at CCP (median 37 vs 40 days; p = 0.002). Median OS was significantly longer at ACP than CCP (6 vs 5.6 years; p < 0.001). Thirty- and ninety-day mortality were lower at ACP (0.2% vs 0.4%, p = 0.002; 0.5% vs 0.7%, p = 0.006). The survival advantage persisted over time, with 2-, 5-, and 10-year OS rates of 79%, 57%, and 28% at ACP versus 77%, 54%, and 25% at CCP (all p < 0.001). Median follow-up was longer at ACP than at CCP (45.4 vs 42.9 months; p < 0.001). Conclusions: Among patients aged ≥75 years with extranodal MZL, treatment at ACP was associated with improved OS and lower early mortality, despite similar overall treatment utilization. Management strategies varied by facility type, and differences in socioeconomic factors, comorbidity burden, and access to multidisciplinary care may underlie observed outcome differences. These findings support efforts to reduce institutional disparities and improve access to high-quality oncology care for older adults with indolent lymphomas.

Consolidated PD-L1 inhibitors after chemoradiotherapy versus placebo in non-resectable non–small cell lung carcinoma: A meta-analysis of phase III randomized controlled trials.

e20075 Background: The PACIFIC trial established the use of durvalumab, an immune-checkpoint inhibitor (ICI), following concurrent chemoradiotherapy in the treatment of non-small cell lung carcinoma. However, the safety and efficacy of PD-L1 inhibitors besides durvalumab has not been adequately explored, and the comparative efficacy of concurrent vs sequential chemoradiotherapy (CRT) in combination with immune checkpoint blockade remains questionable. Additionally, pneumonitis, the most frequently reported immune-related adverse event, has not been systematically analyzed across different immunotherapeutic agents. There remains a dearth of pooled evidence from randomized controlled trials (RCTs) providing definitive evidence in the literature. Methods: We systematically searched PubMed, Embase, Scopus, and Cochrane from inception to January 2026. Heterogeneity was assessed using I 2 statistics. Random-effects models were used to calculate pooled proportions and risk ratios (RR) for survival and toxicity outcomes with 95% confidence intervals. Results: Out of 2,287 articles screened, 4 articles were included. We found that the ICI group had a 13% lower risk of disease progression or death compared to the placebo group although the result was statistically insignificant (p = 0.12, I 2 = 0). Durvalumab achieved greater overall survival at 1 year (RR = 1.15, p = 0.03, I 2 = 32%), 2 years (RR = 1.17, p = 0.005, I 2 = 0%) and progression free survival at 1 year (RR = 1.16, p = 0.02, I 2 = 0%) compared to placebo. However, subgroup analysis revealed no statistically significant difference in terms of survival for concurrent and sequential chemoradiotherapy. Grade 3+ toxicity was reported to be consistently higher in PD-L1 inhibitors group compared to placebo group (RR = 1.33, p = 0.002, I 2 = 70%), with pneumonitis being the most common reaction (RR = 2.97, p = 0.0005, I 2 = 0%). PD-L1 inhibitors significantly increased the risk of pneumonitis compared with placebo (overall RR = 2.97), with durvalumab showing a lower risk than other PD-L1 inhibitors (RR = 2.68 vs 4.84). However, while such an indirect comparison suggests durvalumab may have a lower risk of pneumonitis compared to other PD-L1 inhibitors, such a result must be interpreted cautiously. Conclusions: ICIs demonstrate improved overall and progression-free survival compared to placebo, but increase the risk of severe toxicity, particularly pneumonitis. Durvalumab may confer a lower risk of pneumonitis compared to other PD-L1 inhibitors. Concurrent and sequential CRT show comparable efficacy.

Implementation of serum microRNA-371a-3p testing for testicular germ-cell tumors in a pathology department: Real-world data from a comprehensive cancer center.

5025 Background: The classical serum tumor markers for testicular germ cell tumor (TGCT) patients show limited sensitivity and specificity in some clinical settings. In the last years, serum miR-371a-3p testing has been shown to have superior performance for the detection and follow-up of TGCT patients. A commercial test with IVD approval is already available for use in the clinic. In this work we demonstrate our experience with the clinical implementation of this liquid biopsy test, comparing its performance with the one of AFP, HCG and LDH. Methods: The M371 test (serum) was implemented at the Department of Pathology of our Comprehensive Cancer Center in August 2024, for patients presenting with testicular masses and for TGCT patients during follow-up. Simultaneous collection of AFP, HCG and LDH was performed at the different timepoints, following the guidelines for diagnosis and follow-up of TGCT patients. Blood was collected on the recommended Serum-Gel 7.5mL tubes and processed to serum within 3h of collection. The RTqPCR test and analysis followed the manufacturer's closed protocol (IVDR approved). Clinical charts and CT scans were reviewed to determine disease status, and results were correlated with histology. Results: A total of 128 M371 tests were performed at the Department of Pathology during 16 months, including several contexts of the disease (pre-orchiectomy, follow-up, pre-RPLND, pre and post-chemotherapy). The mean turnaround time for the test (from receiving the blood sample to issuing the report) was of 5.6 days. The median patient age was 35 years (19-81 years). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows: 0.43, 0.96, 0.76 and 0.85 for AFP; 0.57, 0.98, 0.89 and 0.88 for HCG; 0.37, 0.91, 0.55 and 0.82 for LDH; 0.80, 0.92, 0.77 and 0.93 for the combination of AFP+HCG+LDH; and 0.96, 0.96, 0.87 and 0.99 for M371 test alone. Additional collections/testing and subanalyses based on disease setting and histologic findings are ongoing. Conclusions: The M371 IVD serum test alone showed a superior diagnostic performance for detecting active TGCT in an unselected, consecutive cohort of TGCT patients representing different settings of the disease, when compared to the classical serum tumor markers AFP, HCG and LDH, isolated or in combination. The sensitivity of AFP, HCG and particularly LDH isolated (0.43, 0.57 and 0.37) were outperformed by the sensitivity of the M371 test (0.96). The high NPV of the M371 test (0.99) may aid in the decision of de-escalating intervention (treatment or follow-up measures) of young TGCT patients. These real-world data underscore the potential advantages of adding microRNA testing as a an additional test to combine with classical serum tumor markers and imaging.

Comparison of CLDN18/CLDN18.2 IHC assays (43-14A vs EPR19202) and the correlation with clinical efficacy in patients with gastric/gastroesophageal junction adenocarcinoma treated by the novel antibody-drug conjugate XNW27011.

4061 Background: Claudin 18.2 (CLDN18.2), the dominant isoform of CLDN18 in gastric tissues, is a highly specific tight junction protein of the gastric mucosa with considerably retained expressions in gastric and gastroesophageal junction (G/GEJ) adenocarcinoma, making it a clinically actionable therapeutic target. Accurate immunohistochemical (IHC) assessment of CLDN18.2 expression is critical for patient selection in CLDN18.2-targeted therapies. Here, we report the findings of the analytical comparability, concordance and clinical efficacy outcomes between two CLDN18/CLDN18.2 antibodies (VENTANA CLDN18 [43-14A] and Abcam CLDN18.2 [EPR19202]), from a Phase I/II study of a novel antibody-drug conjugate XNW27011 (NCT06792435). Methods: This retrospective study utilized formalin-fixed paraffin-embedded (FFPE) samples of 121 patients with G/GEJ adenocarcinoma enrolled in the Phase I/II study of XNW27011. Each sample was stained with CLDN18 (43-14A) and CLDN18.2-specific (EPR19202) antibodies. Efficacy in objective response rate (ORR) was evaluated across CLDN18/CLDN18.2 expression strata defined by each assay antibody in patients treated with XNW27011 at doses of 2.4–6.0 mg/kg administered intravenously every 3 weeks. Concordance between the two assay antibodies was assessed by the percentage of the overall agreement (positive or negative) primarily at the cutoff of ≥20% tumor cells with 2+ to 3+ membranous staining. Results: Therapeutic efficacy outcomes of XNW27011 in ORR were highly consistent across expression strata defined by either 43-14A or EPR19202 assay antibody. In patients with CLDN18/CLDN18.2 expression defined as IHC ≥2+ in ≥20% of tumor cells, ORRs were 45.5% and 45.3% using EPR19202 and 43-14A assay antibody, respectively. EPR19202 and 43-14A IHC assays demonstrated high concordance, with an overall agreement of 90.1%. Conclusions: The IHC assays of CLDN18.2 expression with EPR19202 or CLDN18 expression with 43-14A demonstrate comparable analytical performance with high concordance. The alignment of efficacy outcomes across the two antibody-defined strata supports that CLDN18 and CLDN18.2-specific antibodies can identify patient populations with similar clinical benefit. Both antibodies can support the clinical development of XNW27011 in the treatment of patients with G/GEJ adenocarcinoma.

Impact of COVID-19 on short- and long-term outcomes in patients with diffuse large B-cell lymphoma: A real-world analysis.

e19066 Background: Patients with diffuse large B-cell lymphoma (DLBCL) are highly vulnerable to infectious complications due to disease-related immune dysfunction and immunosuppressive therapies. The impact of coronavirus disease 2019 (COVID-19) on short- and long-term outcomes in patients with DLBCL remains incompletely characterized in large real-world populations. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, including adult patients (≥18 years) with a diagnosis of DLBCL. Patients were stratified into two cohorts based on the presence or absence of COVID-19 infection. Propensity score matching (1:1) was performed for demographics and major comorbidities. The primary outcome was all-cause mortality. Secondary outcomes included acute respiratory failure, mechanical ventilation, and other COVID-related complications. Outcomes were assessed at 30 days, 90 days, and up to 3 years following the index event using risk ratios and Kaplan–Meier survival analyses. Results: After propensity score matching, 33,026 patients were included in each cohort. Patients with DLBCL and COVID-19 demonstrated significantly higher 30-day mortality compared with those without COVID-19 (22.4% vs 18.5%; risk ratio [RR] 1.21, 95% CI 1.18–1.25; p <0.0001). Over long-term follow-up, COVID-19 infection was associated with worse overall survival, with a significantly increased hazard of mortality on Kaplan–Meier analysis (hazard ratio [HR] 1.97, 95% CI 1.86–2.09; p <0.0001). Additionally, patients with COVID-19 had a markedly higher incidence of acute respiratory failure at 3 years compared with those without COVID-19 (12.9% vs 5.1%; RR 2.52, 95% CI 2.39–2.67; p <0.0001). Conclusions: In this large real-world cohort, COVID-19 infection in patients with DLBCL was associated with significantly increased short-term mortality, worse long-term survival, and substantially higher rates of acute respiratory failure. These findings highlight the profound impact of COVID-19 on outcomes in patients with aggressive lymphoma and underscore the importance of preventive strategies and close monitoring in this high-risk population.

Adjuvant nivolumab compared with platinum-based chemotherapy in bladder cancer: A real-world study.

e16563 Background: Both adjuvant platinum-based chemotherapy and nivolumab are used after radical cystectomy for high-risk bladder cancer, yet comparative real-world survival data are limited. Treatment selection and timing vary substantially outside clinical trials. We compared survival outcomes between adjuvant nivolumab and platinum-based chemotherapy initiated within similar postoperative timeframes. Methods: Using the TriNetX database (2017–2024), we identified adults with bladder cancer who underwent radical cystectomy followed by adjuvant nivolumab or platinum-based chemotherapy (gemcitabine/cisplatin or ddMVAC). Patients who underwent neoadjuvant chemotherapy were excluded. Patients were stratified by treatment type and timing of initiation after surgery ( <60 days and 60–180 days). Propensity score matching (1:1) was performed within each timing window using demographic variables, comorbidities, and prior treatment history. Overall survival (OS) and time to next treatment (TTNT) were analyzed using Kaplan–Meier methods and log-rank testing. Results: In an overall analysis restricted to initiation of adjuvant nivolumab or platinum-based chemotherapy within <60 days of cystectomy, matched cohorts included 102 patients per group. There were not enough deaths within the first year to reliably estimate 1-year OS, however 3-year OS significantly favored nivolumab (74% vs 57%; p = 0.0367). There was no significant difference in TTNT (56 days vs 42 days; p = 0.213). In the 60-180 day analysis, matched cohorts included 85 patients. Nivolumab demonstrated superior 1-year OS that was statistically significant (86% vs 71%; p = 0.0226). 3-year OS favored nivolumab, although this was not statistically significant (71% vs 62%; p = 0.583). TTNT was not statistically significant but trended in favor of nivolumab (56 vs 42 days; p = 0.0512). Conclusions: In this large real-world cohort, adjuvant nivolumab was associated with superior overall survival compared with platinum-based chemotherapy when initiated within comparable postoperative intervals after radical cystectomy. These findings support the effectiveness of adjuvant nivolumab in routine clinical practice and reinforce its role as a preferred postoperative systemic therapy in eligible patients. These results should be interpreted cautiously due to the limited sample size. Further studies incorporating a larger sample size are warranted.

An APP-led intake model to expedite diagnostic workup for patients with suspected lymphoma.

e19111 Background: Lymphoma is a rare, heterogeneous malignancy that often presents with symptoms resembling benign, autoimmune, or other malignant conditions. At large academic centers, rapid clinical assessment is essential to improve outcomes, yet a “biopsy first” approach can delay diagnosis, heighten anxiety, and fragment care. To address this gap, we launched an Advanced Practice Provider (APP) intake clinic for patients with Suspicion of Lymphoma (SoL) to expedite workup and triage before physician evaluation. Methods: The SoL APP intake clinic launched on 10/21/24, with twice weekly sessions to prepare patients for a full diagnostic workup. Eligible patients had “Green” insurance and resided in licensed states (TX, OK, LA, FL). The APP led evaluation included labs, CT or PET imaging, and ordering core needle and/or bone marrow biopsies. Patients with benign findings but ongoing clinical concern remained under surveillance, including those with small volume, non biopsiable adenopathy or atypical lymphocytes. Confirmed lymphoma cases were classified as aggressive or indolent, and timelines to diagnosis, first physician visit, and treatment initiation were recorded. Aggressive lymphomas included Hodgkin, diffuse large B cell, mantle cell, and T cell lymphomas; indolent lymphomas included nodular lymphocyte predominate Hodgkin, marginal zone, mucosa-associated lymphoid tissue, and follicular lymphomas. Results: Between 10/21/24–1/14/26, 99 patients were evaluated (age 18–98, mean 58; 48 female, 51 male). 40 patients (40.4%) were diagnosed with lymphoma (20 aggressive, 20 indolent). One aggressive case had a prolonged 74 day diagnostic interval due to patient driven delays. Among the remaining 19 aggressive cases, median time to imaging was 1.5 days (range 1–10), to diagnosis 7 days (2–18), to physician visit 10 days (3–35), and to treatment start 19 days (5–49). For the 20 indolent cases, median time to imaging was 4 days (1–28), to diagnosis 9 days (1–25), and to physician visit 17 days (3–29). 15 indolent cases required treatment, with a median time to treatment initiation of 36 days (14–66). Conclusions: This pilot analysis shows that an APP led SoL intake clinic is feasible and accelerates lymphoma workup and treatment initiation. The model achieved shorter diagnostic timelines compared with historical physician led pathways and efficiently redirected physician resources toward confirmed malignancies while maintaining surveillance for high suspicion benign cases. Future initiatives targeting broader community engagement and clearer insurance pathways are expected to strengthen patient access and program reach. SoL Clinic Diagnosis # patients (n=99) % of total patient evaluated Lymphoma 40 40.4% Benign with high suspicion and long term follow up 24 24.2% Benign with low suspicion of lymphoma 13 13.1% Other Hematologic malignancy/disorder 11 11.1% Solid tumor 7 7.1% Sarcoidosis 4 4.0%

An integrated method for state of charge estimation, lifetime prediction, and reliability assessment of Lithium-ion batteries under thermal and dynamic conditions

Accurate estimation of the state-of-charge (SOC), remaining useful life (RUL), and reliability of lithium-ion batteries is essential for renewable energy storage and electric mobility systems. This paper proposes a unified experimental–analytical framework that systematically integrates temperature-dependent SOC estimation, degradation modeling, and probabilistic reliability assessment within a single validated pipeline. Two A123 LiFePO 4 pouch cells were experimentally characterized using low-current open-circuit voltage (OCV) protocols and representative dynamic driving cycles (DST, US06, and FUDS) across multiple temperatures. A dual-estimator structure combining Coulomb counting, OCV correction, and an extended Kalman filter (EKF) was developed to enhance both steady-state accuracy and transient responsiveness under thermal variations. In parallel, temperature-aware degradation kinetics were modeled using Arrhenius-based relationships directly linked to cycle-based RUL extrapolation. To explicitly account for inter-cell variability, Weibull survival analysis was incorporated into the same computational framework, enabling probabilistic life prediction rather than purely deterministic estimation. Sensitivity analysis further quantified the propagation of parameter uncertainty into SOC and RUL predictions. Experimental results demonstrate voltage estimation errors below 0.02 V (corresponding to approximately 1–2% SOC deviation under nominal conditions), clear temperature-driven acceleration of aging, and significant life divergence between nominally identical cells (≈1000 vs. 200 cycles). The primary innovation of this work lies not merely in incremental accuracy improvement, but in the coherent integration of estimation, degradation, and reliability modeling under realistic multi-temperature dynamic operation, providing a practical decision-support architecture for real-world battery management systems.

Fourier magnetic imaging of nitrogen-vacancy center with sub-nanometer pixel resolution

Solid-state spins in diamond are promising building blocks for quantum computing and quantum sensing, both of which require precise nanoscale addressing of individual spins. To explore the resolution limit of this approach, we demonstrate Fourier magnetic imaging of nitrogen-vacancy (NV) centers in diamond under state-of-the-art conditions. We constructed a highly compact experimental platform featuring thermal drift compensation under ambient conditions and generated a pulsed magnetic field gradient of up to 13.5 G/μm. By implementing the Fourier magnetic imaging protocol, we achieved localization of a single NV center with a pixel resolution of 0.69 nm and a magnetic field measurement deviation of 9 nT. This technique holds potential for applications such as localizing spins within proteins and cells.

Lateral disorder in Langmuir monolayers: Theoretical derivations and grazing-incidence x-ray diffraction

Recent studies of the self-assembly of Langmuir monolayers have revealed novel forms of lateral molecular ordering. Such studies typically involve the use of grazing-incidence synchrotron radiation scattering, and the lateral order manifests itself as distinct diffraction patterns. As the molecular organization becomes more intricate, the corresponding diffraction pattern becomes more complicated. At this point, standard analysis, such as identifying peak positions and solving the crystal structure, is insufficient to describe the system. In such cases, a physics-based simulation of the diffraction is required. In this article, we present a versatile theoretical framework for simulating complex structural molecular ordering in Langmuir monolayers. We begin by applying the formalism to a simple case of solid-state monolayers and extend the analysis to describe the structural organization in the collapsed state. The applicability of the method is validated through comparison with experimental data collected at the bending magnet synchrotron beamline.

Green synthesis of zinc oxide nanoparticles mediated by marine algae: Trends, challenges and opportunities

A Panoramic View on Plastic Waste Recycling and Upcycling: Heterogeneous Catalytic Strategies for Diverse Plastics and Multiple Pathways

ABSTRACT Plastics have become integral to modern society due to their low cost, versatility, and practicality. However, their rapid production and limited lifespan have led to the accumulation of vast plastic waste, posing severe threats to public health, the environment, and ecological balance. Heterogeneous catalysis has emerged as a key strategy for the value‐added recycling of plastic waste due to its high efficiency and low separation costs. This review systematically summarizes recent advancements in heterogeneous catalytic strategies for converting waste plastics into high‐value chemicals and functional materials. It provides a detailed classification of commercial plastics and their applications while analyzing key efficiency metrics for plastic upcycling. Various heterogeneous catalytic approaches, including thermal catalysis, photocatalysis, electrocatalysis, photothermal catalysis, photoelectrocatalysis, joule heating, microwave‐assisted catalysis, and ball milling are explored in terms of transformation strategies, resource utilization, and catalytic mechanisms. Additionally, the review examines fundamental reaction pathways, such as C─H bond activation and C─C/C─O bond cleavage. Finally, based on current research and theoretical insights, future directions for heterogeneous catalytic plastic upcycling are discussed, including catalyst development, degradable polymer synthesis, mechanistic investigations, and commercial viability assessments. This review aims to provide new perspectives on addressing plastic pollution through advanced catalytic technologies.

Radiomic analysis of abdominal non-contrast CT for identifying aortic syndrome in emergency patients

Molecular insights into juvenile hormone maturation by juvenile hormone acid methyltransferase

Behavioral risk factor–attributable burden of gastrointestinal cancers: A global, site-specific quantification using GBD 2023.

e16363 Background: Behavioral risk factors drive a major fraction of gastrointestinal (GI) cancer deaths worldwide. We analyzed the global burden of behavioral risk factor–attributable GI cancers across six malignancies using Global Burden of Disease 2023 (GBD 2023) data. Methods: We examined colorectal (1.97M cases), gastric (1.09M), esophageal (604K), pancreatic (495K), liver (910K), and biliary tract (177K) cancers. Behavioral risks included tobacco, alcohol, high BMI, physical inactivity, and dietary patterns (low whole grains, high processed meat, low fiber). For each site and region, comparative risk assessment estimated population-attributable fractions (PAF) and attributable DALYs. Results: In 2023, there were 8,320,000 new cases and 8,320,000 deaths from gastrointestinal (GI) cancers globally. Behavioral risk factors accounted for 3,240,000 GI cancer deaths (38.9% of all GI cancer mortality) and 68,400,000 disability-adjusted life years (DALYs). Tobacco use was responsible for 1,180,000 deaths (36.4% of behavior-related GI cancer deaths), alcohol for 892,000 deaths (27.5%), dietary factors (low whole grains, high processed meat, low fiber) for 758,000 deaths (23.4%), and high BMI for 456,000 deaths (14.1%). Regionally, the proportion of GI cancer burden attributable to behavioral factors was highest in Eastern Europe and Central Asia (51.2%), followed by Latin America (44.7%), Western Europe (42.1%), and lowest in Sub-Saharan Africa (28.6%). High-income countries reported a lower PAF (31.4%) but a higher absolute number of attributable deaths (812,000). Among middle-income countries, behavioral risk–attributable GI cancer burden increased by 3.2% annually from 2015 to 2023. Alcohol was the dominant risk factor in six of twelve world regions, while tobacco led in East Asia and the Pacific. Conclusions: Behavioral risk factors account for nearly 40% of global GI cancer mortality and over 68 million DALYs annually, with the heaviest proportional burden in Eastern Europe and Central Asia. Intensified tobacco cessation, alcohol reduction, and dietary improvement efforts could prevent up to 892,000 GI cancer deaths each year by 2030, with the greatest gains achievable in middle- and low-income regions.

Deep learning–based PET/CT radiomics-clinical model for prognostic stratification and immunotherapy exploration in natural killer/T-cell lymphoma.

7072 Background: Natural killer/T-cell lymphoma (NKTCL) is a highly aggressive malignancy with substantial heterogeneity. The value of deep learning on PET/CT-based radiomics for risk stratification in NKTCL remains to be defined. Methods: In this retrospective multicenter study, 425 consecutive NKTCL patients from four hospitals were randomly assigned to training or validation cohorts. Radiomics features extracted from pretreatment PET/CT images were used to construct prognostic models with multiple deep learning algorithms. The best model was integrated with established clinical prognostic factors, and its performance in informing treatment decisions was tested in another independent immunochemotherapy cohort. Results: The XGBoost-based radiomics model achieved the highest prognostic accuracy for progression-free survival (PFS) and overall survival (OS) across cohorts. Integration with clinical factors yielded the Radiomic-Clinical Prognostic Model (RCPM), which further improved prediction (training cohort AUC: PFS 0.977, OS 0.946; validation cohort AUC: PFS 0.834, OS 0.814) and effectively stratified patients into high- and low-risk groups with distinct PFS and OS (all P < 0.001). In another exploratory treatment cohort, high-risk patients derived significant benefit from PD-1 inhibitor therapy (3-year PFS: 67.7% vs. 21.7%, 3-year OS: 81.7% vs. 39.6%; both P < 0.001), whereas low-risk patients did not. Conclusions: In conclusion, the RCPM demonstrated strong prognostic value and may help identify patients who could potentially benefit from immunotherapy in NKTCL.

An EHR-embedded SmartForm (OncAssessment) paired with ePROs to enable real-time structured documentation of key oncologic data during routine cancer care: A pragmatic implementation study.

TPS1682 Background: Real-world evidence generation in oncology is often limited by inconsistent and unstructured documentation within electronic health records (EHRs). Key clinical variables including disease status, performance status, and treatment change rationale are frequently embedded in free text, requiring retrospective manual abstraction that is inefficient and error-prone. As a result, clinically meaningful real-world endpoints, such as time to treatment change and real-world progression-free survival (rwPFS), are inconsistently captured. To address these gaps, the University of Pennsylvania developed OncAssessment (OA), an EHR-embedded SmartForm integrated directly into routine oncology clinical documentation. Unlike post hoc abstraction or standalone registries, OA enables prospective, structured data capture of key oncologic variables at the point of care by treating clinicians, and is paired alongside with electronic patient-reported outcomes (ePROs). This approach aligns clinician decision-making with patient-reported experience within routine workflows, enabling timely, scalable, and higher-fidelity real-world data (RWD) capture. Methods: This pragmatic implementation study, developed by the University of Pennsylvania in collaboration with Gilead Sciences, evaluates OA and ePRO implementation in standard clinical practice. Adult patients with stage IIIB-IV unresectable non-small cell lung cancer (NSCLC) initiating standard-of-care immunotherapy with or without chemotherapy (Cohort I) and adult breast cancer patients receiving systemic infusional therapy (Cohort II) are identified via the EHR. 200 patients per cohort are planned for enrollment over 2 years. Enrollment began July 22, 2025. For identified patients, clinicians are prompted to complete OA at each visit: documenting clinical status, tumor status, treatment changes, and rationale. ePROs are automatically distributed through the EHR to Cohort I patients prior to their visits. Structured data from OA, ePROs, and other EHR sources are auto-extracted. Primary objectives for Cohort I include OA utilization, time to treatment change decision (TTCd), comparison of TTCd with time to treatment change (TTC) derived from EHR reporting, ePRO completion rates, and concordance between patient- and clinician-assessed clinical status. Secondary objectives include rwPFS captured via OA, comparison with rwPFS determined by manual chart and radiology review, characterization of patient experience via ePROs, and exploratory analyses of discordance and factors associated with treatment change. The primary objective for Cohort II is OA utilization. Follow-up continues until progression, treatment change, or 2 years for Cohort I and 12 months for Cohort II.