Browse Articles

Integrating Dynamic Chiral Radiation with Full‐Polarization Invisibility via Cooperative Metasurface Ensembles

ABSTRACT Next‐generation communications and camouflage systems require secure information transmission without electromagnetic exposure. Radiation‐stealth metasurfaces offer a promising route toward this goal, yet radiation and scattering remain intrinsically entangled, compelling existing approaches to segregate them into orthogonal polarizations or disjoint frequency bands. This fundamentally restricts polarization controllability and spectral coexistence, leaving concurrent full‐polarization stealth and radiation control within a shared spectrum unachieved. Here, we propose multigroup metasurface ensembles where cooperative interlayer interactions fully decouple radiation regulation from scattering suppression, enabling dynamic chiral radiation while preserving invisibility to arbitrary polarizations across an overlapping spectrum. By leveraging two independent geometric phases to break the conjugation constraint between radiated and scattered spin waves, along with a customized feed‐addressing strategy, desired spin radiation is channeled into tunable directions, with cross‐polarized scattering effectively suppressed via destructive interference. Meanwhile, reciprocity ensures that co‐polarized illumination passes through the multilayer metasurfaces and is dissipated by the embedded feed network, yielding full‐polarization invisibility. To validate the concept, its versatile radiation‐stealth functionalities, including multifunctional chiral beam scanning and full‐polarization invisibility, are experimentally demonstrated. Our methodology unlocks new opportunities for secure satellite links, low‐altitude networks, and covert tactical communications, providing a versatile foundation for next‐generation aerospace and wireless infrastructures.

Recent Progress in Contact Force Sensing Techniques for Cardiovascular Interventional Procedures

Abstract Cardiovascular diseases (CVDs), such as heart attacks and strokes, are the top causes of death and disability globally. The standard treatment for CVDs usually involves interventional procedures, in which slender instruments such as guidewires and catheters are navigated through blood vessels to reach target lesions. However, the inability to accurately quantify the contact force (CF) between interventional instruments and tissues raises the risks of vascular injury, poor ablation results, and high rates of recurrence after the procedure. With rapid advancements in robot‐assisted interventional surgery, the need for accurate CF measurement and feedback has become increasingly urgent. This review systematically examines the latest research on CF sensing in interventional procedure, organized into four main areas: 1) a comparative analysis of CF sensing methods and their strengths and limitations; 2) an overview of functional materials for CF sensing and their properties; 3) a comparative evaluation of sensor designs regarding performance and constraints; and 4) a practical summary of CF sensing applications in guidewire navigation, occlusion penetration, catheter ablation, and related procedures. Finally, future directions for CF sensing, highlighting its critical role in advancing biomedical applications, are discussed.

Self‐Adaptive Mechanical Metasurface Enabling Zero‐Power‐Consumption Thermal Management of Electronic Devices

Abstract Effective thermal management is essential for ensuring the reliability of electronic devices. However, conventional thermal management technologies often require significant space or consume substantial power, which limits system integration and alters the electromagnetic performance, including operating bandwidth and efficiency. Here, a zero‐power‐consumption, self‐adaptive mechanical metasurface is introduced that provides dual‐mode thermal management. Composed of liquid crystal elastomer and copper, the periodically arranged units harness a thermally driven strain mismatch between these materials to achieve temperature‐dependent structural reconfiguration. This mechano‐thermal transduction mechanism passively converts excess heat into mechanical energy, thereby providing efficient thermal management for multiple electronic devices in this experimental demonstration. As a proof of concept, by designing the deep‐subwavelength unit cells of metasurface without perturbing the surface current distribution of a Vivaldi antenna, it is shown that the mechanical reconfiguration can be decoupled from electromagnetic functionality, thereby enabling the integration of adaptive thermal management with stable electromagnetic performance. This framework effectively combines multi‐physics functionality, encompassing thermal, mechanical, and electromagnetic domains. This work not only reveals a previously unexplored application for stimuli‐responsive materials but also holds significant promise for various applications, including advanced communication and wearable systems.

Decoding the regulatory code: O-GlcNAcylation in epithelial-mesenchymal transition (EMT)

Can clinico-genomic characterization reveal more aggressive prostate cancer among older patients with lower Gleason grade groups?

395 Background: The prevalence of prostate cancer (PCa) increases with age, with the average age of diagnosis being 66. Current guidelines emphasize risk stratification and life expectancy in choosing next steps in management. In the growing elderly population, chronological age may be insufficient in choosing treatment and predicting outcomes. Therefore, additional biomarkers may be needed to help tailor treatment strategies. We evaluated age-related differences with clinic-genomic prognostic indices of aggressiveness, using the Prolaris test, in patients harboring localized prostate cancer. Methods: Clinical and genomic data for 107,471 patients from the Myriad Prolaris (PCa) Database were obtained. Conventional and genomic prognostic indices were analyzed, including Prolaris treatment grouping recommendations (active surveillance (AS) vs single treatment vs multimodal treatment), cell cycle risk scores, NCCN risk groups, tumor stage, and Gleason groups (GG). MVLR was performed to evaluate the association of age, prostate specific antigen level (PSA), tumor stage (T1a-T1c vs T2a-T2c vs T3a), positive biopsy cores (less than vs greater than 50%), and GG (1-2 vs 3-5) with Prolaris treatment scores (AS and single treatment vs multimodal treatment recommendations). Results: With increasing age, we observed a higher proportion of high-risk GG and more aggressive Prolaris scores. Even within the same prostate cancer GG, the Prolaris scores worsened with age. On MVA, age was associated with a statistically significant increase in Prolaris scores (60-65 – HR 1.15; 95% CI 1.04-1.28, 65-70 – HR 1.30; 95% CI 1.18-1.43, 70-75 – 1.39; 95% CI 1.26-1.54, 75-80 – 1.56; 95% CI 1.40-1.74, > 80 – HR 1.83; 95% CI 1.60-2.08). Additionally, and as expected, PSA levels (HR 1.21; 95% CI 1.20-1.21), GG (HR 105.70; 95% CI 96.75-115.47), tumor stages (T2a-T2c – HR 1.27; 95% CI 1.17-1.39), T3a (HR 9.94; 95% CI 6.25-15.82) & number of positive biopsy cores (HR 4.02; 95% CI 3.79-4.27) were all associated with a more aggressive Prolaris score (Table). Conclusions: Our data suggests that age may be associated with higher Prolaris scores, signaling possible worse disease outcomes with age, even with lower GGs. Whether this increase in Prolaris score is suggestive of aggressive disease or results from age alone is yet to be determined and needs to be further studied. On MVA, there was a statistically significant increase in Prolaris treatment scores with increasing age groups. Multivariable logistic regression model for predicting outcome. Variable OR 95% CI p-value Age group (ref: <60)  60-64 1.15 1.04–1.28 0.007  65-69 1.3 1.18–1.43 <0.001  70-74 1.39 1.26–1.54 <0.001  75-79 1.56 1.40–1.74 <0.001  ≥80 1.83 1.60–2.08 <0.001  PSA level (ng/ml; log) 1.21 1.20–1.21 <0.001 Tumor stage (ref: T1a-T1c)  T2a-T2c 1.27 1.17–1.39 <0.001  T3a 9.94 6.25–15.82 <0.001 Gleason grade group (ref: 1-2)  3-5 105.7 96.75–115.47 <0.001

Association of prostate specific antigen (PSA) doubling time (DT) and prostate specific membrane antigen (PSMA) findings in biochemically recurrent prostate cancer (BCR).

33 Background: Historically, PSA DT can be prognostic for metastasis free survival in BCR (as defined on computed tomography (CT) and bone scan). PSA DT is also an important tool in risk stratification in BCR to identify which patients (pts) require therapy (e.g. pts with a PSA DT>6 months). The emerging use of PSMA imaging creates another tool to assess BCR pts, but there is no data on the association of PSA DT and PSMA findings. Methods: NCT05588128 enrolls BCR pts after definitive +/- salvage therapies. Pts must have a PSA>0.5 ng/ml, testosterone >100 ng/dL, and negative CT/bone scans. Lymph nodes (LNs) up to 1.5 cm and prior therapies are permitted. All patients undergo a baseline PSMA PET scan, along with measurement of PSA and PSA DT. Here we describe the relationship between baseline PSA metrics and baseline PSMA imaging findings in patients with BCR. Results: 130 patients are currently evaluable with a median age= 71 years, baseline PSA of 1.95 ng/dL (range: 0.5 to 71) and PSA DT of 10.6 months (range 1.2 to 132) off therapy. Of all participants, 16.9% (n=22) had findings limited to the prostate bed and 34.6% (n=45) had PSMA+ avidity in the prostate bed with other findings. 42.3% (n=55) had PSMA + LNs, and 13.8% (n=18) had PSMA+ bone lesions. Four patients had serosal deposits with PSMA avidity, and one patient had a PSMA+ lung nodule. Conclusions: These data are the first to compare PSMA imaging results with corresponding PSA levels and PSA DT in a large cohort of patients with BCR. Results show that pts with historically favorable/long PSA DT may have high volume/bone+ findings on PSMA. There is no data to suggest treatment escalation is required in BCR pts with high volume PSMA findings, but long/favorable PSA DT. These results highlight the caveats of using PSMA imaging alone to drive treatment decisions in BCR without further data for how baseline PSMA imaging corresponds with long-term outcomes. Clinical trial information: NCT05588128 . PSMA PET+ lesion locations by PSA doubling time in patients with BCR prostate cancer (total n=130). PSA DT # Pts Median PSA PSMA Neg Prostate+ only Lymph Nodes+ ≥ 4 Lymph Nodes+ Bone+ ≥12 mo 52 3.55 9 (17.3%) 16 (30.8%) 24 (46.2%) 12 (23%) 6 (11.5%) 9 to <12 mo 20 1.56 2 (10%) 4 (20%) 11 (55%) 3 (15%) 3 (15%) 6 to <9 mo 17 0.9 5 (29.4%) 0 (0%) 12 (70%) 8 (47.1%) 2 (11.8*) <6 mo 41 2.1 5 (12.2%) 2 (4.9%) 28 (68.3) 15 (36.6) 7 (17.1)

Treatment utilization in metastatic renal cell carcinoma (mRCC) following implementation of a national cancer drug list (CDL) drug reimbursement program in Singapore: A real-world single-centre study.

482 Background: Immune checkpoint inhibitor (ICI) based combination therapy and Cabozantinib have shown overall survival benefits, for first-line (1L) and post-treatment settings respectively, in Phase 3 trials for metastatic renal cell carcinoma (mRCC). However, high drug costs pose barriers to therapeutic utilization. In addition, treatment with Cabozantinib often necessitates dose reductions for control of toxicities which may significantly impact quality of life. Singapore’s national Cancer Drug List (CDL), implemented on 1 st September 2022, is intended to improve drug access through indication-based state-funded reimbursement of treatment. We describe treatment utilization and outcomes in a real-world cohort of mRCC in National Cancer Centre Singapore (NCCS). Methods: In this real world study, patients treated at NCCS for mRCC were consented for inclusion into the genitourinary cancer registry. Data on demographics, disease characteristics, treatment and toxicities were extracted from electronic medical records, with data cutoff at 30th June 2025, and treatment utilization compared pre- and post-CDL implementation. Results: Of 244 consented patients, 217 received palliative systemic therapy. 152 were male, ethnicity distribution was 170/26/11/10 for Chinese/Malay/ Indian/Others respectively. Median age at treatment initiation was 64.4 (range 25.0-92.2). Subtypes include 164 clear-cell, 14 papillary, 3 chromophobe and 36 with histology not otherwise specified (NOS). 205 had 1L treatment initiated from 2018 following approval of immunotherapy-based combinations in 1L. Of 132 initiated 1L treatments pre-CDL, 79 (54.5%) incorporated ICI-based combinations, compared to 52 (71.2%) out of 73 post-CDL. Of 193 who did not receive Cabozantinib in 1L, 58 received Cabozantinib monotherapy subsequently (37/16/5 in 2 nd /3 rd /4 th lines respectively), with 25 initiated pre-CDL, and 33 post-CDL. Only 17 (29.3%) were initiated at the full dose of 60mg daily, while 41 (70.7%) were initiated at a dose reduction (37 at 40mg daily, 4 at 20mg daily). Further dose reductions were required in 22 due to significant treatment-related toxicities. Progression-free survival (PFS) for Cabozantinib monotherapy in this cohort was 6.8 months (95% CI 3.8-9.8). Conclusions: The implementation of CDL in Singapore has increased utilization of ICI-based combination therapy in 1L (71.2% vs 54.5%) in our institution. Widespread employment of Cabozantinib dose reductions to manage toxicities, both at initiation and during treatment, did not significantly impact efficacy in this real-world Asian cohort, with median PFS comparable to historical cohorts.

<i>MTAP</i> loss in sarcomatoid renal cell carcinoma (srcRCC): A genomic landscape study.

529 Background: srcRCC is a rare, highly aggressive malignancy with poor prognosis, and thus further exploration of genomic profiling is essential in development of the targeted therapies. Recent evidence has emerged that novel anti-cancer treatments focused on synthetic lethality mechanisms may have efficacy in patients with clinically advanced malignancies. Methods: Using the FoundationOne CDx assay, 140 srcRCC underwent hybrid capture based comprehensive genomic profiling (CGP) to identify all classes of genomic alterations (GA). Microsatellite instability status (MSI) and tumor mutation burden (TMB) were determined from the sequencing data. PD-L1 expression was determined by immunohistochemistry (IHC) using the Dako TPS score (0% = negative; 1-49% = low positive and &gt; 50% = high positive). Results: 36 (25.7%) of srcRCC featured whole or partial loss (homozygous deletion) of the MTAP gene. Of the 36 srcRCC with MTAP loss ( MTAP loss+) there were 24 (66.7%) cases with 8/8 MTAP exons lost, 1 (2.8%) with 7/8 MTAP exons lost, 1 (2.8%) 6/8 MTAP exons lost, 5 (13.9%) with 4/8 MTAP exons lost and 5 (13.9%) with 3/8 MTAP exons lost. The srcRCC with MTAP loss+ were younger (median age of 60 vs 63 years; p &lt; .0001) and more often male gender (75.0% vs 72.1%; NS), compared to MTAP wild type ( MTAP loss-). Biomarkers of immunotherapy response in MTAPloss+ vs MTAPloss- srcRCC including MSI High status (2.8% vs 1.0%) and TMB 10-20 mutations/Mb (2.8% vs 3.8%; NS) were uncommon in both groups. At least 1% or higher PD-L1 expression was also similarly high in both groups (75.0) vs 71.4%; NS) in both groups. CDKN2A (100.0% vs 28.4%; p &lt; .0001) and CDKN2B (97.2% vs 23.1%; p &lt; .0001) were co-deleted with MTAP in the MTAP loss+ srcRCC. Other GA more frequent in the MTAP loss+ AM groups included NF2 (38.9% vs 20.2%; NS) and TERT (30.6% vs 18.3%; NS). GA more frequent in the MTAPloss- srcRCC included RB1 (13.5% vs 0.0%; NS), and TP53 (16.7% vs 40.4%; NS). GA in the VHL gene were similar in both groups (44.4% vs 41.3%; NS). Conclusions: MTAP loss+ status occurs in 25.7% of srcRCC and is most often associated with loss of all 8 exons (66.7%) of the MTAP gene. Although the biomarkers associated with immunotherapy response (MSI, TMB, PD-L1) are similar in both groups, the genomic landscape of MTAP loss+ srcRCC is different from that in MTAP loss- srcRCC. Further study of MTAP loss+ srcRCC in the emerging era of PRMT5 and MAT2A inhibitor-based clinical development appears warranted. MTAP Loss 36 cases MTAP Wild Type 104 cases P value CDKN2A 100.0% 32.7% &lt;.0001 CDKN2B 97.2% 23.1% &lt;.0001 NF2 38.9% 20.2% 0.20 RB1 0.0% 13.5% 0.12 TERT 30.6% 18.3% 0.38 TP53 16.7% 40.4% 0.09 VHL 44.4% 41.3% 1.0

Sulfur‐Modified Amorphous Noble‐Metal‐Free High‐Entropy Alloy Ultra‐Thin Nanosheets for Low‐Overpotential and Long‐Lifespan Li‐O ₂ Batteries

ABSTRACT While noble‐metal‐free high‐entropy alloys (NHEA) represent promising low‐cost catalysts for Li‐O 2 batteries, their catalytic capability is limited by the low metal‐site utilization and unfavorable electronic structure inherent in conventional configurations. Herein, we report a novel design for a CuFeCoNiMn‐NHEA catalyst, characterized by its entirely amorphous structure and the Metal─S bonds (especially Ni─S) introduced by S‐doping. The successful synthesis of this catalyst relies on a rapid low‐temperature strategy, where the 5°C reaction temperature limits atomic diffusion and long‐range ordering, while the sub‐1‐min duration kinetically traps the atoms in a disordered state. Within this architecture, the ultra‐thin 2D morphology, disordered atomic arrangement, and unsaturated atomic coordination offer abundant active sites by eliminating constraints from crystal planes and boundaries; simultaneously, the Metal─S bonds significantly optimize the electronic structure. The electronegativity gradient between metal and S induces electron delocalization at metal sites, which lowers the d‐band center and optimizes the adsorption energy of * LiO 2 intermediates, thereby accelerating the redox kinetics. Meanwhile, strengthened Metal─S coordination elevates metal vacancy formation energies by 1–3 times, which suppresses atomic leaching to improve structural stability. Therefore, our unique catalyst achieves a low overpotential (0.48 V), and an exceptional lifespan (452 cycles), significantly outperforming most reported noble‐metal‐free catalysts.

Breaking the Trade‐Off Relationship Between Thermal Conductivity and Toughness of Ferroelastic Oxide Ceramics via a High‐Density Dislocation Strategy

ABSTRACT The trade‐off relation between thermal conductivity and fracture toughness limits applications of brittle ceramic thermal insulation materials, and we propose that the high‐density dislocation engineering acts as an effective strategy to synergistically reduce thermal conductivity and enhance toughness. The spark plasma sintering (SPS) and heat treatments introduce high‐density dislocations (10 8 ∼10 10 mm −2 ) into the ferroelastic YTaO 4 /Y 3 TaO 7 ceramic composites as thermal insulation materials. The effects of high‐density dislocations on reducing thermal conductivity and enhancing toughness are elucidated from the phonon relaxation time and crack propagation behaviors, respectively. The high‐density dislocations produce large lattice strains to reduce phonon relaxation time, and the lowest thermal conductivity reaches 1.32 W·m −1 ·K −1 . The interfacial enhancements, ferroelastic domains, and high‐density dislocations synergistically boost the toughness to 5.0 MPa·m 1/2 , and the increment is higher than 50%. The effects of high‐density dislocations on toughness and thermal conductivity are revealed from an atomic scale, and the proposed high‐density dislocation strategy breaks the trade‐off relationship between thermal conductivity and toughness for brittle ceramic thermal insulation materials.

Tensile‐Strained 2D Bi ₂ Ti ₂ O ₇ for CO ₂ Photoconversion

Abstract Although the photocatalytic reduction of CO 2 to value‐added chemicals, such as CO, offers a sustainable path to carbon neutrality, the optimization of the charge separation and active site density remains challenging in conventional bulk photocatalysts. In this study, it is shown that atomically thin tensile‐strained 2D layered Bi 2 Ti 2 O 7 nanosheets ( t ‐BT) possess high efficiency for CO 2 ‐to‐CO photoreduction. The tensile‐strain‐induced asymmetric Bi–O vac –Ti sites enhance the directional charge‐transfer pathway, concentrating photogenerated electrons at metallic active sites to achieve a charge separation efficiency of 91.5%. Additionally, these asymmetric sites laterally adsorb CO 2 molecules, generating an electron “push–pull” effect distinct from that of traditional Lewis acid–base pairs, to synergistically optimize * COOH activation and * C─O bond cleavage, thereby accelerating CO 2 conversion and CO desorption. Notably, t ‐BT produces CO at 31.06 µmol g −1 h −1 , with ≈100% selectivity, outperforming the CO production rate of the unstrained bulk material (0.9 µmol g −1 h −1 ). This study highlights strain engineering in 2D pyrochlore architectures, revealing how defect–strain synergy overcomes conventional tradeoffs in photocatalyst design and promotes efficient CO 2 ‐to‐CO conversion.

S-nitrosylation of the scaffold protein STRAP enhances oxidative stress–induced apoptosis

Impact of baseline hot flashes on sleep metrics during initial treatment in LIBERTAS clinical trial.

186 Background: Libertas is a study of intermittent ADT administered with apalutamide monotherapy in metastatic castration sensitive prostate cancer. Sleep disturbances are prevalent among these patients and can substantially impair quality of life and influence therapeutic efficacy. Vasomotor symptoms, particularly hot flashes, are frequently reported during hormonal therapy and may exacerbate sleep disruption. Understanding the association between hot flashes and sleep metrics is essential for optimizing supportive care strategies and enhancing overall treatment outcomes in this population. Methods: Participants were stratified into two groups based on severity-adjusted hot flash scores: No Hot Flash (score = 0) and Any Hot Flash (score &gt; 0). Digital sleep metrics-Wake After Sleep Onset (WASO), number of awakenings, and sleep efficiency-were derived from triaxial acceleration data collected via the Ametris CentrePoint Insight Watch, that participants wore on wrist throughout the study. Sleep/wake classification was performed using validated algorithms (Cole-Kripke or Sadeh). Sleep metrics were aggregated over ±7-day window around the time point of hot flash diary collection. Wilcoxon rank-sum test was used to assess statistically significant differences in sleep metrics between groups at each timepoint. Actigraphy compliance ranged between 90.49% – 92.62% across timepoints, calculated as the percentage of time the device was worn over a 24-hour period. In addition, sleep disturbances and fatigue were also evaluated using the PHQ-9 questionnaire, offering patient-reported insights into overall well-being. Results: Following the start of initial treatment phase, all participants showed increased WASO, number of awakenings and a decline in sleep efficiency. PHQ-9 data also indicated heightened sleep disturbances and fatigue, despite stable depression scores during initial treatment phase. Participants with baseline hot flashes experienced a statistically significant greater increase in WASO and number of awakenings, and a statistically significant lower decline in sleep efficiency compared to those without baseline hot flashes (p&lt;0.05). By the end of the initial phase, both groups trended toward baseline values; however, the baseline hot flash group maintained statistically significant higher WASO and lower sleep efficiency (p &lt; 0.05). Furthermore, individual PHQ-9 items revealed a similar pattern of sleep disturbance, highlighting subjective experiences aligned with objective sleep metrics. Conclusions: Baseline hot flashes were associated with more pronounced and enduring sleep disturbances during the initial treatment phase in participants with prostate cancer. These findings emphasize the critical need for simultaneous monitoring of vasomotor symptoms and sleep quality, and may inform targeted interventions to improve patient well-being during therapy. Clinical trial information: NCT05884398 .

Metformin effects on renal function in mCRPC during PSMA radiopharmaceutical therapy (RPT): A retrospective analysis.

203 Background: Preclinical research indicates that metformin may mitigate renal accumulation of lutetium-177-labeled PSMA radioligands in metastatic castration-resistant prostate cancer (mCRPC) by inhibiting organic cation transporters in the kidneys, thereby offering potential protection against radiopharmaceutical-induced nephrotoxicity. Methods: In this IRB-exempt retrospective analysis, 181 mCRPC patients treated with PSMA-RPT were identified from UCLA electronic health record database (2016–2025) and stratified by metformin exposure. Data on their age at treatment onset, hypertension diagnosis, treatment cycles, estimated glomerular filtration rate (eGFR), serum creatinine (Cr), and prostate-specific antigen (PSA) were collected. The study protocol was reviewed by the Internal Scientific Peer Review Committee. Inclusion required documented baseline and post-treatment eGFR and Cr. Primary endpoints were absolute changes in eGFR (|ΔeGFR|) and Cr (|ΔCr|) from baseline to first post-treatment assessment. Missing data was addressed using complete-case analysis. Two-sided t-tests were performed at α = 0.05. Multivariate analysis of variance (MANOVA) was conducted to evaluate ΔeGFR and ΔCr from metformin exposure, with age, hypertension, treatment cycles, and PSA as predictors. Results: Metformin-exposed patients (n=23), compared to controls (n=158), exhibited better baseline renal function (eGFR 89.6 ± 11.0 vs 81.7 ± 18.8 mL/min/1.73 m², p =0.048; creatinine 0.82 ± 0.18 vs 0.98 ± 0.30 mg/dL, p =0.009) despite significantly higher hypertension prevalence (47.8% vs 23.4%, p=0.019). In univariate analyses of posttreatment changes, metformin exposure was significantly associated with lower eGFR decline (-2.2 ± 16.8 vs -9.2 ± 27.1 mL/min/1.73 m², p =0.048) and creatinine increase (0.003 ± 0.20 vs 0.124 ± 0.32 mg/dL, p =0.042). However, metformin showed no significant multivariate effect on posttreatment ΔeGFR and ΔCr (Wilks’ λ = 0.944, F (2,92) = 2.72, p = 0.071). Conclusions: Renal preservation observed in the unadjusted analysis was likely attributable to confounding factors such as indication bias. Future research will address this limitation through a randomized, placebo-controlled trial with standardized metformin dosing, serial assessment of renal biomarkers, and quantitative PET SUV with predefined imaging outcomes. Variable Metformin (n = 23) Control (n = 158) p -value Age (years), mean ± SD 74.4 ± 8.1 72.9 ± 9.2 0.45 Hypertension (%) 47.8 23.4 0.019* Baseline eGFR (mL/min/1.73 m²), mean ± SD 89.6 ± 11.0 81.7 ± 18.8 0.048* Baseline serum creatinine (mg/dL), mean ± SD 0.82 ± 0.18 0.98 ± 0.30 0.009* Baseline PSA (ng/mL), mean ± SD 189.3 ± 358.7 266.5 ± 603.3 0.55 Treatment cycles, mean ± SD 3.7 ± 2.2 3.6 ± 2.1 0.85 Posttreatment ΔeGFR (mL/min/1.73 m²), mean ± SD -2.2 ± 16.8 -9.2 ± 27.1 0.048* Posttreatment ΔCr (mg/dL), mean ± SD 0.003 ± 0.20 0.124 ± 0.32 0.042* * p &lt;0.05.

Prognostic factors affecting racial impact in testicular cancer outcomes in the United States.

591 Background: We previously reported demographics, race, stage, treatment, and survival patterns in testicular cancer (TC) patients in the U.S. using the National Cancer Database (NCDB) data (Yu et al., JCO:43 (5): Abs 622). We now examine race in a multivariable model to further understand survival outcomes in both seminoma and non-seminoma. Methods: Patient-level data were extracted from NCDB for TC cases diagnosed between 2004 and 2020, including histologic subtypes seminoma (S) and non-seminoma (NS). Statistical analyses involved descriptive statistics, chi-square tests comparing categorical variables, Kaplan-Meier method analyzing overall survival (OS) , and log-rank tests comparing OS across racial/ethnic groups, disease stages, comorbidity scores, facility types, and insurance statuses. Multivariate Cox Proportional Hazards models were used to examine the impact of race, Spanish origin, facility type, Charlson-Deyo Score, Insurance, Stage, Education, and median income on OS. Results: The cohort included 89,550 patients: 81,571 White, 2,860 Black, 3,624 with other races, and 1,495 Unknown. We previously showed that White patients were primarily treated at comprehensive community cancer and academic/research programs, while Black patients were more frequently treated at academic centers. Hispanic patients were underrepresented at academic and comprehensive community cancer programs. Private insurance predominated overall (72%), highest in Whites (72.9%) and lowest in Blacks (54.1%) and Hispanics (48.8%). Medicaid coverage and uninsured status were higher in Black and Hispanic groups. 23589 non-seminoma patients and 18298 seminoma patients were included in the multivariate analyses. Significant factors were worse Charlson-Deyo scores (combined 2&amp;3 vs 0 vs 1) P&lt;0.0001, insurance (combined Medicaid &amp; Medicare &amp; other government vs not insured vs private vs government) P&lt;0.0001, stage (stage I, II, III) P&lt;0.0001, while education (P=0.9044) and median income (P=0.1118) were not significant factors. Conclusions: Race appears to be an important contributing factor to overall survival in non-seminoma patients when accounting for Charlson-Deyo score, stage, and insurance status, but income did not seem to have a significant contributory effect. In multivariate analyses of our TC population overall and specifically in seminoma patients, race appears to have less of an effect on overall survival.

Real-world neoadjuvant therapy utilization and outcomes in patients with muscle-invasive bladder cancer ineligible for cisplatin treatment.

672 Background: Cisplatin-based neoadjuvant chemotherapy (NAC) is standard of care for cisplatin-eligible (CE) patients (pts) with muscle-invasive bladder cancer (MIBC). Many pts are deemed cisplatin-ineligible (Cis-I) due to impaired renal function, poor performance status, or comorbidities, and optimal management strategies for this population remain unclear. This study aimed to assess real-world (rw) NAC utilization in Cis-I pts and evaluate the impact of NAC receipt on outcomes. Methods: This retrospective cohort study used the US-based, EHR-derived deidentified Flatiron Health Research Database containing data from &gt; 20,000 pts with bladder cancer (cutoff: May 31, 2025). Pts with MIBC diagnosed on or after 2015 who had primary surgery were included. Cisplatin eligibility was based on baseline creatinine clearance (CrCl) and ECOG performance status (ECOG PS). The effect of cisplatin-based NAC vs no NAC on rw overall survival (rwOS, from MIBC diagnosis) and rw disease-free survival (rwDFS, from primary surgery) was assessed in Cis-I pts using unadjusted Kaplan-Meier curves and Cox proportional hazards models adjusted for age, sex, race, ECOG PS, CrCl, practice type, T stage, histology, and residual disease status (rwDFS only). Results: Of 5016 pts with MIBC who underwent surgery, 26.9% were CE, 10.2% Cis-I, and 62.9% indeterminate. Median rwOS and rwDFS (95% CI) were longer in CE vs Cis-I pts: 74.7 (69.6-86.6) vs 39.9 months (30.9-48.2), and 59.7 (52.3-63.8) vs 17.0 months (13.7-23.0), respectively. Among Cis-I pts, 45.2% (n = 231) received cisplatin-based NAC and 32.9% (n = 168) did not receive NAC. Pts who received cisplatin-based NAC were younger, had better performance status and higher baseline CrCl, were more likely to present with T2 (vs T3/4) disease, and less frequently had upper tract disease compared to Cis-I pts who did not receive NAC. Median rwOS (95% CI) was 48.2 months (30.9-67.6) in CI pts who received cisplatin-based NAC and 29.6 months (20.4-46.1) in those who did not; median rwDFS (95% CI) was 21.1 months (14.3-34.2) with NAC and 15.0 months (11.7-21.3) without. In the adjusted Cox PH analysis, receipt of cisplatin-based NAC vs no NAC was suggestive of a lower hazard of death (HR 0.75; 95% CI: 0.55-1.04) in Cis-I patients during follow-up; rwDFS was similar between groups (HR 1.00; 95% CI: 0.73-1.37). Conclusions: Inferior clinical outcomes were observed in Cis-I compared to CE pts. Nearly half of Cis-I pts still received cisplatin-based NAC, reflecting rw extension of therapy to selected pts. The trend toward improved OS associated with receipt of cisplatin-based NAC in Cis-I pts suggests that carefully selected pts may benefit from this treatment. Further research is needed to better understand the optimal treatment strategies for Cis-I pts to address the unmet needs in this population.

Decoding NASICON and Its Metal Interface for Solid‐State Batteries

ABSTRACT Solid‐state batteries (SSBs) are among the most promising next‐generation energy storage technologies, offering exceptional safety, high energy density, and fast‐charging capability. Among all kinds of solid electrolytes, sodium super ionic conductor (NASICON) is one of the most promising candidates due to its inexpensive material precursors, air stability, and high ionic conductivity. However, it faces a critical challenge: interfacial instability with metal anodes, leading to dendrite formation and penetration that ultimately cause battery failure. Addressing this issue requires a systematic understanding of the solid electrolyte itself, interfacial failure mechanisms, and robust mitigation strategies. Therefore, this review focuses on NASICON as a model system for both sodium‐ and lithium‐based SSBs, providing a comprehensive overview and new insights into NASICON and its metal interfaces. A top‐down approach is adopted, beginning with the fundamentals of NASICON's crystallography, thermodynamics, and kinetics to elucidate its intrinsic properties and interfacial degradation behaviors. Advanced characterization techniques for probing such failures are then reviewed, followed by a comprehensive discussion of mitigation strategies targeting the electrolyte, electrode, and their interface, along with practical insights into NASICON manufacturing. Finally, future research directions are proposed to guide the advancement of NASICON‐based SSBs toward practical commercialization.

Thermo‐Crosslinking Organic Electron Transport Layers for Stable Perovskite Solar Cells Decoded by In Situ Acoustic Resonance

ABSTRACT Electron transport layer (ETL) plays a pivotal role in determining the interfacial integrity and operational robustness of n‐i‐p structured perovskite solar cells (PSCs). Conventional tin oxide based inorganic ETLs are often plagued by inherent point defects, while organic small‐molecule ones frequently suffer from limited device efficiency and durability. In this study, we present an innovative molecular design strategy via developing thermo‐crosslinking organic ETLs to overcome these persistent interfacial challenges. Novel organic electron transport materials (ETMs) have been successfully designed by strategically incorporating heat‐inducible cross‐linking triallyl or oxetane functional groups into naphthalene diimide‐based conjugation scaffold, respectively. Such cross‐linkable ETMs exhibit exceptional electronic properties, facile heat‐induced film‐forming capability, and enhanced charge transport. Specifically, featuring optimized energy level alignment and superior surface wettability, oxetane‐functionalized ETL endowed n‐i‐p structured PSCs with a champion power conversion efficiency of 25.23%, among the highest values reported for organic ETL‐based devices. Non‐destructive ultrasonic testing and accelerated aging assessments have been explored for the first time to decode the substantial improvements in interfacial robustness and operational stability under thermal (85°C) and humid conditions (65% relative humidity). This work establishes a versatile material design paradigm for developing robust organic ETLs, paving the way for high‐performance and durable perovskite photovoltaics.

Modulating Conductivity and Porosity of Interlayer for Long‐Cycling All‐Solid‐State Lithium Metal Batteries

Abstract Sulfide‐based all‐solid‐state lithium metal batteries (ASSLMBs) are considered promising next‐generation energy storage solutions due to their high energy density and enhanced safety. However, persistent challenges such as dendrite formation, solid electrolyte (SE) decomposition, and unstable interfaces impede the utilization of lithium metal anodes. In this study, a triple Si/Carbon nanotube (CNT) interlayer featuring meticulously engineered gradients in conductivity and porosity is introduced. Thus, the designed interlayer consists of low electronic conductivity and high ionic conductivity with a densely low‐porosity structure at the SE interface, balanced ionic‐electronic conductivity in the porous middle layer, and high electronic conductivity adjacent the current collector. This strategic configuration effectively suppresses dendrite growth, minimizes SE degradation, and promotes uniform lithium deposition. Experimental results demonstrate that the triple Si/CNT interlayer achieves an initial Coulombic efficiency of 95.1% and maintains approximately 99.9% cycling efficiency over 150 cycles in half‐cell tests. Notably, full‐cell evaluations with an Ni‐rich LiNi 0.8 Co 0.1 Mn 0.1 O 2 cathode exhibit outstanding performance, delivering a capacity retention of 85.2% after 500 cycles and demonstrating long‐term cycling stability up to 1800 cycles, alongside superior rate capabilities (85.2% at 2C, 76.3% at 5C, and 65.2% at 10C). These results highlight the efficacy of gradient‐structured interlayers in enabling high‐energy‐density, long‐cycling ASSLMBs.

Correction: The biosynthesis of N-acyalated tryptazolone in Mycobacterium tuberculosis and related bacteria