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Healthcare resource utilization (HCRU) and costs among US patients (pts) with locally advanced or metastatic urothelial cancer (la/mUC) treated with first-line (1L) treatment regimens: Results from the ELEVATE UC-I study.
871 Background: While real-world safety of 1L tx regimens for la/mUC has been previously described, data characterizing HCRU and costs are limited since the introduction of newer tx options. This study assessed all-cause HCRU and costs in pts with la/mUC receiving contemporary 1L txs. Methods: This retrospective cohort study using the Premier Healthcare database included US adult pts diagnosed with la/mUC (Jan 2020-Jun 2024). Pts were stratified by 1L tx: enfortumab vedotin + pembrolizumab (EV + P), platinum-based chemotherapy (PBC; cisplatin- or carboplatin-based) ± avelumab maintenance, and immune checkpoint inhibitor (ICI) monotherapy. Mean all-cause HCRU and costs were assessed from 1L tx initiation through the earliest of either 90 days after 1L discontinuation, initiation of subsequent tx, death, or end of study, and were reported per pt per month (PPPM). Cost components included inpatient (IP) hospitalization; emergency department (ED) visits; outpatient (OP) visits, including medications; and total costs (IP + OP). Length of stay (LOS) was defined as number of hospitalization days. Results: Among 7,984 pts, median age was 72 years (IQR 64-78); 73% were male and 83% were White. Mean all-cause HCRU and costs by 1L tx regimen are shown in the Table. EV + P had the highest mean total PPPM all-cause costs, largely driven by medication expenses and accounting for 89% of PPPM OP visit costs. PBC ± avelumab treated cohorts had the lowest total PPPM costs, reflecting the fixed duration of PBC and lower drug costs. Conclusions: HCRU and economic burden of la/mUC are substantial and vary by 1L tx type. EV+P was associated with the highest OP and total costs. These findings may inform resource allocation planning as new tx are incorporated into routine care. Future studies should assess the impact of comorbidities and disease status on HCRU. All-cause HCRU and costs by 1L tx regimen for la/mUC. HCRU & Costs (2024 USD) Overall Cohort(n=7,984) EV+P (n=343) Cisplatin-based chemo + avelumab (n=223) Cisplatin-based chemoalone (n=3,608) Carboplatin-based chemo + avelumab (n=201) Carboplatin-based chemo alone(n=1,250) ICI monotherapy (n=2,359) Median follow-up time, days 140 147 298 139 278 112 154 Pts with IP hospitalization, n (%) 3,582 (44.9) 129 (37.6) 90(40.4) 1,663(46.1) 85(42.3) 647(51.8) 968(41.0) Mean PPPM LOS for IP hospitalization, days 0.86 0.75 0.37 1.01 0.34 1.91 0.60 Pts with ED visits, n (%) 1,930 (24.2) 78(22.7) 88(39.5) 796(22.1) 70(34.8) 322(25.8) 576(24.4) Mean PPPM ED visits 0.07 0.06 0.06 0.08 0.05 0.10 0.06 Mean PPPM costs, IP hospitalization 2,858 2,233 1,106 3,831 935 5,471 1,815 Mean PPPM costs, ED visits 109 79 92 115 100 174 92 Mean PPPM costs, OP visits 9,667 34,137 11,458 5,454 11,203 5,395 11,733 Mean PPPM costs, Total (IP + OP) 12,525 36,370 12,564 9,285 12,138 10,866 13,549
Material‐Level Integration of Magnetic Actuation and Triboelectric Sensing for Adaptive Soft Robotic Platforms (Adv. Mater. 14/2026)
STAR Therapy: Spatiotemporal Antitumor Regimen via a Size‐Gated DNA Hydrogel Drug Delivery System
ABSTRACT Current cancer therapies for solid tumors are significantly hampered by the dense tumor extracellular matrix (ECM), which restricts antitumor drug penetration and accumulation. Hence, there is a critical need for controllable drug delivery systems capable of spatiotemporally controlling the sequential action of ECM‐modulating agents and cytotoxic drugs. However, conventional carriers often suffer from “non‐selective synchronous release”, failing to achieve such spatiotemporal control. Herein, we propose a spatiotemporal antitumor regimen (STAR) based on a size‐gated DNA supramolecular hydrogel (DSH) drug delivery system. In this system, a small‐molecule drug Losartan (Los) and a larger indocyanine green‐loaded platelet‐mimetic particle (ICG/PLT) are co‐encapsulated within the DSH. The programmable size‐selectivity of DSH allows for the rapid diffusion of Los to first remodel tumor ECM by reducing matrix density and enhancing tissue perfusion; meanwhile, the larger ICG/PLT particles are retained within the hydrogel structure and released later along with hydrogel degradation. Notably, this size‐gated sequential release strategy significantly enhances the accumulation of ICG/PLT at the tumor site, resulting in superior light‐activated photodynamic therapeutic outcomes against tumors. Taken together, this study establishes a novel STAR paradigm based on size‐gated DSH, holding promise to advance the therapeutic strategy for solid tumors with dense ECM.
Effect of HER2 IHC on enfortumab vedotin (EV) or EV+pembrolizumab (EVP) benefit in metastatic urothelial carcinoma.
780 Background: Nectin-4 is the primary target of enfortumab vedotin (EV), an antibody-drug conjugate approved for metastatic urothelial carcinoma (mUC). Nectin-4 frequently co-expresses with HER2 (ERBB2) in urothelial tumors, suggesting overlapping molecular phenotypes. HER2 IHC adequately stratifies EV/EVP outcomes remains unclear. This study evaluates whether HER2 IHC reliably predicts response to EV versus EVP in mUC. Methods: We retrospectively abstracted all treatment lines receiving EV or EVP (2021–2024). The primary endpoint was ORR (RECIST 1.1). Secondary endpoints were PFS/OS from treatment start using a 42-day landmark Kaplan–Meier analysis. Prespecified IHC splits were 2-group (IHC 2/3 vs 0/1) and 3-group (0/1 vs 2 vs 3). Exploratory SISH-integrated schemas were: two-tier (IHC3 or IHC2/SISH+ vs IHC2/SISH− or 0/1) and three-tier (HER2-high: IHC3 or IHC2/SISH+; intermediate: IHC2/SISH−; negative: IHC0/1). Fisher’s exact test compared ORR; log-rank compared survival. Analyses were EV, EVP, and pooled. Results: Among 64 evaluable lines with HER2 IHC and response, IHC 2/3 vs 0/1 enriched for response: EVP 83.3% (20/24) vs 40.0% (4/10), p =0.034; EV 50.0% (12/24) vs 16.7% (1/6), p =0.196 (same direction, underpowered); pooled 66.7% (32/48) vs 31.3% (5/16), p =0.019. The 3-group IHC model showed a graded increase in ORR (3 > 2 > 0/1) with global significance in pooled ( p =0.037) and EVP ( p =0.018) cohorts (EV non-significant, p =0.305). Landmark PFS mirrored ORR: pooled median 7.42 vs 2.92 months (IHC2/3 vs 0/1; p =0.129); EVP 8.31 vs 4.30 ( p =0.234); EV 4.83 vs 1.35 ( p =0.308). OS was not interpretable due to insufficient events. Adding SISH did not change the clinical signal: SISH-integrated two-/three-tier schemas reproduced the same gradients and did not outperform IHC-only; defining HER2-positivity by SISH alone likewise failed to exceed the simple IHC 2/3 vs 0/1 split. Conclusions: In real-world mUC, HER2 IHC alone—independent of SISH—reliably enriches for benefit with EV-based therapy, with the clearest separation in EVP. A pragmatic IHC-only approach using 2-group or 3-group stratification is readily implementable. Prospective validation is warranted. ORR and landmark PFS by IHC 2/3 vs 0/1. Cohort IHC 2/3 ORR (k/n) IHC 0/1 ORR (k/n) Fisher p PFS, mo (2/3 vs 0/1) Log-rank p EVP 83.3% (20/24) 40.0% (4/10) 0.034 8.31 vs 4.30 0.234 EV 50.0% (12/24) 16.7% (1/6) 0.196 4.83 vs 1.35 0.308 EV+EVP pooled 66.7% (32/48) 31.3% (5/16) 0.019 7.42 vs 2.92 0.129
Effect of remote exercise on fatigue and quality of life (QOL) across genitourinary (GU) cancer types.
487 Background: Patients with GU cancers experience declines in physical function and QOL during treatment. Exercise may improve QOL, potentially by reducing fatigue. We evaluated whether adherence to a remote exercise program improves QOL, if fatigue mediates this effect, and whether treatment type or cancer subtype influences outcomes. Methods: Patients with metastatic prostate, bladder, or kidney cancer initiating systemic therapy were assessed at baseline (T1) and after 12 weeks (T2) using FACT-G (0-108). Fatigue was assessed on a 0-5 scale. Participants joined a remote exercise program (3-5 h/week, resistance + aerobic) via Vedius platform. Adherence was categorized as moderate-to-high (≥6 weeks) or low (≤5 weeks). Linear mixed models evaluated FACT-G over time, including treatment type, cancer group, and interactions. Mediation analysis assessed whether fatigue changes from T1 to T2 mediated exercise adherence effects on FACT-G. Results: Seventy-five patients were recruited (median age 71, 81% male, 47% college educated). Cancer types: prostate 47% (chemotherapy 85%, ± hormonal blockade 57%), kidney 37% (immunotherapy 67%, combination regimens 18%, tyrosine kinase inhibitors 15%), bladder 16% (chemotherapy 58%, antibody-drug conjugate 42%). FACT-G showed no significant effects by cancer type or treatment. Adherence predicted larger fatigue reductions (B=-1.36, p<0.001). Fatigue changes predicted FACT-G at T2 (B=-2.18, p=0.02). The direct effect of adherence on FACT-G was not significant (B=2.57, p=0.41), but the indirect effect through fatigue was significant (effect=2.98, BootSE=1.48, 95% CI [1.08, 5.79]), indicating that improvements in QOL with exercise are mediated by fatigue reduction. Conclusions: Participation in a remote exercise program was associated with improved QOL in patients with metastatic GU cancers, primarily through reductions in fatigue. These benefits were observed across cancer types and treatment modalities, highlighting the value of structured exercise interventions as an integral component of supportive care in this population. Exercise adherence, fatigue change, and quality of life. Analysis Predictor Outcome B / F SE t / df p-value 95% CI Linear Mixed Model Treatment Type FACT-G - - F(3,8)=0.62 0.624 - GU Cancer Group FACT-G - - F(2,8)=0.98 0.415 - FACT-G T1 FACT-G - - F(29,8)=2.76 0.068 - FACT-G × Treatment FACT-G - - F(7,8)=1.69 0.238 - FACT-G × GU Group FACT-G - - F(4,8)=0.86 0.525 - Mediation Analysis Exercise Adherence Fatigue -1.36 0.27 -5.06 <0.001 -1.90, -0.83 Fatigue Change FACT-G -2.18 1.23 -1.78 0.020 -4.64, -0.27 Direct Effect (Adherence → FACT-G) FACT-G 2.57 3.12 0.82 0.41 -3.66, 8.79 Indirect Effect via Fatigue FACT-G 2.98 1.48 - - 1.08, 5.79 FACT-G T2 = quality of life at 12 weeks. B = unstandardized coefficient; SE = standard error; CI = confidence interval.
Effect of curcumin on the gut microbiota of patients with ulcerative colitis, Crohn’s disease and healthy participants
Prostate cancer screening in a geriatric population.
317 Background: PSA screening often results in diagnosis of clinically nonsignificant prostate cancer, which may lead to unnecessary treatment especially in the geriatric population. The best practice for screening this population remains controversial. Methods: We conducted a retrospective observational analysis of men referred by their primary care provider to the PSA clinic at Banner Gateway MDACC from 2022 to 2024. Diagnostic work-up was managed by urologic oncology specialists and incorporated routine pre-biopsy 3.0T contrast-enhanced prostate MRI. Inclusion criteria were abnormal PSA per referring physician without other symptoms of or a history of prostate cancer. Patients were divided into geriatric (age ≥75) and nongeriatric (age <75) groups. Bivariate analysis was performed, using t-tests or Mann–Whitney U tests for continuous variables and Chi-square or Fisher’s exact tests for categorical variables, as appropriate. Results: A total of 533 subjects were included. The median PSA was 5.8 ng/mL (IQR 4.6-8.1), with a higher median PSA observed in the geriatric group (6.8 ng/mL, IQR 5.3-11.4) than in younger patients (5.5 ng/mL, IQR 4.4-7.5; p < 0.001). Locally assessed PI-RADS scores were categorized into three groups: 0–2, 3, and 4–5. MRI was performed in 401 patients (75.2%) and biopsy in 264 patients (49.5%), with no significant differences between age groups. There was a trend toward a higher proportion of PI-RADS 4-5 lesions in the geriatric population compared with younger patients (58.6% vs. 47.6%), though this did not reach statistical significance (p = 0.19). Prostate cancer was diagnosed in 186 patients (34.9% of the cohort). The proportion of biopsies yielding a cancer diagnosis was significantly higher in the geriatric group (88.5% vs. 65.0% p < 0.001), corresponding to a positive biopsy odds ratio of 4.15 (95% CI 1.79-9.6). 36 patients (19.3%) had Gleason grade 1, and 151 patients (80.7%) had Gleason grade ≥2. The distribution of Gleason scores did not differ significantly by age group. Conclusions: Prostate cancer screening in a cancer center setting incorporating routine pre-biopsy prostate MRI resulted in a high detection rate of clinically significant prostate cancers in geriatric men. This suggests that screening in the geriatric population can be appropriate, with a low rate of negative or clinically non-significant prostate cancer diagnoses minimizing unnecessary biopsies and overtreatment risk. Screening outcomes by age group. Overall (n=533) Age <75 (n=415) Age ≥75 (n=118) p-value Median PSA (IQR) 5.8 (4.6-8.1) 5.5 (4.4-7.5) 6.8 (5.3-11.4) <0.001 MRI, n (%) 401 (75.2%) 314 (75.7%) 87 (73.7%) 0.67 PI-RADS 0-2 91 (22.9%) 75 (24.1%) 16 (18.4%) PI-RADS 3 108 (27.1%) 88 (28.3%) 20 (23.0%) PI-RADS 4-5 199 (50.0%) 148 (47.6%) 51 (58.6%) Biopsy, n (%) 264 (49.5%) 203 (48.9%) 61 (51.7%) 0.59 Prostate cancer 186 (70.5%) 132 (65.0%) 54 (88.5%) <0.001 GG 1 36 (19.3%) 29 (22.0%) 7 (12.7%) 0.14 GG ≥ 2 151 (80.7%) 103 (78.0%) 48 (87.3%) 0.14
Archeo‐Inspiration from the Cultural History of Glass: Historic Accounts, Anecdotes and Hard Facts as Challenges to Modern Material Science (Adv. Mater. 16/2026)
Coupling Data‐Driven and Reinforcement Learning for Material Development and Device Management in Batteries
ABSTRACT The growing demand for high‐energy, safe, and durable batteries demands innovative strategies in both material discovery and device management. Conventional approaches, rooted in empirical trial‐and‐error and physics‐based modeling, often struggle to address the complexity and dynamic nature of next‐generation battery systems. Here, we highlight the emerging synergy between data‐driven machine learning and reinforcement learning (RL), establishing a coupled paradigm that unifies predictive modeling with adaptive optimization. Data‐driven methods enable rapid screening of cathodes, anodes, and liquid/solid electrolytes through multi‐source data mining, while RL agents iteratively optimize synthesis conditions, interfacial properties, and charging protocols. Together, these approaches create closed‐loop frameworks for materials development (prediction, exploration, and validation) and device management (data insight and strategy optimization), which accelerate discovery, enhance safety, and improve performance across the battery lifecycle. Finally, we further outline critical opportunities in data processing, feature engineering, and model building that can elevate this coupled paradigm from conceptual promise to industrial deployment. This integration of data‐driven learning with reinforcement intelligence paves a pathway toward autonomous, high‐throughput battery innovation, providing new foundations for next‐generation energy technologies.
Preliminary results from phase II enfortumab vedotin plus toripalimab compared to gemcitabine-cisplatin as neoadjuvant therapy for patients with muscle-invasive bladder cancer (MIBC).
782 Background: Cisplatin-based neoadjuvant chemotherapy is the standard of care in MIBC with improved overall survival (OS). Enfortumab Vedotin plus pembrolizumab prolongs OS in MIBC pts. This study will evaluate the efficacy and safety of toripalimab (an anti-PD-1 monoclonal antibody) combined with Enfortumab Vedotin (EVT) as neoadjuvant therapy in comparison with gemcitabine-cisplatin (GC) neoadjuvant regimen for patients with MIBC. Methods: This study is an open label, multi-center, 2-arm clinical trial. Arm A enrolls eligible pts with MIBC (cT2-T4a, N≤1, M0) who were candidates for RC. Enfortumab Vedotin (1.0mg/ m 2 d1,d8) plus Toripalimab (240mg, d1) every 21 days, up to 4 cycles. Arm B received GC chemotherapy (gemcitabine 1000mg/ d1,d8 plus cisplatin 35mg/m 2 d1,d2) every 21 days, up to 4 cycles. RC was performed within 4 weeks after the last dose treatment. The dual primary endpoint was PaR(≤ pT1,N0) and pCR (ypT0N0). Secondary endpoints were DFS at 2 years and safety. Results: Between Mar 2025 and Oct 2025. 18 pts (7 pts cT2, 6 pts cT3, 5 pts cT4) were enrolled. The median age was 69.5, and 61.1% (11/18) were male. 7 pts were enrolled in arm A, in which 5 pts completed all 4 cycles of EVT. All 11 pts in arm B completed 4 cycles of GC. 16 of the 18 pts underwent RC and two are still in EVT neoadjuvant cycles. Among EVT arm, PaR was 60% (3/5), and pCR was 40% (2/5). In GC arm, PaR was 45.45% (5/11), while no pts had achieved pCR. Survival data are not yet mature. The most common adverse events (AEs) of any grade were fatigue (17/18; 94.44%), anemia (16/18; 88.89%), and fever (10/18, 55.56%). 33.33% (6/18) pts had Grade ≥3 Severe AEs. One patient in GC arm had post-operative pneumonia. Two pts in GC arm had bowl obstruction. Two pts in GC arm and one patient in EVT arm had post-operative lymphocele. Conclusions: Neoadjuvant Enfortumab Vedotin plus Toripalimab demonstrated promising efficacy and safety in comparison with GC regimen in MIBC. This combination was well tolerated without any delays in RC and more data are required for mature conclusion.
Diagnostic performance of <sup>18</sup> F-flotufolastat PET/CT compared with conventional imaging in men with biochemical recurrence of prostate cancer: Descriptive post-hoc analysis from the phase 3 SPOTLIGHT study.
30 Background: SPOTLIGHT (NCT04186845) assessed the diagnostic performance of prostate-specific membrane antigen (PSMA)-targeting PET radiopharmaceutical 18 F-flotufolastat in men with suspected biochemical recurrence (BCR) of prostate cancer. This descriptive post-hoc analysis compared the diagnostic performance of 18 F-flotufolastat with baseline conventional imaging (BCI). Methods: Men with suspected BCR of prostate cancer underwent PET/CT 50–70 min after 18 F-flotufolastat (296 MBq ± 20%) administration. Patients enrolled in SPOTLIGHT underwent BCI with either, CT, MRI, 99m Tc bone scan, 18 F-NaF PET/CT or 18 F-fluciclovine PET/CT based on institute guidelines and read by a study site reader. 18 F-Flotufolastat PET images were interpreted by three blinded independent central readers. This analysis included a subset of patients who had histopathology data from biopsies conducted ≤ 60 days post-PET available as a standard of truth (SoT). Patient-level positive predictive values (PPV), detection rates (DR) and verified detection rates (VDR; equivalent to DR x PPV) were compared between BCI and 18 F-flotufolastat PET. A scan was considered true positive (TP) if it had ≤ 1 scan-positive region confirmed by histopathology, or false positive (FP) if not proven TP. Results: From the 69 patients with histopathology as SoT in SPOTLIGHT, one patient had indeterminate histopathology and one had indeterminate BCI, therefore the 18 F-flotufolastat and BCI groups contain 68 and 67 patients, respectively. Median PSA for patients in the 18 F-flotufolastat and BCI groups was 2.22 and 2.10 ng/mL, respectively. Compared with 18 F-flotufolastat, BCI had a lower DR (94–100% vs 33%, respectively) and accordingly detected fewer TP cases (24%) than 18 F-flotufolastat (63%). This conferred a higher VDR for 18 F-flotufolastat (63%) than BCI (24%) and an anticipatedly comparable PPV given disease on BCI are more overt and amenable to verification (Table). Of note, 18 F-fluciclovine PET was the highest performing BCI modality. Conclusions: This descriptive post-hoc analysis shows that 18 F-flotufolastat PET has superior diagnostic efficacy, including DR and VDR compared with BCI for patients with BCR of prostate cancer. Clinical trial information: NCT04186845 . DR, n (%) VDR, n (%) PPV,TP/TP+FP (%) 18 F-Flotufolastat PET reader 1N=68 68/68 (100) 43/68 (63) 43/68 (63) 18 F-Flotufolastat PET reader 2N=68 64/68 (94) 43/68 (63) 43/64 (67) 18 F-Flotufolastat PET reader 3N=68 66/68 (97) 43/68 (63) 43/66 (65) BCI*N=67 22/67 (33) 16/67 (24) 16/22 (73) Baseline CT † N=31 3/31 (10) 2/31 (7) 2/3 (67) Baseline MRI † N=18 8/18 (44) 5/18 (28) 5/8 (63) Baseline 99m Tc bone scan † N=35 2/35 (6) 2/35 (6) 2/2 (100) Baseline 18 F-fluciclovine † PETN=22 13/22 (59) 10/22 (46) 10/13 (77) *Includes CT, MRI, 99m Tc bone scan, 18 F-fluciclovine PET/CT. † Patients could undergo ≥ 1 imaging modality.
Versatile and portable Cas12a-mediated detection of antibiotic resistance markers
Relevance of fresh frozen sections (FFS) for carcinoma in situ (CIS) detection in radical cystectomy for bladder cancer.
667 Background: Radical cystectomy is the standard of care for muscle invasive bladder cancer after neoadjuvant chemotherapy. Complete resection is mandatory. To detect CIS in the ureter or urethra FFS are performed and sequential resections of the ureter or urethrectomy are performed in case of positive findings. In this retrospective analysis we highlight the frequency of CIS in FFS and locations of recurrences in patients with CIS in the final specimen. Methods: We retrospectively analyzed patients undergoing radical cystectomy between 2015 und 2024. CIS in the urethra and ureters was analyzed in FFS and final pathologic results. In patients with CIS in the final pathology recurrence patterns were analyzed. Results: In 369 patients CIS was detected in 17 (4,9%) patients. After sequential resection of the urethra or ureter a complete resection in FFS was demonstrated in 13 (3,5%) of the patients. In 4 patients (1,1%) persistent CIS and in another 4 (1,1%) patients CIS is described after negative FFS. In five and three patients CIS was located in the ureter and urethra. 5 patients had either BCG or HIVEC for local treatment. Within 2 years 4(50%) of the patients developed recurrent disease. In none local recurrence but retroperitoneal lymph nodes, hepatic, pulmonary and or bone metastases were detected. Conclusions: The detection of CIS in FFS is rare, time and cost consuming. The oncologic benefit is limited as in all cases distant metastases developed. According to our results the routine use of FFS to detect CIS must be questioned.
Significantly Unconventional Enhancement of Anomalous Hall Angle in Magnetic Weyl Semimetal Co <sub>3</sub> Sn <sub>2</sub> S <sub>2‐x</sub> Se <sub>x</sub>
ABSTRACT Theoretically, introducing inhomogeneous magnetization into magnetic topological Weyl semimetals can dramatically enhance the anomalous Hall conductivity owing to the chiral‐gauge field effect. However, an enhancement strategy remains elusive. Here, we demonstrate the successful generation of inhomogeneous magnetization in a recently discovered magnetic Weyl semimetal Co 3 Sn 2 S 2 by introducing a dopant with strong spin–orbit coupling. The giant anomalous Hall angle reached 42% at 130 K, even under a relatively weak magnetic field (∼0.1 T), making it the highest reported value. Theoretical and magnetic microstructure analyses suggest that the significantly enhanced anomalous Hall effect may be due to the chiral‐gauge field induced directly by inhomogeneous magnetization in real‐space. Furthermore, considering the electronic band structure of Co 3 Sn 2 S 2 and the chiral‐gauge field, the theoretical Hall resistivity is quantitatively in good agreement with the experimental value. This study demonstrated the feasibility of dramatically manipulating the physical properties of Anomalous‐Hall‐angmagnetic topological materials using magnetic microstructure engineering.
Breaking the 2‐nm Barrier in Hard Disk Drives Using Monolayer Amorphous Carbon Overcoats
ABSTRACT The rapid growth of artificial intelligence (AI) has increased the demand for large‐scale data storage, making hard disk drives (HDDs) indispensable in data centers due to their cost‐effectiveness and stability. To support AI‐driven data requirements, increasing the areal storage density is critical. However, this metric is increasingly constrained by the carbon overcoat (COC), the essential protective layer for magnetic media. Traditional diamond‐like carbon (DLC) can no longer fulfill the stringent demands for ultrathin coatings and high thermal stability required by next‐generation technologies like Heat‐Assisted Magnetic Recording (HAMR) and bit‐patterned media. Here, we introduce monolayer amorphous carbon (MAC) as a superior alternative. MAC is directly grown on the heterogeneous (Fe, Pt, SiO 2 ) HDD surface at low temperatures (∼ 300°C), achieving an uniform 0.8 nm thickness across 2.5‐inch disks. Despite its atomic thickness, MAC demonstrates high corrosion resistance and low roughness comparable to commercial 2.5 nm COCs. Its fully amorphous, sp 2 ‐hybridized structure ensures excellent thermal stability under HAMR‐like conditions (∼450°C) and a low friction coefficient, enabling potential lubricant‐free operation. Replacing traditional COCs with MAC facilitates the development of HDD media capable of achieving 10 Tb/in 2 , addressing the urgent storage demands of the digital era.
Oncological outcomes and HER2 expression of urothelial carcinoma with squamous differentiation: A retrospective study.
702 Background: Urothelial carcinomas (UCs) often exhibit regions of divergent differentiation, such as squamous differentiation (SqD). UCs exhibiting SqD (UCSD) are more invasive and advanced, as SqD was frequently identified in patients with advanced T stage (pT3-4) and nodal metastasis. Clinically, humanized anti-human epidermal growth factor receptor 2 (HER2) antibody conjugated with monomethyl auristatin E (DV, RC48-ADC) is a promising therapy for bladder cancer. Methods: The aim of this study was to identify the HER2 expression of UCSD and oncological outcomes. We evaluated consecutive patients underwent radical cystectomy of bladder cancer and radical nephroureterectomy of UTUC at a single institution. Her2 expression of UCSD was evaluated by immunohistochemistry in the Pathology Department of our center. Postoperative follow up was done for each patient. Results: Totally 82 patients were included, consisting of 29 UTUC and 53 bladder UC. 82.8% of upper tract UCSD had none or low HER2 expression and 71.7% bladder UCSD had none or low HER2 expression (Table 1). To this end, median follow-up time is 33 months. Many patients experience rapid recurrence and progression. Even after systematic treatment, median DFS of UCSD was 8.4 months, and median OS was 20.1 months. DV was used in 13 UCSD recurrent patients, but the ORR was relatively low (23.1%). Conclusions: Rapid progression was a significant characteristic of UCSD, and the survival outcomes of UCSD were very poor. HER2 expression of UCSD was generally low, and more effective treatment methods or clinical trials are needed for squamous differentiation subtypes. The characteristics of UCSD patients. Characteristic UCSD UTUC Bladder UC Total Number 29 53 82 Age (median) 67 69 68.5 Gender Male (%) 24 (82.8) 38 (71.7) 62 (75.6) Female 5 15 20 T-stage T1 3 7 10 T2 3 8 11 T3 19 (65.5) 27 (50.9) 46 (56.1) T4 4 (13.8) 11 (20.8) 15 (18.3) LN positive 5 (17.2) 18 (34.0) 23 (28.0) Her2 expression (%) 0 14 (48.3) 20 (37.7) 34 (41.5) 1+ 10 (34.5) 18 (34.0) 28 (34.1) 2+ 4 (13.8) 13 (24.5) 17 (20.7) 3+ 1 (3.4) 2 (3.8) 3 (3.7)
A dyadic exercise approach to prevent declines in physical and mental health in couples during radiation treatment for cancer: Protocol for a hybrid type I efficacy implementation trial.
TPS410 Background: Compared to couples that aren’t facing a chronic illness, both cancer patients and their spouses suffer from poorer physical and mental health that leads higher morbidity and mortality. Exercising Together is a partnered exercise program aimed to amplify the dose of exercise and build teamwork to improve dyadic outcomes (i.e., physical and mental health of patients and partners) but has only been tested in the post-treatment setting as a rehabilitation strategy. We posit that the program would be most effective at mitigating the impact of newly diagnosed cancer and treatment if implemented much earlier in the point of care for patients and was delivered in a scalable way. Methods: The EMBark on RAdiation therapy with a Clinic-based Exercise program: Exercising Together (EMBRACE Exercising Together ) is a Type I hybrid effectiveness-implementation trial of Exercising Together adapted for the radiation oncology setting. This randomized controlled Phase II trial randomly assigns couples (n=200) to participate in an 8-week program of Exercising Together (3 x/ week) at the start of radiation therapy for prostate or breast cancer or to a usual care control group that receives standard written exercise guidance each month and receipt of a video of the Exercising Together at the end of participation. Couples assigned to the intervention group have the option to continue exercising in a maintenance class for another 48 weeks. Eligible survivors must have a diagnosis of prostate or breast cancer, be scheduled to receive radiation therapy with curative intent, and have a co-residing partner willing to participate; Eligible survivors and partners must be >18 years, not currently engaged in resistance training, and have no contraindications to participation. Couples are tested at baseline, post-intervention (2 mos.), and 4- and 6-mos. follow up. Assessments include online surveys (physical functioning, fatigue, sleep, anxiety, depressive symptoms, sexual function and satisfaction, quality of life, physical activity, health care utilization, relationship quality, physical intimacy, communication, collaboration social support, and self-efficacy); internet-based physical performance battery (chair stand, walk speed, balance tests); actigraphy-based physical activity and sleep behavior; high-sensitivity C-Reactive Protein using a dried blood spot technique. Exercise training and assessments are delivered through remote technology and/or collected at home. Intent-to-treat analysis will compare Exercising Together vs. usual care on physical and mental health of the dyad. Implementation outcomes of acceptability, appropriateness, adoption, sustainability and cost will be assessed, tracked, and analyzed. Trial registration: ClinicalTrials.gov, NCT06049355. Clinical trial information: NCT06049355 .
An integrated multi-hazard assessment using machine learning in the complex terrains of Northern Pakistan
Abstract The increasing frequency of natural hazards, intensified by climate change, poses substantial challenges to sustainable development worldwide. Northern Pakistan, particularly the Hunza district, is highly susceptible to multiple hazards, including landslides, earthquakes, glacier-induced floods, debris flows, and Glacier Lake Outburst Floods (GLOFs), driven by both climatic and tectonic factors. A multi-hazard assessment is essential to understand the complex interactions between these hazards, offering a comprehensive perspective on risk and facilitating more effective disaster preparedness and mitigation strategies. This study addresses the existing gap in multi-hazard assessments, which are often confined to single-hazard evaluations, by developing an integrated multi-hazard susceptibility map for the Hunza district in Northern Pakistan. The region’s complex topography, active tectonics, and accelerated glacier melting contribute to its high vulnerability to cascading and co-occurring hazards. The integrated assessment utilizes diverse data sources, including topographic attributes, geological, hydro-meteorological, environmental variables, and literature-derived hazard map for multi-hazard susceptibility analysis. A Machine Learning (ML) Forest-Based Classification and Regression (FBCR) model, Analytical Hierarchy Process (AHP), and Vs30-based site characterization was employed to classify and generate hazards individually and as integrated multi-hazard susceptibility map. The model incorporates eighteen geo-environmental variables for individual hazards assessment. The resulting multi-hazard susceptibility map indicates that 23.11% of the area is prone to landslides, 6.07% to flash floods, 4.66% to debris flows and flash floods, and 3.98% to a combination of flash floods, landslides, and debris flows. The highest multi-hazard zone, comprising seismic hazard, debris flows, landslides, and flash floods, covers 2.88% of the area, whereas low-hazard zones constitute 56.84% of the region. The landslide susceptibility model classifies 20% of the area as very high susceptible, while the flash flood, debris flow, and seismic hazard models indicate 5, 2, and 13% of the area, respectively, fall under very high susceptibility/hazard. This integrated multi-hazard approach provides a comprehensive risk assessment framework, supporting evidence-based disaster risk reduction policies and infrastructure planning in hazard-prone regions. The findings identify critical high-hazard zones, offering data-driven insights for targeted mitigation strategies and disaster risk reduction efforts.