Lung cancer is the leading cause of cancer mortality in Jordan, with most cases presenting at advanced stages. Low-dose computed tomography (LDCT) screening has demonstrated mortality reduction in high-risk populations in developed countries. This study evaluates the feasibility and potential impact of implementing LDCT lung cancer screening in Jordan and includes a health benefit analysis.

We analyzed Jordan's at-risk population using NELSON trial eligibility criteria and 2019 STEPS smoking survey data. Current radiological resources were assessed through official government sources and compared with international benchmarks from countries with established lung cancer screening programs. Health benefits were modeled using stage migration data from the NELSON trial applied to Jordan's lung cancer registry data (2013-2022) to calculate a benefit analysis.

An estimated 622,499 Jordanians, age 50-74 years, meet screening eligibility criteria. Jordan has 37.69 radiologists per million population (PMP; range, 6.03-62.47 across governorates), compared with the modeled minimum of 65.63. CT scanner availability is 16.37 PMP, very close to the minimum requirement of 16.76 but with significant geographic disparities. Modeling suggests screening could increase stage I diagnoses from 8.38% to 35.28% and reduce stage IV diagnoses from 73% to 54%, projecting a reduction of 34.93 advanced-stage presentations annually.

Although Jordan approaches adequacy in CT scanner availability, significant radiologist shortages and geographic disparities present major implementation challenges for LDCT lung cancer screening. Modeling uncertainties and infrastructure gaps necessitates pilot studies to validate assumptions before national implementation. Targeted infrastructure investment and workforce development are essential prerequisites for effective lung cancer screening in Jordan.

Unpaid caregivers provide essential support for people with cancer, yet the economic burden of this labor is not well quantified. This study provides pooled estimates of caregiving time and productivity outcomes to better understand the impact of unpaid caregiving on caregivers' economic well-being.

We systematically searched PubMed and EBSCO databases in June 2025 for peer-reviewed studies reporting primary or secondary data on six prespecified caregiver outcomes related to labor and time-use. Eligible studies focused on adult cancer care and included precision measures. After screening 3,904 records and reviewing 106 full-text articles, 59 studies from 16 countries were included in the meta-analyses. Where required for comparability, outcomes were standardized to a 35-hour work week and 250 workdays per year.

Caregivers provided an estimated 45 hours of unpaid care each week (95% CI, 31 to 58). Among employed caregivers, working hours declined by 13% (95% CI, 9 to 18). Caregivers were absent for 5% of working days (95% CI, 4 to 6) and experienced a 24% loss in workplace productivity (95% CI, 20 to 28). In addition, 30% reported reduced job responsibilities (95% CI, 24 to 37) and 1% exited employment (95% CI, -3 to 5). Burdens were greater among caregivers of people with advanced cancer and during palliative care. Women consistently reported greater labor and productivity impacts than men.

Unpaid caregivers of people with cancer face substantial time- and labor-related burdens that may affect their financial stability and long-term well-being. These findings highlight the need for supportive polices and workplace practices that protect caregiver well-being and economic security throughout the cancer care continuum. They also offer essential evidence to inform policies and interventions that protect caregiver well-being, economic stability, and long-term participation in the workforce.

Lung cancer (LC) remains a leading cause of cancer mortality worldwide. In Brazil, budgetary constraints in the public health system may influence access to oncologic care. This study analyzes temporal trends in average costs per hospitalization and length of stay (LOS) for LC across Brazil between 2001 and 2024.

This national ecologic time-series study used data from the Hospital Information System of the Unified Health System (SIH/SUS) for LC (International Classification of Diseases, 10th Revision: C34). Adults 20 years and older were stratified by sex, age, and five administrative regions. Costs were adjusted for inflation using Broad Consumer Price Index and converted to $2000 US dollars (USD). Linear regression was the primary approach, and quadratic models were applied when adjusted R² and visual inspection indicated poor linear fit. Spearman's rho (ρ) assessed correlation between LOS and daily costs (Stata 15.0; α = .05).

A total of 457,152 LC hospitalizations were recorded (total expenditure: $134,999,677.20 USD). Decreasing national trends were observed for average cost per admission (men: β = -5.19; women: β = -4.65; P < .001) and LOS (men: β = -.192; women: β = -.195; P < .001). Costs were consistently higher among women, despite more hospitalizations among men. The 20- to 34-year age group showed the highest average costs; elderly patients had the lowest. The South presented the highest costs, and the North, the lowest. A negative correlation between LOS and daily costs was observed across all regions (P < .001).

Average LC hospitalization costs and LOS showed declining trends. Subgroup analyses revealed regional, age-, and sex-related differences, suggesting persistent inequalities in SUS resource distribution and the need for evidence-based strategies for more equitable resource allocation.

Thin-cut formalin-fixed paraffin-embedded (FFPE) tumor sections on glass slides represent a large, underused biorepository for precision oncology, but their long-term room temperature storage raises concerns about nucleic acid integrity and analytical validity. We evaluated whether 20- to 30-year-old archival breast cancer FFPE slides could support contemporary DNA and RNA molecular profiling, including tumor subtyping using orthogonal DNA, and RNA-based approaches.

Two archival cohorts were studied: (1) SWOG S8897 low-risk breast tumors stored as 6-µm unstained FFPE sections on slides for approximately 20-30 years (20 tumors; 19 matched cancer-free lymph nodes [LN]) and (2) similarly aged unrelated FFPE tumor blocks (n = 13) used for assay development. DNA and RNA were extracted with quality assurance/quality control. DNA profiling included low/ultra-low-pass whole genome sequencing for copy number analysis (CNA) and IntClust subtyping plus high-depth targeted sequencing using a 93-gene Unique Molecular Identifier (UMI)-based panel. RNA profiling included RNA-seq on block-derived specimens and a custom droplet digital polymerase chain reaction (ddPCR)-based reverse transcription-quantitative PCR (RT-qPCR) assay to enable subtype calling from highly fragmented RNA.

DNA and RNA were recovered from >90% of specimens, despite extensive fragmentation (RNA in a range of 30-100 nt). RNA Access/Exome and NanoString approaches were unsuccessful in the most degraded slide-derived RNAs, prompting development of the ddPCR-based RT-qPCR assay, which successfully quantified targets and enabled intrinsic-like subtype calling across archival tumors. DNA profiling achieved high success for CNA/subtyping and UMI-based mutation detection, and the dual RNA/DNA framework showed strong subtype concordance (ddPCR v IntClust approximately 87% among evaluable cases).

Decades-old FFPE slide sections, stored at room temperature with no special conditions, can yield usable DNA along with highly degraded RNA for integrated multiomic molecular profiling and breast cancer subtyping. This capability expands access to legacy trial materials with long-term follow-up and supports efficient retrospective and virtual clinical trials.

This pilot study provides evidence that multimodal online recruitment and engagement are feasible for mixed methods social determinants of health research with sociodemographically diverse Black breast cancer survivors.

As treatment guidelines differ based on the causal effects of hard-to-heal (chronic) leg ulcers, correct diagnosis is essential for the best therapeutic outcomes. The aim of the study was to ascertain the prevalence of patients displaying atypical and uncommon manifestations of hard-to-heal leg ulcers and to explore the corresponding diagnostic challenges.

This was a prospective analysis of the aetiologies of hard-to-heal leg ulcers in patients hospitalised at the University Clinic of Dermatology, Venereology and Allergology, Poland, between 2015-2022. Data were coded into a database. Patients had an initial diagnosis of L97 according to the International Classification of Disease (ICD)-10-a non-pressure hard-to-heal ulcer of the lower limb, not elsewhere classified. Ulcer duration was >6 weeks, as this is the most used definition of a hard-to-heal wound.

Of the 327 patients who took part in the study, 119 had a diagnosis other than vascular. Patients were aged between 18-97 (mean 67.5) years; 163 were male and 164 were female. In patients with ulcers of rare aetiology, the most common was pyoderma gangrenosum, followed by vasculitis, then neoplasms or complication after antineoplastic treatment.

It is important to be acquainted with rare aetiologies of leg ulcers for best therapeutic outcome, as atypical ulcers may require different treatment modalities.

Near-infrared (NIR) photocatalysis promises deep-tissue compatibilities but remains fundamentally constrained by two bottlenecks: insufficient photon energy and rapid charge recombination. Here, we report packing-accelerated consecutive excitation (PACE), a mechanism enabling low energy near-infrared (NIR) photons to drive high energy single electron transfer (SET) reactions. We design a self-assembling ruthenium complex, Ru-3, that forms densely packed nanoaggregates exhibiting aggregation-stabilized excited states, a pronounced excited state absorption band at ∼1315 nm, and nanosecond scale triplet lifetimes. Under dual NIR-I/IIa irradiation (808 nm/1310 nm), Ru-3 nanoparticles exhibit photophysical behavior consistent with consecutive photon harvesting and access to a higher-energy reactive state that supports efficient SET catalysis under aqueous conditions. This PACE-driven reactivity enables robust oxidation of mitochondrial NADH to NAD⁺, disrupting electron-transport homeostasis, inducing cGAS-STING dependent pyroptosis, and reprogramming tumor-associated macrophages toward an M1 phenotype. In multiple murine tumor models, PACE-mediated photocatalysis elicits strong antitumor immunity and leads to tumor regression with minimal systemic toxicity. This work establishes PACE as a new photochemical paradigm that overcomes the intrinsic energy and charge-separation limits of NIR photoredox chemistry, opening a route toward high-energy photocatalysis in complex biological environments.

IntroductionPretreatment prediction of benefit from targeted therapy plus immunotherapy remains uncertain in unresectable hepatocellular carcinoma (HCC). We developed and internally validated a model integrating baseline 18F-FDG PET/CT radiomics with clinical indicators.MethodsThis single-center retrospective study included 325 patients, comprising a development cohort (n = 182) and an internal validation cohort (n = 143). Clinical/PET, radiomics, and fusion logistic models were developed to predict 12-week objective response assessed according to the modified Response Evaluation Criteria in Solid Tumors. Development-derived preprocessing parameters, coefficients, and cutoffs were applied unchanged to validation. Discrimination was assessed using AUCs with bootstrap 95% confidence intervals and paired patient-level bootstrap comparisons; calibration was assessed using the Brier score, calibration intercept, and calibration slope.ResultsIn the 143-patient internal validation cohort, the clinical, radiomics, and fusion models had AUCs of 0.69 (0.60-0.77), 0.75 (0.67-0.83), and 0.84 (0.78-0.90), respectively. The paired AUC difference was 0.16 (95% CI, 0.05 to 0.26; P = 0.002) versus the clinical model and 0.09 (-0.001 to 0.19; P = 0.053) versus the radiomics model. The fusion-model Brier score was 0.16, calibration intercept was -0.02, and calibration slope was 0.83.ConclusionThe fusion model integrating clinical and radiomics features demonstrated favorable discrimination and calibration for predicting 12-week objective response in patients with HCC. It improved predictive performance compared with the clinical model alone and may provide a noninvasive tool for pretreatment response assessment. Prospective multicenter studies are warranted to evaluate its generalizability and clinical utility.

American Indian and Alaska Native patients represent a uniquely vulnerable population in the US. Epidemiological studies have shown significant health disparities within this group. Contemporary outcomes and utilization studies of cancer in this population could aid in public health interventions in the future.

To analyze utilization, spending, and mortality outcomes for American Indian and Alaska Native beneficiaries with cancer covered by traditional Medicare (TM).

A multiyear cross-sectional analysis of a near population of TM beneficiaries in the US using Medicare beneficiary summary files and prescription drug event International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) linked claims from January 1, 2016 to December 31, 2023.

TM coverage for American Indian and Alaska Native beneficiaries with cancer.

Aggregate claims for care utilization and spending from Medicare Parts A, B, and D to assess cancer prevalence, care utilization (ie, inpatient, outpatient, and prescription usage), total spending, mortality and secondary outcomes (hospice usage, screening utilization, and out-of-pocket costs).

A sample of 26 867 866 TM beneficiaries in 2023 had 123 597 (0.46%) identifying as American Indian and Alaska Native (69 294 [56%] female). In this American Indian and Alaska Native subpopulation, 10.8% (n = 13 291) had a cancer diagnosis, lower than the 19.4% (5 211 773) prevalence noted in the overall TM population. The annual all-cause mortality rate among American Indian and Alaska Native beneficiaries with cancer in 2023 was 12.4% (1643), nearly double the overall TM cancer population at 6.9% (358 049). American Indian and Alaska Native beneficiaries had elevated rates of renal, hepatocellular, and biliary carcinomas. The mean (SD) spending per American Indian and Alaska Native beneficiary with cancer spent was $32 775 ($58 089) annually whereas the mean (SD) spending per TM beneficiary was $25 073 ($47 226) annually. Annual uptake of breast and colorectal screenings were lowest among American Indian and Alaska Native beneficiaries. Finally, only 939 of 1642 American Indian and Alaska Native beneficiaries with cancer (57.2%) filed hospice claims near date of death, lower than the 234 809 of 357 941 in the overall TM population (65.6%).

In this cross-sectional analysis the American Indian and Alaska Native cancer population experienced significant differences in spending and outcomes in TM from 2016 through 2023. American Indian and Alaska Native beneficiaries with cancer displayed the worst all-cause mortality across demographics, elevated total and out-of-pocket spending as well as lower rates of apparent access to preventive and hospice services. The magnitude of these differences is critical in formulating action plans to promote health and reduce cancer among American Indian and Alaska Native beneficiaries.

This report aims to describe the evolution, achievements, and impact of the clinical nurse specialist (CNS) role within cancer services in the State of Qatar from 2011 to 2024.

A descriptive design guided by Hamric's Integrative Framework for Clinical Nurse Specialists was used to explore the multifaceted CNS role across 3 spheres of influence, patient, nursing practice, and the healthcare system. The report outlines the progression of the CNS role at the National Center for Cancer Care and Research (NCCCR), from the early stages of implementation to the establishment of locally trained CNSs covering oncology, hematology, palliative, and cardio-oncology services. CNSs have significantly contributed to advancing cancer care through clinical expertise, patient advocacy, research, education, and leadership. Their roles have enhanced patient satisfaction, supported multidisciplinary collaboration, and fostered a culture of evidence-based and patient-centered care.

The introduction and expansion of CNS roles have strengthened Qatar's cancer care continuum, improving quality outcomes and professional nursing standards. Continued investment in CNS development, recognition, and policy integration is essential to sustain these achievements and advance the national vision for excellence in healthcare.