Critical Gaps Research Articles

Multidimensional Framing of Environments Beyond Blocks and Texts in K–12 Programming

Computer programming provides a framework for interdisciplinary learning in sciences, arts and languages. However, increasing integration of programming in K–12 shows that the block-based and text-based dichotomy of programming environments does not reflect the spectrum of their affordance. Hence, educators are confronted with a fundamental hurdle of matching programming environments with learners’ cognitive abilities and learning objectives. This study addresses this challenge by analyzing 111 articles evaluating the affordances of programming environments to identify both structural and theoretical models to support educators’ choice of programming environments. The following dimensions of programming environments were identified: connectivity mode, interface natural language, language inheritance, age appropriateness, cost of environment, output interface, input interface, and project types. For each of these dimensions, the synthesis of the literature ranged from examining its nature and effect on learning programming to the implications of choosing an environment and the critical gaps that future studies should address. The findings offer instructors useful parameters to compare and assess programming environments’ suitability and alignment with learning objectives.

Preserving Law and Order: How Institutions Implementing International Norms on Refugee Protection Can Restrict Asylum Outcomes

Abstract The international frameworks on refugee protection, including the 1951 Convention and the 1967 Protocol Relating to the Status of Refugees, are among the strongest norms to govern international mobility. Despite the salience and universality of these international norms, however, asylum outcomes, as indicated by refugee recognition rates (RRRs), vary extensively across state parties. The variation in RRR signals a critical normative gap between the institutionalization and implementation of international norms on refugee protection. In this article, I offer an explanation for this gap by examining the role of domestic institutions responsible for implementing relevant international (and domestic) laws on the ground. Through in-depth interviews, participant observation, and analysis of government, media, and non-governmental organization materials, I investigate the case of South Korea, a wealthy liberal democracy known for its exceptionally low RRR. I argue that South Korea’s low RRR is a result of the preexisting and prevailing ethos of the institutions responsible for refugee status determination, which is deeply rooted in the preservation of law and order and therefore fundamentally conflicts with the human protection principles underlying the Convention.

Digital Marketing in the New Era: Exploring the Affordances of Chatbots in Consumer Engagement and Brand Connection

This article explores the evolving landscape of marketing and personalized communication in the digital era, with a particular focus on the affordances of chatbots as pivotal tools for businesses. As consumers increasingly turn to online platforms for information and purchasing decisions, chatbots have emerged as indispensable tools for enhancing customer engagement and delivering personalized experiences. While previous research has outlined the potential benefits and drawbacks of chatbots in marketing, a critical gap exists in understanding their context-specific impact on user perceptions and behaviors. To bridge this gap, this study adopts the affordance theory to investigate how chatbots offer unique affordances to users across various shopping scenarios. Through in-depth interviews with 10 participants spanning different fields and shopping contexts, this research delves into the intricate interplay between chatbots and users. The findings reveal that chatbots indeed provide interactive intelligence, improve user experiences through flexibility in time and place, and contribute to personalized interactions. Yet, specific technological attributes of chatbots, such as their capacity for emotional support and gender portrayals, can be both advantageous and limiting, contingent on the distinct needs of customers. This research underscores the importance of considering the nuanced context-specific interactions between chatbots and users, thus paving the way for a more comprehensive understanding of their multifaceted role in shaping consumer-company identification.

Strategies and sustainability in fast charging station deployment for electric vehicles.

This comprehensive review investigates the growing adoption of electric vehicles (EVs) as a practical solution for environmental concerns associated with fossil fuel usage in mobility. The increasing demand for EVs underscores the critical importance of establishing efficient, fast-charging infrastructure, especially from the standpoint of the electrical power grid. The review systematically examines the planning strategies and considerations for deploying electric vehicle fast charging stations. It emphasizes their unique dual role as loads and storage units, intricately linked to diverse road and user constraints. Furthermore, the review underscores the significant opportunity surrounding these stations for the integration of distributed renewable energy sources. It thoroughly explores the challenges and opportunities intrinsic to the planning and localization process, providing insights into the complexities associated with these multifaceted stations. Renewable resources, including wind and solar energy, are investigated for their potential in powering these charging stations, with a simultaneous exploration of energy storage systems to minimize environmental impact and boost sustainability. In addition to analyzing planning approaches, the review evaluates existing simulation models and optimization tools employed in designing and operating fast charging stations. The review consolidates key findings and offers recommendations to researchers and grid authorities, addressing critical research gaps arising from the escalating demand for electric vehicle fast-charging infrastructure. This synthesis is a valuable resource for advancing understanding and implementing robust strategies in integrating EVs with the electrical power grid.

Predicting the impacts of clearing on vegetation communities: a model-based approach for identifying conservation priorities in Queensland, Australia

ABSTRACT Predicting outcomes is critical for conservation prioritisation. We predicted the areas that are likely to be impacted using a generalised estimating equation from a logistic regression and intersected our model with vegetation community mapping for Queensland, Australia. Under the assumption that areas with a high probability of clearing would eventually be cleared, we identified vegetation communities at risk of transitioning into a more vulnerable status, addressing a critical knowledge gap. Specifically, we identify: 1) areas within the study region's bioregions face the highest risk of forest cover loss; 2) communities may transition to more vulnerable according to their extent-based vulnerability status. Our analysis determined high-risk areas within the study region and vegetation communities vulnerable to changing status. Three clearing scenarios – low, moderate and high – were evaluated. In the low scenario, 0.3 per cent of vegetation communities experienced clearing, with 26 communities changing their status. The moderate scenario impacted 35 per cent of vegetation communities, with 103 communities at risk. In the high scenario (our most aggressive assumption), 45 per cent of vegetation communities overlapped with areas suitable for clearing, affecting the status of 158 communities. We emphaise the need to protect high-risk communities while implementing effective management strategies in areas where clearing poses minimal threat.

The Reading, Reception, and Collecting of Isabella Whitney’s A Sweet Nosgay, c.1573–1871

ABSTRACT Much recent scholarship on early modern women’s writing has focussed on their marginalia. Yet how active readers responded to their printed work after it left the bookseller’s stall has remained largely unexplored. This article responds to this critical gap by applying the principles of feminist bibliography to copy-specific annotations found in Isabella Whitney’s poetic miscellany A Sweet Nosgay (1573). Texts by early modern women often enjoyed a surprisingly long reception history and textual afterlife. By analysing early modern ownership inscriptions and nineteenth century marginalia found in the sole extant copy of Whitney’s text, this article considers how A Sweet Nosgay was read across time as a valuable work of ameliorating literature. Descriptions of Whitney's text in nineteenth century auction catalogues similarly allow us to trace changing attitudes towards, and readership of, her work: raising questions of how gender contributed to an author’s desirability, economic value, and ultimate survival. Ultimately, this case study demonstrates the need for a wider chronological and generic framework by which to consider the layered reception of the multitude of women’s texts like Whitney’s that survive in a single recorded source.

Drought Atlas of India, 1901–2020

India has been considerably affected by droughts in the recent past. Despite the considerable impacts of droughts on agriculture and water resources, long-term datasets to examine droughts and their consequences at appropriate spatial and temporal scales have been lacking in India. Datasets that provide drought information are mostly available for a short period and at coarser resolutions, therefore, these do not comprehend the information regarding the major droughts that occurred in the distant past at administrative scales of decision-making. To fill this critical gap, we developed the high-resolution (0.05°) and long-term monthly precipitation and temperature datasets for the 1901–2021 period. We used long-term high-resolution precipitation and temperature to estimate droughts using standardized precipitation and evapotranspiration index (SPEI). As SPEI considers the role of air temperature in drought estimation, it can be used to examine meteorological, agricultural, and hydrological droughts. Using high-resolution SPEI, we developed drought atlas for India (1901–2020) that can provide comprehensive information on drought occurrence, impacts, and risks in India.

Flow and heat transfer in annuli owing to inner shrinking and outer stationary cylinder

The scope of the present work is to investigate the motion of the fluid flow and heat exchange within two concentric cylinders. It is assumed that the inner cylinder is moving (shrunk) and the outer cylinder is stationary. It derives the physical phenomenon, which can find industrial practical applications. The gap between the cylinders, curvature of cylinders, and Prandtl number are three physical parameters controlling the hydro-thermal flow motion. Asymptotic solutions are available when the gap size is moderately small. These and other solutions based on the numerical simulations clearly indicate that there are critical gap sizes beyond which either no solutions or dual solutions are possible. The common salient characteristic of solutions is that the axial fluid dragged into the cylinder as a result of surface shrinkage is thrown radially out through the outer cylinder. The non-existence of solutions after identifying critical gap sizes explains why the shrinking sheet and shrinking cylinder problems with an unbounded flow zone could not have been treated in the literature so far. This is the prime reason that with infinite gap size, other controlling mechanisms like surface transpiration, unsteadiness, velocity slip or magnetic field need to be included in the mathematical model to get a solvable problem under the surface shrinking process often studied among researchers. One of the solutions called branch I solution, has rational profiles with small pertinent physical quantities like skin friction, vertical/radial thrown velocity, and heat transfer rate. However, from a stability analysis, it can be shown that the branch II solution, possesses comparatively larger such quantities, making them questionable to appear in real physics with unstable eigenvalues.

Utilisation of mobile phone interventions to improve the delivery of maternal health services in sub-Saharan Africa: A scoping review protocol.

There has been significant progress in maternal health outcomes in the sub-Saharan African region since the early 1990s, in part due to digital and mobile health interventions. However, critical gaps and disparities remain. Mobile phones in particular have potential to reach underserved, hard-to-reach populations with underdeveloped infrastructure. In spite of the opportunities for mobile phones to address maternal mortality in the region, there is no extensive mapping of the available literature on mobile phone interventions that aim to improve access of maternal care in sub-Saharan Africa. The proposed scoping review aims to map literature on the nature and extent of mobile phones interventions designed to improve maternal care health services in the region. Conduct of this scoping review will be guided by the Joanna Briggs Institute approach. Literature searches will be conducted in multiple electronic databases, including MEDLINE, Embase, CINAHL, APA PsycInfo, Cochrane Central Register of Controlled Trials, Global Health, African Index Medicus, Web of Science, and Applied Social Sciences Index & Abstracts. Grey literature will also be identified. Keyword searches will be used to identify articles. Two reviewers will independently screen eligible titles, abstracts and full articles with a third reviewer to help resolve any disputes. We will extract data on general study characteristics, population characteristics, concept, context, intervention details, study results, gaps and recommendations. Understanding use of mobile phones among underserved, hard-to-reach populations with underdeveloped infrastructure to address maternal mortality in developing countries is very critical to informing health systems on potential effective strategies. This review will complement the evidence base on utilisation of mobile phone interventions to improve the delivery of maternal health services in sub-Saharan Africa.

Radiolytic evaluation of a new technetium redox control reagent for advanced used nuclear fuel separations.

Technetium is a problematic radioisotope for used nuclear fuel (UNF) and subsequent waste management owing to its high environmental mobility and coextraction in reprocessing technologies as the pertechnetate anion (TcO4-). Consequently, several strategies are under development to control the transport of this radioisotope. A proposed approach is to use diaminoguanidine (DAG) for TcO4- and transuranic ion redox control. Although the initial DAG molecule is ultimately consumed in the redox process, its susceptibility to radiolysis is currently unknown under envisioned UNF reprocessing conditions, which is a critical knowledge gap for evaluating its overall suitability for this role. To this end, we report the impacts of steady-state gamma irradiation on the rate of DAG radiolysis in water, aqueous 2.0 M nitric acid (HNO3), and in a biphasic solvent system composed of aqueous 2.0 M HNO3 in contact with 1.5 M N,N-di-(2-ethylhexyl)isobutyramide (DEHiBA) dissolved in n-dodecane. Additionally, we report chemical kinetics for the reaction of DAG with key transients arising from electron pulse radiolysis, specifically the hydrated electron (eaq-), hydrogen atom (H˙), and hydroxyl (˙OH) and nitrate (NO3˙) radicals. The DAG molecule exhibited significant reactivity with the ˙OH and NO3˙ radicals, indicating that oxidation would be the predominant degradation pathway in radiation environments. This is consistent with its role as a reducing agent. Steady-state gamma irradiations demonstrated that DAG is readily degraded within a few hundred kilogray, the rate of which was found to increase upon going from water to HNO3 containing solutions and solvents systems. This was attributed to a thermal reaction between DAG and the predominant HNO3 radiolysis product, nitrous acid (HNO2), k(DAG + HNO2) = 5480 ± 85 M-1 s-1. Although no evidence was found for the radiolysis of DAG altering the radiation chemistry of the contacted DEHiBA/n-dodecane phase in the investigated biphasic system, the utility of DAG as a redox control reagent will likely be limited by significant competition with its degradation by HNO2.

Implementing health worker training on sepsis in South Eastern Nigeria using innovative digital strategies: an interventional study.

Sepsis is a leading cause of morbidity and mortality especially in low- and middle-income countries such as Nigeria. Training of health workers using digital platforms may improve knowledge and lead to better patient outcomes. To assess the effectiveness of a digital health educational module on sepsis in improving the knowledge of medical doctors in Cross River State Nigeria on the diagnosis and management of patients presenting with sepsis. Quasi-experimental analytical study. We developed and deployed a sepsis module through an innovative application (Sepsis tutorial app) to doctors in Calabar, Nigeria. We assessed quantitative pre- and post-intervention knowledge scores for those completing the tutorial on sepsis between both assessments. A user satisfaction survey evaluated the content of the tutorial and the usability of the app. One hundred and two doctors completed the course. There were more males than females (58.8% versus 41.2%). Over half (52%) were junior doctors, a minority were general practitioners and house officers (3% and 5%, respectively), and 72.6% had practiced for periods ranging from 1 to 15 years post-qualification. Gender and age appeared to have no significant association with pre- and post-test scores. The oldest age group (61-70) had the lowest mean pre- and post-test scores, while general practitioners had higher mean pre- and post-test scores than other cadres. The majority (95%) of participants recorded higher post-test than pre-test scores with a significant overall increase in mean scores (25.5 ± 14.7%, p < 0.0001). Participants were satisfied with the content and multimodal delivery of the material and found the app usable. Digital training using context-responsive platforms is feasible and may be used to close the critical knowledge gap required to respond effectively to medical emergencies such as sepsis in low- to middle-income settings.

Ethics: Crisis Standards of Care Simulation.

Ethical dilemmas exist with decision-making regarding resource allocations, such as critical care, ventilators and other critical equipment, and pharmaceuticals during pandemics. Triage artificial intelligence (AI) algorithms based on prognostication tools exist to guide these decisions; however, implicit bias may affect the decision-making process leading to deviation from the algorithm recommendations. Conflict within the ethical domain may be affected as well. A knowledge gap was identified within the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) curriculum regarding ethics in crisis standards of care (CSC) medical decision-making. Incorporating a CSC simulation looked to address this knowledge gap. A simulation-based learning (SBL) experience was designed as a critical access setting where CSC are in place and three diverse, medically complex patients in need of critical care present to the hospital where one critical care bed remains open. Given the complexity of the simulation scenario, a table-top pilot test was selected. Three AG-ACNP fourth-quarter students in their critical care rotation volunteered for the pilot test. Students were provided with the topic, "ethics crisis standards of care" and the article, "A catalogue of tools and variables from crisis and routine care to support decision-making during pandemics" by M. Cardona et al. (2021), to read in advance. Students were provided with the triage AI algorithm (M. Cardona et al., 2021) utilizing prognostication tools to prioritize which patient requires the critical care bed. The expectation was that implicit bias would enter the decision-making process, causing deviation from the triage AI algorithm and moral distress. The debriefing session revealed that students deviated from the triage AI algorithm, experienced implicit bias, moral distress, and utilized clinical judgment and experience to care for all three patients. The pilot test results support that a CSC SBL experience addresses a critical knowledge gap in AG-ACNP education and an SBL experience incorporating ethical decision-making curriculum with standardized patients should be developed and trialed as the next step.

Development of educational package and participatory consumer groups to improve food handling practices in food establishments in Sri Lanka.

Improper food handling contributes to many foodborne diseases and food outbreaks globally leading to witnessed morbidities and mortalities. The study aims to develop an educational package and participatory consumer groups to improve food handling practices among food handlers and in food establishments in the Regional Director of Health Services area, Kalutara, Sri Lanka. The study developed an educational package and participatory consumer groups to improve the food handling practices among food handlers and in food establishments. The critical knowledge gaps were identified during the first component of this study, which was conducted as a descriptive study, and the findings were further discussed in the Focus Group Discussion. Posters, info sheets, and workshops were used for educational packages, and four consumer groups were formed. The second component of the study following the development of the interventions was continued as a three-arm, non-randomized controlled community trial for 4 months in the Regional Director of Health Services, Kalutara. The educational package for food handlers was introduced as a package of a workshop, info sheets, posters to display at workplaces, and short refresher training two weekly to direct good food handling practices in food establishments. Consumer groups were strengthened to exercise their legal rights on their purchases and the ratings showed improvements in the hygiene levels with repeated consecutive visits. The novel educational package and participatory consumer groups are designed and implemented to improve food handling practices among food handlers and in food establishments.

Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport.

Military working canines are critical assets and force multipliers for the Joint Force. Most often deployed forward of Role 2 assets, they are reliant on non-veterinary resources when wounded, ill, or injured in an operational environment. Hemorrhagic shock is the most prevalent form of shock seen in battlefield injuries and is most effectively treated with whole blood transfusion. Dogs cannot be transfused with human blood and there is no formal Department of Defense (DoD) canine blood product distribution system to operational settings. A walking blood bank is helpful when multiple dogs are geographically co-located and the resource can be provided to an injured patient quickly. In areas as widely dispersed as the Horn of Africa, the likelihood of co-location is slim and delaying this vital resource can mean the difference between life and death. Therefore, personnel at the Role 2 facility in Camp Lemonnier, Djibouti, filled a critical capability gap for the operational area by producing a local canine whole blood bank with distribution to multiple countries. This protocol can be replicated by other locations to improve medical readiness for the working canines who serve to maintain DoD Force Protection.

Pragmatic Adaptive Trial for Respiratory Infection in Children (PATRIC) Clinical Registry protocol

IntroductionAcute respiratory infections (ARI) are the most common cause of paediatric hospitalisation. There is an urgent need to address ongoing critical knowledge gaps in ARI management. The Pragmatic Adaptive Trial...

Aboveground carbon sequestration of Cunninghamia lanceolata forests: Magnitude and drivers

Understanding the spatial variation, temporal changes, and their underlying driving forces of carbon sequestration in various forests is of great importance for understanding the carbon cycle and carbon management options. How carbon density and sequestration in various Cunninghamia lanceolata forests, extensively cultivated for timber production in subtropical China, vary with biodiversity, forest structure, environment, and cultural factors remain poorly explored, presenting a critical knowledge gap for realizing carbon sequestration supply potential through management. Based on a large-scale database of 449 permanent forest inventory plots, we quantified the spatial-temporal heterogeneity of aboveground carbon densities and carbon accumulation rates in Cunninghamia lanceolate forests in Hunan Province, China, and attributed the contributions of stand structure, environmental, and management factors to the heterogeneity using quantile age-sequence analysis, partial least squares path modeling (PLS-PM), and hot-spot analysis. The results showed lower values of carbon density and sequestration on average, in comparison with other forests in the same climate zone (i.e., subtropics), with pronounced spatial and temporal variability. Specifically, quantile regression analysis using carbon accumulation rates along an age sequence showed large differences in carbon sequestration rates among underperformed and outperformed forests (0.50 and 1.80 ​Mg⋅​ha−1·yr−1). PLS-PM demonstrated that maximum DBH and stand density were the main crucial drivers of aboveground carbon density from young to mature forests. Furthermore, species diversity and geo-topographic factors were the significant factors causing the large discrepancy in aboveground carbon density change between low- and high-carbon-bearing forests. Hotspot analysis revealed the importance of culture attributes in shaping the geospatial patterns of carbon sequestration. Our work highlighted that retaining large-sized DBH trees and increasing shade-tolerant tree species were important to enhance carbon sequestration in C. lanceolate forests.

Multi‐Proxy Evidence for Atlantic Meridional Overturning Circulation (AMOC) Weakening During Deglaciations of the Past 150,000 Years

AbstractDespite decades of research, the cause of deglaciations is not fully understood, leaving a critical gap in our understanding of Earth's climate system. During the most recent deglaciation (Termination I (T I)), abrupt declines in the stable carbon isotope ratio (δ13C) of benthic foraminifera occurred throughout the mid‐depth (1,500–2,500 m) Atlantic. The spatial pattern in δ13C anomalies was likely due to Atlantic Meridional Overturning Circulation (AMOC) weakening and the accumulation of respired carbon, which also yields negative excursions in carbonate ion concentration (). To investigate whether a similar pattern occurred during prior deglaciations, we developed δ13C and records from 1,800 and 2,300 m water depth in the Southwest Atlantic spanning the last 150 ka. The new records reveal negative δ13C and anomalies during Termination II (TII) and the smaller deglaciations of Marine Isotope Stages (MIS) 4/3, 5b/a, and 5d/c, suggesting AMOC weakening is a common feature of deglaciation. The anomalies are more pronounced in the shallower core following MIS 2, 4, and 6 and in the deeper core following MIS 5b and 5d. The depth‐dependent pattern is most likely due to shoaling of Northern Source Water during glacial maxima and deepening during interglacial intervals. Comparison of records from TI and TII suggests similar levels of carbon accumulation in the mid‐depth Atlantic. The Brazil Margin δ13C and results indicate the AMOC plays a key role in the series of events causing deglaciation, regardless of differences in orbital configuration, ice volume, and mean global temperature.

Uncovering the Dynamics of Multi‐Sector Impacts of Hydrological Extremes: A Methods Overview

AbstractHydrological extremes, such as droughts and floods, can trigger a complex web of compound and cascading impacts (CCI) due to interdependencies between coupled natural and social systems. However, current decision‐making processes typically only consider one impact and disaster event at a time, ignoring causal chains, feedback loops, and conditional dependencies between impacts. Analyses capturing these complex patterns across space and time are thus needed to inform effective adaptation planning. This perspective paper aims to bridge this critical gap by presenting methods for assessing the dynamics of the multi‐sector CCI of hydrological extremes. We discuss existing challenges, good practices, and potential ways forward. Rather than pursuing a single methodological approach, we advocate for methodological pluralism. We see complementary or even convergent roles for analyses based on quantitative (e.g., data‐mining, systems modeling) and qualitative methods (e.g., mental models, qualitative storylines). The data‐driven and knowledge‐driven methods provided here can serve as a useful starting point for understanding the dynamics of both high‐frequency CCI and low‐likelihood but high‐impact CCI. With this perspective, we hope to foster research on CCI to improve the development of adaptation strategies for reducing the risk of hydrological extremes.

Artificial Intelligence and Information System Resilience to Cope With Supply Chain Disruption

Artificial Intelligence (AI) as a technology has the potential to interpret and evaluate alternatives where multidimensional data are involved in dynamic situations such as supply chain disruption. This article aims to explore the role of resilient information systems in minimizing the risk magnitude in disruption situations in supply chain operations. The article is conducted in the qualitative mode through a semistructured interview schedule for professionals of supply chains. A thematic analysis has been used to create emerging categories. The findings of this article present critical gaps in current information systems and demonstrate how AI-oriented systems can facilitate the ecosystem of disrupted supply chains to save costs and drive efficiency on multiple parameters. The article also proposes a conceptual framework where organizational values and architectural components can be viewed jointly for quick and adequate business decisions in complex and uncertain disruptions. The framework presents the relationships among AI, information systems, and supply chain disruption. Installing appropriate AI-based data acquisition, processing, and self-training capabilities along with information system infrastructure can help organizations lessen the impact of supply chain disruption while aligning the transportation network and ensuring geographically suitable supply chains and cybersecurity. Finally, the implications for theory and practice with the limitations and scope for future research are described.

Lung Cancer Survivorship: Physical, Social, Emotional, and Medical Needs of NSCLC Survivors.

Newer therapies prolong survival for patients with lung cancer. Beyond extending survival, the needs of lung cancer (LC) survivors are poorly described. We conducted a single-institution needs assessment survey of LC survivors alive ≥1 year from diagnosis. Needs were rated on a 5-point Likert scale for 4 domains (physical, social, emotional, and medical). Multiple regression models identified demographic or treatment characteristics associated with more needs in each category. A subset analysis of survivors with metastatic LC was performed. Of 360 patients approached, 235 surveys were completed. Among completed survey respondents, the median age was 69 years; most were female (62%), married (71%), and White (74%); and 41% had stage IV cancer. Finding support resources (34%) was the most common medical need. Fatigue (70%), sleep disturbance (60%), memory and concentration (57.5%), weakness (54%), and trouble breathing (51%) were physical needs affecting more than half of respondents. The most common social need was managing daily activities (42%). Emotional needs were highly prevalent, with 79% of respondents reporting a fear of recurrence and 74.5% reporting living with uncertainty. Multiple regression analysis identified that receipt of multiple lines of systemic therapy and lower household income were associated with higher physical and social needs. Younger age was associated with having a greater number of social and emotional needs. Similar results were found in the subset of survivors with metastatic disease at diagnosis. The needs of LC survivors are diverse across multiple domains. Several clinical and demographic factors are independently associated with higher numbers of patient-reported needs. Our study identifies critical gaps in survivorship care for LC survivors with all stages of disease and highlights areas of future intervention.