On December 4, 2025, the American Association for Cancer Research (AACR) released its inaugural AACR Pediatric Cancer Progress Report, which highlights the remarkable scientific and clinical advances transforming outcomes for children (ages 0-14) and adolescents (ages 15-19) with cancer. This first-of-its-kind report encompasses progress against pediatric cancers made over the past decade and chronicles major developments in molecularly targeted therapies, immunotherapies, and genomic profiling that are reshaping pediatric cancer diagnosis, surveillance, and treatment. The report also underscores the enduring challenges that impede progress, including the lack of effective therapies for rarer and aggressive pediatric cancers and the persistent inequities in access to high-quality treatment and supportive care, both in the United States and worldwide. Collectively, these insights reaffirm the urgent need for increased federal investment, strengthened international collaboration, and innovative research strategies to accelerate progress against pediatric cancer. The full report is freely available at PediatricCancerProgressReport.org.

ABSTRACT This study analysed the spatial distribution of urban tree cover and its relationship with socioeconomic variables and environmental quality in Ipatinga, Minas Gerais, Brazil. Tree cover was mapped via remote sensing and geoprocessing to calculate the tree cover index (ICA), which represents the tree canopy area per inhabitant, and the tree cover percentage (PCA), which is the proportion of urban land occupied by tree canopies. Socioeconomic data, including the population density and average household income, were obtained from the IBGE Census. The urban area of Ipatinga exhibited 32.5% tree cover and an average ICA of 102 m2 per inhabitant, with a heterogeneous spatial distribution. Tree cover was negatively correlated with population density (ICA: r = –0.5782; PCA: r = –0.7926; p < 0.001). For income, the correlations were positive but weak and were only statistically significant for PCA (r = 0.4365; p < 0.05). A qualitative checklist complemented the quantitative analysis by evaluating the functional, ecological, and landscape aspects of afforestation, such as vegetation distribution, connectivity, conservation status, and benefits related to shading, thermal comfort, and visual quality. Overall, these findings demonstrate that afforestation significantly contributes to urban environmental quality, highlighting the social inequalities in access to green infrastructure across the city. The integrated approach, combining spatial indices and qualitative evaluation, provides an innovative framework for diagnosing urban vegetation patterns and demonstrates the role of afforestation in promoting environmental quality and equity in industrialised urban contexts.

Does pay for performance affect socioeconomic inequalities in access? Evidence from hospital specialised care in England.

Cancer screening is increasingly promoted as a public health intervention, yet its effective translation with demonstrable impact on disease burden remains limited in low resource settings due to the suboptimal implementation of guidelines. While evidence from high-income countries and settings have informed international guidelines, the direct application of these recommendations often overlooks the realities of under-resourced settings, where diagnostic infrastructure, referral pathways, and treatment capacity are fragmented and inadequate. Moreover, the societal and health belief systems in many societies are different from high income country settings where screening was well received. This perspective provides a critical look at cancer screening with a focus on breast, cervical, colorectal, and oral cancers in low- and middle-income countries (LMICs) and draws on global and national guidelines and capacity to highlight gaps in implementation and system preparedness. Considerable variation exists across countries in terms of eligible age groups, test modalities, and screening intervals, reflecting both contextual adaptation and the challenges of aligning evidence with feasibility. Emerging innovations, including digital technologies and artificial intelligence, offer potential benefits but raise important concerns related to validation, ethical use, and equity of access. Ultimately, cancer screening can serve as a "best buy" intervention only if countries invest in strengthening early diagnosis and treatment pathways, ensure system readiness, and adopt phased implementation strategies tailored to local contexts. Without such preparedness, large-scale screening risks misallocation of scarce resources without measurable impact on the disease burden.

This study aims to evaluate and describe the Prodamas Plus program in improving community income in Burengan Village, Kediri City. Using a descriptive qualitative approach, the research assesses the program based on six evaluation criteria: effectiveness, efficiency, adequacy, equity, responsiveness, and accuracy. The findings indicate that Prodamas Plus is effective in fulfilling basic community needs, particularly in infrastructure development and public facilities, yet it has not optimally improved community income due to limited community capacity and the lack of sustainable post-training assistance. In terms of efficiency, program governance is well-structured, but implementation in the field is constrained by tight execution timelines and high administrative burdens. Program adequacy is strong at the basic level but remains insufficient in economic empowerment efforts. Equity in access to development has been achieved, although equality in economic outcomes is still uneven among residents. The program demonstrates high responsiveness through various public participation channels and service mechanisms that accommodate community aspirations. Accuracy is reflected in the program’s alignment with infrastructure needs but is not yet fully evident in generating significant income improvements. Overall, Prodamas Plus has successfully enhanced environmental quality and public services; however, stronger economic empowerment strategies are required to ensure more optimal and sustainable contributions to the income of Burengan residents.

Understanding the interplay between public transport travel time variability and jobs competition on accessibility inequalities

ABSTRACTBackgroundPeople living with neurological conditions have needs that require an integrated care approach. Existing models of integrated care have often emphasized system structures but neglected the micro‐level interactions that matter most to people.ObjectivesTo develop a micro‐level model for integrated care that represents the care components most valued by people affected by Huntington's disease (HD).MethodsA mixed methods study with a co‐designed approach was delivered through three phases. This paper reports on the latest two, where interviews and workshops were conducted with people with lived experience of HD and professionals, from January to October 2024. Patient and public contributors were involved from project design to data interpretation.ResultsThree themes were identified that position integrated care from the perspective of those affected by HD, representing these as the EC4Neuro model. Theme 1 identified the core components of micro‐level integrated care: expert knowledge, person‐ and family‐centred care, care coordination and continuity of care. Theme 2 underlined access inequities. Theme 3 highlighted people's responsibility to manage care without true agency to do so. The workshops prioritized strategies that enhance relational continuity between service users and providers. A tiered strategy was undertaken to support decision‐making towards improving person‐centred outcomes.ConclusionsEC4Neuro is the first integrated care model developed in HD. Its co‐designed approach with end users successfully embedded people's perspective to guide what needs to be achieved at the micro‐level. The EC4Neuro model offers prospective replication opportunities, particularly for stakeholders concerned with reducing access inequities and supporting relational continuity.Patient or Public ContributionA group of 25 experts by lived experience of HD and other neurological disorders, co‐designed this research project, working with the researchers from conception of the studies to analysis and interpretation of the data.

Food delivery services reduce inequality in urban food accessibility: Evidence from 19 Chinese megacities

Introduction: The configuration of the food environment directly influences the eating habits and nutritional health of the population. In Chile, although research on these environments has increased in the Metropolitan Region, gaps still exist in other urban areas such as Antofagasta, making it difficult to understand territorial inequalities in access to healthy food. Objective: Analyze the diversity of the food supply in the cities of Santiago and Antofagasta using georeferencing tools and ecological indices, characterizing territorial differences in food environments. Materials and Methods: A descriptive and comparative study was conducted in two cities in Chile. Nutrition and Dietetics students collected data by recording food establishments within a four-block radius of their homes. The establishments were classified as healthy (SAL), unhealthy (NOSAL), mixed (MIX), and supermarkets (SUPER). The data were compiled in Excel spreadsheets, and absolute and relative frequencies were calculated. Food diversity was assessed using the Shannon and Simpson indices. The results were presented in tables, graphs, and thematic maps. Results: A total of 323 establishments were identified: 165 in Santiago and 158 in Antofagasta. In both cities, unhealthy food options predominated, especially in districts like Lo Prado and Independencia. However, Antofagasta showed greater food diversity, with a more balanced distribution of establishment types, reflected in higher diversity indices (Shannon Index: 1.29 vs. 1.14; Simpson Index: 0.68 vs. 0.63). Conclusions: Both cities exhibit food environments characterized by a greater availability of unhealthy foods and intra-urban inequalities. Georeferencing and ecological indices allow for a precise characterization of the urban food structure. These findings reinforce the need for urban and public health policies aimed at improving access to healthy food and reducing territorial inequities in Chile.

School-related anxiety constitutes one of the most prevalent and disruptive mental health challenges in secondary education, particularly during adolescence—a developmental stage marked by emotional sensitivity, academic pressure, and heightened social evaluation. Persistent anxiety associated with school demands has been linked to impaired academic performance, emotional dysregulation, absenteeism, and increased risk of school refusal. In recent years, advances in Artificial Intelligence (AI) have generated new opportunities for the early identification, prevention, and management of school-related anxiety through adaptive, personalized, and data-driven digital interventions. This paper examines how AI-based technologies can be employed to support adolescents experiencing school-related anxiety within secondary education settings, drawing on an integrative narrative review of literature published between 2010 and 2025. The review focuses on AI-supported mental health applications, affective computing systems, intelligent tutoring environments, and digital anxiety-regulation tools explicitly targeting anxiety-related symptoms and stress responses. The analysis is grounded in psychological and educational frameworks relevant to anxiety, including cognitive-behavioral theory, self-determination theory, Universal Design for Learning (UDL), and inclusive education perspectives. The paper critically discusses the potential of AI to detect early indicators of anxiety, provide individualized anxiety-management strategies, and support timely school-based interventions while avoiding stigmatization and exclusion. Ethical concerns related to data privacy, surveillance, algorithmic bias, and equity of access are also examined. The findings suggest that AI-based tools can enhance school-based anxiety support when implemented within human-centered, inclusive, and ethically governed educational ecosystems. Implications for educational policy, teacher mediation, and future research on AI-supported anxiety interventions in secondary education are discussed.

ABSTRACT The purpose of this work was to analyse water access based not only on the indicators proposed by the Joint Monitoring Program (JMP) and the expenditures incurred by households in Mexico, but also by performing an analysis by groups at all income deciles nationally as well as in urban and rural areas. Inequalities in access and the cost of access to this resource between rural and urban households, as well as between low – and high-income households, becomes evident when estimating the indicators proposed by the JMP for WASH of the WHO and UNICEF. These indicators were estimated at the national, urban, and rural levels. Lastly, a test of means (ANOVA) was performed to determine whether there was a statistical difference among household deciles, considering WASH levels and whether they were urban or rural households. The JMP indicators to measure household access to water show a statistically significant difference between urban and rural households, among income decile levels, and among the different years analysed. Thus, there is a need to generate new water policies and/or projects that seek to reduce or eliminate this inequality for the benefit of society as a whole, and especially for the most vulnerable households.

Multi-cancer detection tests (MCDs) have the potential to reduce cancer-related deaths by identifying cancers early when they can be more effectively treated. While initial studies show promise in detecting multiple cancer types, there is a lack of large-scale, prospective trials evaluating their clinical utility and real-world impact. We conducted 23 focus groups with 158 participants to identify and describe key stakeholders' perspectives on the benefits and risks of MCD tests. Participants included clinicians (n=58), patients (n=17), and community members recruited from partner community advisory boards (n=83). Participants recognized the benefits of early cancer detection and the convenience of a single blood test in reducing barriers to cancer screening. However, they shared concerns about insufficient clinical validation for MCD tests and the potential physical and psychological harm that false positives, overdiagnosis, and overtreatment may cause. They also expressed concerns about the financial costs and time burden associated with follow-up care, as well as potential inequities in access and outcomes in underserved communities. Patients and clinicians want better evidence before routine use of MCD testing for cancer screening. Future research should prioritize rigorous randomized controlled trials that evaluate cancer-mortality, quality of life, diagnostic workup, and potential harms.

The primary objective is to evaluate associations between emergency department (ED) total length of stay in Alberta and multiple patient-, visit-, and facility-level factors known to contribute to overcrowding and healthcare inefficiencies. This work aims to inform ongoing efforts to optimize ED performance and patient flow and, to our knowledge, is the largest population-based Canadian study examining associations with ED length of stay at multiple levels. We conducted a cross-sectional study of 587,419 ED visits from 14 facilities in Alberta between May 2022 and March 2023 using administrative health data from Alberta Health Services, linked to the National Ambulatory Care Reporting System. Multivariable negative binomial regression was used to examine associations between ED length of stay and patient-, visit-, and facility-level characteristics. Analyses were stratified by patient disposition (admitted, discharged, or other). Older age, greater material or social deprivation, and any mode of emergency medical services transport were associated with longer ED length of stay across all disposition categories. Higher hospital inpatient occupancy rate and a greater number of emergency inpatients were associated with increased length of stay, particularly for admitted patients. Higher nurse staffing rates were associated with shorter length of stay, though this association disappeared when accounting for random differences between facilities. Higher patient continuity to physician was associated with a lower length of stay, suggesting a potential benefit of primary care integration. ED length of stay is associated with modifiable factors, including hospital capacity constraints, hours worked per nurse, and healthcare access inequities. Addressing hospital occupancy, optimizing staffing, and improving care coordination across the patient trajectory-such as between the ED, inpatient units, and post-discharge services-may enhance ED efficiency and reduce prolonged stays. Our findings align with established frameworks describing ED overcrowding and support targeted, system-level interventions to improve the efficiency of emergency care.

To estimate the prevalence and identify the determinants of assistive device usage in daily life among older adults in India. Cross-sectional analysis of nationally representative survey data. India PARTICIPANTS: A total of 66 316 adults aged ≥45 years with complete information on assistive device use from Wave 1 of the Longitudinal Ageing Study in India, 2017-2018. The primary outcome was self-reported use of any assistive device, including visual, hearing, mobility or other assistive devices. There were no predefined secondary outcome measures. Sociodemographic and health-related variables were analysed as covariates to assess factors associated with assistive device use. The prevalence of assistive device use was 38.61% (95% CI: 37.73% to 39.50%). Use increased with age, from 34.48% among adults aged 45-59 years to 52.07% among those aged ≥75 years (adjusted prevalence ratios (aPR) 1.30; 95% CI: 1.25 to 1.35). Prevalence was higher among men (40.94%) than women (37.51%) (aPR 1.06; 95% CI: 1.03 to 1.09), among individuals with education above primary level (54.28%) compared with those with up to primary education (28.35%) (aPR 1.42; 95% CI: 1.36 to 1.48), and among urban residents (53.88%) vs rural residents (31.16%) (aPR 1.18; 95% CI: 1.14 to 1.22). A clear socioeconomic gradient was observed, with prevalence increasing from 27.65% in the poorest to 50.66% in the richest wealth quintile (aPR 1.32; 95% CI: 1.25 to 1.39). Assistive device use was higher among participants with chronic conditions (47.30%) than those without (28.16%) (aPR 1.15; 95% CI: 1.11 to 1.19) and was markedly higher among those with a prior eye or vision diagnosis (64.93%) compared with those without (14.61%) (aPR 3.94; 95% CI: 3.78 to 4.11). Among users, spectacles or contact lenses were most common (89.26%), followed by walking sticks or walkers (11.62%) and dentures (6.15%). State-level prevalence varied widely, ranging from 71.27% in Goa to 13.44% in Arunachal Pradesh. Assistive device use was reported by less than half of Indian adults aged ≥45 years. The findings reveal clear socioeconomic and geographic inequities in access to assistive devices, with substantially lower use among older adults with less education, those in poorer wealth quintiles and rural residents. These disparities highlight the need for equity-focused interventions that improve accessibility to assistive devices, particularly for socially and economically disadvantaged groups and individuals with chronic conditions.

Purpose: Cycling is a highly sustainable mode of transport with well-documented physical and psychosocial health benefits. In school settings, promoting cycling can foster healthy behaviours and environmentally friendly mobility choices among children and adolescents, while also addressing social inequalities in access to active transport. The Bikepool Project, led by the non-profit association Bikepool Hessen e.V., trains teachers to implement safe cycling activities in schools and to integrate the bicycle as a regular means of transport. To investigate the project’s public health impact and its potential to contribute to sustainability goals, the project was evaluated regarding: (1) the development of cycling competencies among students, (2) effects on school practices and mobility preferences, and (3) barriers and facilitators for sustainable implementation and growth of the project – especially in socioeconomically and culturally diverse populations. Methods: A mixed-methods approach was applied to capture both individual and institutional outcomes. The evaluation includes: standardised questionnaires for bikepool coordinators (n = 160), teachers trained within the project (n = 40), and students (n = 900), a motor skills cycling test in a pre-post design (n = 225), guided interviews with teachers (n = 15), and focus group discussions with students (n = 25). Data collection was conducted from February to September 2025. Results: First insights from the evaluation indicate high acceptance among educators and a strong demand for structural support to embed cycling sustainably in school life. At the same time, schools struggle with competing demands and bikepool activities tend to be carried out less rigorously, if other urgent demands have to be met. On the individual level, students seem to benefit from the activities and show improved skills in biking. Conclusion: Bikepool demonstrates how a practice-based school intervention can effectively address both health and climate goals by promoting safe, active, and sustainable mobility among children and adolescents. It particularly holds potential for reducing mobility-related health inequalities. The evaluation of the project further highlights key lessons for scaling up such initiatives and integrating sustainability more systematically into school-based health promotion.

Physical activity is important for young children’s (aged 0-5 years) health and development. However, young children with disabilities have markedly low levels of daily physical activity. While the childcare setting offers a unique environment to target physical activity promotion among young children, several inequalities exist that affect physical activity opportunities for young children with disabilities in these settings. As such, this article discusses the inequality in access to physical activity opportunities for young children with disabilities in childcare settings. It draws on, and suggests that, application of a proportionate universalism approach to promote inclusive physical activity opportunities for young children with disabilities in childcare settings may support participation.

Abstract Background Energy poverty remains an urgent social and economic challenge, exacerbated by rising energy costs, climate change, and inequalities in access to renewable technologies. Renewable energy communities (RECs) offer a promising approach that combines local energy production, democratic participation, and shared benefits, with the potential to reduce costs and improve energy access for vulnerable households. However, their effectiveness depends on economic viability, equitable distribution of benefits, regulatory support, and active community involvement. This study is relevant in that it assesses the viability, critical success factors, and benefit-sharing mechanisms of a photovoltaic REC, providing insights into how such models can foster sustainable, inclusive, and socially cohesive energy transitions. Results The analysis assesses the profitability of an 80 kW photovoltaic system for a REC located in Northern Italy. The project’s profitability ranges from 2556 to 5791 €/kW for self-consumption levels of 30% to 70%. Even without incentives, the investment remains economically sustainable, with profits ranging from 1693 to 3777 €/kW. Profitability is strongly influenced by self-consumption, but the incentive also makes the project much more attractive to prosumers. Sensitivity, scenario, and risk analyses confirm the project’s robustness with respect to other variables, including energy purchase and sale prices, investment costs, and the opportunity cost of capital. A new methodology for distributing benefits across stakeholder categories (producers, consumers, households in energy poverty, territorial redevelopment, and the State) is proposed, also including ESCOs as facilitators and catalysts for RECs. Conclusions RECs can be a tool for energy transition, capable of generating economic and social benefits even without government incentives in a mature photovoltaic market. However, incentives significantly enhance the project’s economic viability and promote broader participation in the creation of these communities. From a policy perspective, this suggests a shift from direct subsidies to creating conditions conducive to community development, through programs that protect vulnerable families and aim to balance the needs of all stakeholders. From a managerial point of view, profitability depends above all on optimising self-consumption, while the equitable distribution of benefits among stakeholders strengthens legitimacy, fairness, and social cohesion.

Earth System Models (ESM) are our main tool for projecting the impacts of climate change. However, running these models at sufficient resolution for local-scale risk-assessments is not computationally feasible. Deep learning-based super-resolution models offer a promising solution to downscale ESM outputs to higher resolutions by learning from data. Yet, due to regional variations in climatic processes, these models typically require retraining for each geographical area-demanding high-resolution observational data, which is unevenly available across the globe. This highlights the need to assess how well these models generalize across geographic regions. To address this, we introduce RainShift, a dataset and benchmark for evaluating downscaling under geographic distribution shifts. We evaluate state-of-the-art downscaling approaches including GANs and diffusion models in generalizing across data gaps between the Global North and Global South. Our findings reveal substantial performance drops in out-of-distribution regions, depending on model and geographic area. While expanding the training domain generally improves generalization, it is insufficient to overcome shifts between geographically distinct regions. We show that addressing these shifts through, for example, domain adaptation can improve spatial generalization. Our work advances the global applicability of downscaling methods and represents a step toward reducing inequities in access to high-resolution climate information.

This article analyzes the ethical and pedagogical challenges arising from the incorporation of Artificial Intelligence (AI) into the educational field, considering the profound transformations this technology has brought to teaching and learning processes. The research, of a qualitative and bibliographic nature, is based on authors such as Floridi (2022), Pimenta and Lara (2022), and UNESCO (2023), seeking to understand how AI affects notions of authorship, data privacy, algorithmic transparency, and equity in access to knowledge. The analysis also discusses the teacher’s role as a critical mediator in the face of automated content generation and assessment systems, as well as the ethical implications of AI use in educational settings. The results indicate that an ethics of educational AI must be grounded in the principles of autonomy, equity, and social justice, ensuring that digital technologies are used to promote integral human development rather than subordinating pedagogical practices to technocratic logics.

Background: Globalization has significantly transformed literary production and circulation, particularly influencing the English novel’s thematic scope, formal experimentation, and global readership. Despite extensive critical discussion, existing scholarship often remains fragmented across theoretical traditions. Methods: This study adopts a qualitative, interpretive approach based exclusively on secondary sources. A systematic review and thematic analysis of peer reviewed books, journal articles, and authoritative literary criticism were conducted using theoretical frameworks from world literature, postcolonial studies, Marxist cultural theory, and globalization studies. Results: The analysis demonstrates that globalization has reshaped the English novel through the increased prominence of transnational themes such as migration, displacement, cultural hybridity, and economic precarity. Formally, contemporary novels employ fragmented narratives, multiple perspectives, and multilingual strategies to reflect global mobility and cultural complexity. The study also reveals how global publishing markets, literary prizes, and international readerships influence literary visibility while reproducing inequalities in recognition and access. Conclusion: The English novel emerges as a dynamic and adaptable literary form capable of mediating between local experiences and global processes. However, its global circulation remains shaped by uneven power relations rooted in historical and economic structures. Novelty: This study contributes an original conceptual synthesis by integrating world literature, postcolonial, and political-economic perspectives into a unified analytical framework, demonstrating how thematic transformation, narrative form, and global literary markets jointly shape the contemporary English novel, an approach rarely articulated within a single, methodologically explicit study.