Young Population Research Articles

Incidence and survival trends for primary carcinomas of the liver in the pediatric and younger adult population: Fibrolamellar carcinoma, hepatocellular carcinoma, and cholangiocarcinoma.

e16251 Background: Multiple studies have shown a rise in the incidence of carcinoma among the pediatric and younger adult populations, including breast, kidney, and pancreas carcinomas. In contrast, there is little data on changes in the incidence of liver cancer in the pediatric and young adult population for primary liver carcinomas, especially for rare liver cancer such as fibrolamellar carcinoma and cholangiocarcinoma. This study determines the incidence and mortality of primary liver carcinomas in the pediatric and young adult population. Methods: Patients diagnosed with cholangiocarcinoma, fibrolamellar carcinoma, and hepatocellular carcinoma were selected from the National Cancer Database (NCDB) using histology codes 8160, 8171, and 8170. United States census data stratified by age groups from 2000 – 2022 was also collected. Years 2001 – 2009, for which there was no yearly census data, was estimated. Yearly incidence rates per age group were calculated, with ages of 0-9 years classified as the pediatric population and 11-35 years as the younger adult population. Linear regression models were made. Data was analyzed using R version 4.4.2 with α = 0.05. Results: There was a significant increase in the incidence of hepatocellular carcinoma among the younger adults from 2002 – 2022 (β = 0.0014, p = 0.00315), with a significant decrease in survival (β = -4.478, p = 0.00216), but no significant change in the incidence or survival in the pediatric population. Conversely, there was no significant increase in the incidence of fibrolamellar carcinoma among the younger adults, but there was a slight significant increase in incidence for the pediatric population (β = 0.0002, p = 0.04175) as well as a significant decrease in survival outcomes (β = -1.2990, p = 0.02548). While there was no incidence change in fibrolamellar carcinoma in the younger adult population, there was a significant decline in mortality (β = -2.342, p < 0.0001). Finally, there was no significant change in incidence for cholangiocarcinoma among either the pediatric or young adult population. Conclusions: Together, these data show hepatocellular carcinoma and fibrolamellar carcinoma are increasing in the younger population, pointing towards the need for further study.

Trends of infective endocarditis mortality in young adult population of US: A concerning rise and its association with substance abuse.

Trends of infective endocarditis mortality in young adult population of US: A concerning rise and its association with substance abuse.

Is Immediate Breast Reconstruction an Option for Elderly Women? A Comparative Study Between Elderly and Younger Population.

To evaluate the incidence of postoperative complications (POC) in elderly patients (EP) compared to younger patients (YP) following immediate breast reconstruction (IBR) after total mastectomy (TM). This retrospective study included patients treated at the Institut Universitaire of Cancer of Toulouse-Oncopole (IUCT-O) between January 2014 and May 2022. The primary outcome was the incidence of POC within 30 days postoperatively. Secondary outcomes included the delay before initiation of adjuvant treatments and re-hospitalization rates. Elderly patients had a significantly higher rate of POC compared to younger patients, affecting 27.9% of EP and only 14.8% of YP. However, the severity of complications does not differ significantly between YP and EP (69.1% of major POC for YP and 64.7% for EP, P = .6680). Rates of re-hospitalization within 30 days between the 2 groups are similar (67.3% for YP and 61.8% for EP, P = .5962). Most importantly, these complications are not responsible for a delay in initiating adjuvant treatment compared with the younger population. Age ≥ 70 years and obesity (BMI ≥ 30) were identified as independent risk factors for POC. Despite a higher rate of POC, immediate breast reconstruction can be considered for elderly patients, but these patients should be carefully selected and assessed preoperatively to limit the risk of POC.

Genetic analysis of mixed lineage kinase domain-like pseudokinase (MLKL) in oral squamous cell carcinoma: A comparative evaluation between young and old patients.

Genetic analysis of mixed lineage kinase domain-like pseudokinase (MLKL) in oral squamous cell carcinoma: A comparative evaluation between young and old patients.

Methods to discriminate between nociceptive, neuropathic and nociplastic in children & adolescents: A systematic review of psychometric properties and feasibility.

Methods to discriminate between nociceptive, neuropathic and nociplastic in children & adolescents: A systematic review of psychometric properties and feasibility.

Age- and sex-specific analysis of the impact of bipolar disorder in Iran and its provinces: Prevalence, incidence, and disability-adjusted life years: Global burden of disease 2021.

Age- and sex-specific analysis of the impact of bipolar disorder in Iran and its provinces: Prevalence, incidence, and disability-adjusted life years: Global burden of disease 2021.

Effect of adding global postural reeducation to kendall exercises for treating asymptomatic forward head posture: A single-blinded randomized controlled trial.

Effect of adding global postural reeducation to kendall exercises for treating asymptomatic forward head posture: A single-blinded randomized controlled trial.

Demographic characteristics of inflammatory bowel disease patients in Saudi Arabia and their relation to gastrointestinal cancers: An observational, prospective cohort study.

e15691 Background: Inflammatory Bowel Diseases (IBD), including Crohn’s disease (CD), ulcerative colitis (UC), and fistulizing CD (FCD), are chronic conditions that can increase the risk of gastrointestinal (GIT) cancers. IBD, particularly when diagnosed early, is associated with an increased risk of developing GIT cancers, including colorectal cancer (CRC). Long-standing inflammation in IBD patients can lead to genetic mutations and alterations, such as changes in the p53 tumor suppressor protein, which are early events in the progression to cancer. This study aims to evaluate the demographic characteristics of IBD patients in Saudi Arabia treated with Infliximab biosimilar. Methods: This observational, prospective cohort study was conducted across four medical centers in Saudi Arabia. The study included 154 patients, with 62 naïve and 92 switched from infliximab. Patients were followed for 48 weeks, with demographic data collected at baseline. Results: The study population had a mean age of 29.6 years (SD 10.1), with 57.7% males and 42.3% females. The majority of patients (87.8%) were Saudi nationals. Among the patients, 37.6% had moderate to severe active CD, 36.3% had fistulizing CD, and 26.1% had moderate to severe active UC. Naïve patients constituted 39.5% of the cohort, while 60.5% were switched from infliximab. The study sites included King Abdul Aziz University Hospital (28.2%), King Saud Medical City (21.2%), National Guard Hospital in Riyadh (31.4%), and National Guard Hospital in Jeddah (19.2%). Conclusions: The demographic profile of IBD patients in Saudi Arabia is consistent with regional data, showing a relatively young population with a higher prevalence of CD. The association between early IBD and the development of GIT cancers underscores the importance of early diagnosis, regular screening, and monitoring to manage and mitigate cancer risk in IBD patients. Patients’ disposition per site. Naïve patients Switched Patients Naïve patients Switched Patients Naïve patients Switched Patients KAUH 7(35.0) 14(35.9) 2(8.0) 5(16.1) 6(35.3) 10(41.7) 44 NGHA-Jeddah 5(25.0) 12(30.8) - 3(9.7) 3(17.6) 7(29.2) 30 NGH-Riyadh 4(20.0) 13(33.3) 3(12.0) 22(71.0) - 7(29.2) 49 KSMC 4(20.0) - 20(80.0) 1(3.2) 8(47.1) - 33 Total patients/ disease/ dynamic group 33.9% 66.1% 44.6% 55.4% 41.5% 58.5% - Total patients/ disease 12.8% 25.0% 16.0% 19.9% 10.9% 15.4% - Total Patients 20 39 25 31 17 24 156

Development of a machine learning model for predicting cardiovascular risk factors and major adverse cardiovascular events in young adults with glucose metabolism disorders.

Development of a machine learning model for predicting cardiovascular risk factors and major adverse cardiovascular events in young adults with glucose metabolism disorders.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Exploring Systemic Impacts and Innovative Therapies.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Exploring Systemic Impacts and Innovative Therapies.

Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis.

Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis.

Exposure to high temperature and sleep in preadolescents from two European birth cohorts.

Exposure to high temperature and sleep in preadolescents from two European birth cohorts.

Insight into the global mortality trends due to prostate cancer among the under-55 population: An analysis of the Global Burden of Disease-2021.

5109 Background: Prostate cancer (PC) is the most prevalent non-skin cancer among males, and it is increasingly diagnosed in those under 55. This younger demographic often faces more aggressive disease progression and a higher risk of metastasis, driven by genetic predispositions, family history, and racial factors. Methods: Data were systematically collected from the GBD-2021 covering key metrics such as incidence, prevalence, death rates, Disability-Adjusted Life Years (DALY), Years of Life Lost (YLL), and Years Lived with Disability (YLD) across the age group of 20-54 years. Global estimated and stratified data based on 204 regions were further analyzed to assess average annual percentage changes (AAPC) and 95% confidence interval (CI) from 1990 to 2021. Results: There were 2,06,612 deaths due to prostate cancer among those aged 20-54 from 1990-2021. Between 1990 and 2021, the global PC incidence in individuals aged 20-54 increased from 0.82 to 1.55 per 100,000, with an AAPC of 2.03 (CI: 1.65-2.41, p<0.0001). The highest incidence was recorded in Lithuania, Bermuda, and Australia, while Vietnam, Bhutan, and Algeria reported the lowest. Notable AAPC increases were observed in Cabo Verde (7.26, CI: 6.80-7.72, p<0.0001), followed by the Republic of Korea and Vietnam. Conversely, Somalia experienced a significant decline (-1.73, CI: -2.04 to -1.43, p<0.0001). During the same period, the global prevalence of PC rose from 7.18 to 13.94 per 100,000, with an AAPC of 2.13 (CI: 1.75-2.54, p<0.0001). Prevalence trends across countries were similar to incidence trends. Between 1990 and 2021, the global mortality rate for prostate cancer in individuals aged 20-54 rose slightly from 0.37 to 0.41 per 100,000, with an AAPC of 0.20 (CI: 0.07-0.32, p=0.003). Significant increases were observed in Cabo Verde (AAPC 4.24, CI: 3.89-4.58, p<0.0001) and the Northern Mariana Islands. Conversely, Sweden and Luxembourg showed declines, with AAPCs of -2.55 (CI: -3.11 to -1.98) and -2.28 (CI: -2.49 to -2.06), respectively. The highest increases across DALY, YLD, and YLL were observed in Cabo Verde, Zambia, and the Republic of Korea, while Somalia, Sweden, and Luxembourg observed significant declines. Conclusions: There has been a rise in mortality rates among young prostate cancer patients aged 20-54, along with increasing morbidity indicators such as YLD, DALY, and YLL. African countries have consistently noted significant rises in both incidence and mortality rates, while a decline was noted in European countries. This could be attributed to the lack of screening protocols and the inadequacy of treatment. The global incidence and prevalence of prostate cancer in this age group have nearly doubled over the past 30 years. Future research should focus on regional disparities and develop strategies to reduce the impact of this disease on younger populations.

Incidence rates of liver and intrahepatic bile duct cancers in young Hispanic populations: An exploratory study of the SEER database, 2017-2021.

e22539 Background: Liver & intrahepatic bile duct cancers rank 6th in U.S. cancer-related deaths. Prior studies have shown rising incidence of cancers in younger populations since the start of the century, with noted demographic disparities. We analyzed gender, age, and race/ethnicity-specific temporal trends from 2017-2021 to determine if similar trends are occurring in liver & intrahepatic bile duct cancers. Methods: This exploratory analysis used Surveillance, Epidemiology, and End Results (SEER) program data to compare liver & intraheptic bile duct cancer incidence rates from 2017-2021. These rates were further evaluated based on gender, age, and race/ethnicity. SEER*Stat software was utilized to compare incidence rates and average annual percentage change (AAPC). AAPC is a single measure that summarizes yearly percent change over a fixed period of time. Results: We initially analyzed incidence of liver & intrahepatic bile duct cancers amongst all genders, races/ethnicities, and ages and compared this to younger populations aged 15-39. Amongst all age groups, the AAPC was 0.2% (CI - 0.1-0.8, p-value 0.15), compared to 0.7% (CI 0.0-0.8, p-value 0.05) in ages 15-39. We then further analyzed differences within the younger group, including gender, race, and ethnicity. Young Hispanic males aged 15-39 showed a significant AAPC increase of 2.5% (CI 2.0-3.2, p-value < 0.01), while non-hispanic white males experienced a 0.9% decline (CI - 1.9- - 0.2, p-value 0.01). In non-Hispanic black males, the AAPC was 0.1% (CI - 0.1-0.3, p-value 0.18). Among Hispanic females aged 15-39, the AAPC increased significantly to 2.5% (CI 2.0-3.7, p-value < 0.01), whereas decreases in non-Hispanic white and black females were non-significant at - 0.3% (CI - 1.4-0.4, p-value 0.25) and - 0.4% (CI - 2.1-0.6, p-value 0.40) respectively. Conclusions: Between 2017-2021, the incidence rates of liver & intrahepatic bile duct cancers steadily increased amongst certain populations. This study specifically identified young Hispanic men and women aged 15-39 as a demographic group with a rising incidence for the development of these cancers. These findings highlight a prevention opportunity through improved screening methods. Recent trends in SEER Age-Adjusted incidence rates, 2017-2021. Group Average Annual Percent Change (AAPC) Lower 95% C.l. Upper 95% C.I. P-Value Males & Females, All Races/Ethnicities, All Ages 0.2% -0.1 0.8 0.15 Males & Females, All Races/Ethnicities, Ages 15-39 0.7% 0.0 0.8 0.05 Males, Non-Hispanic White, Ages 15-39 -0.9% -1.9 -0.2 0.01 Females, Non-Hispanic White, Ages 15-39 -0.3% -1.4 0.4 0.25 Males, Non-Hispanic Black, Ages 15-39 0.1% -0.1 0.3 0.18 Females, Non-Hispanic Black, Ages 15-39 -0.4% -2.1 0.6 0.40 Males, Hispanic (any race), Ages 15-39 2.5% 2.0 3.2 <0.01 Females, Hispanic (any race), Ages 15-39 2.5% 2.0 3.7 <0.01

Racial disparities and prognostic factors in cancer-specific survival for patients with metastatic rectal cancer.

e15674 Background: Significant advances in early diagnosis and treatment have improved cancer-specific survival rates for rectal cancer. However, these gains have not been equitably distributed across all racial and ethnic groups, with minorities experiencing worse outcomes compared to non-minorities. Despite increasing awareness of racial disparities in oncology, research specifically examining disparities in cancer-specific survival (CSS) among patients with metastatic rectal cancer remains limited. This study seeks to address this gap by investigating racial disparities in survival outcomes and its associated prognostic factors. Methods: We evaluated patients ≥18 years of age with rectal cancer from the Surveillance, Epidemiology, and End Results (SEER) database, with a study period from 2018 to 2021. SEER has collected information regarding MSI status since 2018, hence, our study period. The study population included adult patients diagnosed with rectal cancer as first primary, histologically confirmed diagnoses, complete data on MSI status, metastatic diagnosis, and known cause of death. A retrospective cohort study was done. Categorical variables were described as frequencies and percentages and compared using chi-squared test. Univariate and multivariate Cox regression models were used to assess the association between the exposure variables and CSS. Results: We included 3,095 individuals with metastatic rectal cancer (mRC). The majority were non-Hispanic White (NHW) (65.82%), followed by Hispanic (H) (15.15%), Asian/Pacific Islander (API) (10.11%), Non-Hispanic Black (NHB) (8.17%), and American Indian/Alaskan Native (AIAN) (0.74%). Most patients were male (63.10%), with 36.90% female. Young-onset metastatic rectal cancer (YO-mRC) counted for 23.72% of cases, while average-onset metastatic rectal cancer (AO-mRC) comprised 76.28%. NHB individuals had a significantly higher risk of mortality compared to NHW individuals (HR: 1.29, 95% CI: 1.05–1.60, p=0.015). Patients with AO-mRC demonstrated worse survival compared to those with YO-mRC (HR: 1.30, 95% CI: 1.12–1.50, p=0.001). MSI-high tumors were associated with significantly lower mortality risk compared to MSI-stable tumors (HR: 0.57, 95% CI: 0.37–0.87, p=0.01). The presence of bone metastases (HR: 2.15), brain metastases (HR: 2.27), and liver metastases (HR: 1.40) significantly increased mortality risk (all p<0.001). Conclusions: We found significant racial disparities in cancer-specific survival among Black patients with mRC, who have a 29% higher risk of death compared to non-Hispanic White patients. YO-mRC is associated with better survival compared to AO-mRC, possibly reflecting improved treatment tolerance in younger populations. Additionally, the lower risk of death observed in patients with MSI-high tumors reinforces the prognostic importance of MSI status in mRC. Racial disparities and prognostic factors in cancer-specific survival for patients with metastatic rectal cancer. Variable Unadjusted HR (95% CI) p value Adjusted HR (95% CI) p value Race Non-Hispanic White Ref. Hispanic 1.03 (0.87-1.22) 0.697 1.05 (0.88-1.25) 0.536 Non-Hispanic Black 1.38 (1.12-1.70) 0.002 1.29 (1.05-1.60) 0.015 Non-Hispanic Asian/PI 0.83 (0.67-1.03) 0.102 0.86 (0.69-1.07) 0.194 Non-Hispanic AI 1.17 (0.62-2.18) 0.617 1.14 (0.61-2.15) 0.666 Onset Young-Onset Ref. Average-Onset 1.45 (1.25-1.68) <0.001 1.30 (1.12-1.50) 0.001 ☨ Sex Male Ref. Female 0.92 (0.81-1.04) 0.188 0.91 (0.81-1.04) 0.184 Socioeconomic Status <$40,000 Ref. $40,000-$79,999 1.08 (0.69-1.69) 0.72 *Not included due to collinearity $80,000-$100,000 0.99 (0.63-1.55) 0.969 >$100,000 0.89 (0.56-1.40) 0.62 Area of Living Non-Metropolitan Ref. Metropolitan 0.97 (0.81-1.15) 0.734 1.04 (0.87-1.24) 0.657 MSI status MSI stable Ref. MSI low 1.17 (0.81-1.69) 0.391 1.13 (0.78-1.64) 0.511 MSI high 0.65 (0.43-0.99) 0.045 0.57 (0.37-0.87) 0.01 ☨ Bone Metastases 2.59 (2.16-3.10) <0.001 2.15 (1.79-2.59) <0.001 ☨ Brain Metastases 2.98 (2.07-4.29) <0.001 2.27 (1.56-3.30) <0.001 ☨ Lung Metastases 1.35 (1.20-1.52) <0.001 1.10 (0.97-1.24) 0.126 Liver Metastases 1.38 (1.20-1.58) <0.001 1.40 (1.21-1.61) <0.001 ☨ Surgery 0.30 (0.26-0.36) <0.001 0.34 (0.29-0.40) <0.001 ☨ Chemo 0.26 (0.22-0.32) <0.001 0.22 (0.18-0.27) <0.001 ☨ Radiation 0.62 (0.55-0.70) <0.001 0.79 (0.70-0.90) <0.001 ☨ Survival analysis adjusted for race, sex, onset, area of living, MSI status and stage. Income was not included due to a VIF >10, suggesting collinearity. ☨: p value <0.05, statistically significant.

Oncology primary care clinics for comprehensive care of high-risk adolescent and young adult (AYA) cancer survivors.

1641 Background: Adolescent and young adult (AYA) cancer survivors experience early development of chronic medical conditions compared to healthy peers. Due to their young age at diagnosis and living decades beyond treatment, they are also at higher risk for second primary malignancies (SPM) and late effects than older adult-onset cancer survivors. Primary care providers are responsible for most long-term care of survivors and many are unfamiliar with the effects of cancer treatment in younger populations. Oncology primary care providers are uniquely positioned to address increased needs of AYA patients because of their additional survivorship expertise. Methods: In 2020, the University of Cincinnati Cancer Center established an oncology primary care clinic. An accompanying clinical registry was developed to track patient outcomes longitudinally Electronic medical records of all patients seen between 1/2021 and 1/2025 (n = 901) were extracted and entered in REDCap. Records of AYA cancer survivors, defined as cancer diagnosis between the ages of 18-39, were queried and analyzed (9%, n = 85). Results: The patient population’s mean age was 36 yrs (range 20-74; std dev = 11.3). Hematologic cancers (37%) were most common followed by breast (13%) and brain (9%). Additionally, 14% were diagnosed with a SPM. Comorbid conditions were prevalent with 60% of patients having cardiovascular disease such as hypertension. Neurologic (46%), endocrine (44%), and psychologic (71%) co-morbidities were also common. Over half of patients were overweight/obese (68%) and many patients were former (19%) or current (7%) smokers. Eligible patients received their recommended cancer screening including breast (82%), colon (60%), and cervical (40%). Due to treatment exposures, 53% of patients were eligible for cardiomyopathy screening and 73% received recommended echocardiograms. A reduced ejection fraction was found in 26% of patients screened. Conclusions: Comprehensive primary care services and longitudinal monitoring are imperative in this high-risk population. Oncology primary care provides necessary survivorship-informed care and longitudinal monitoring for early onset comorbidities and SPMs. Tailored education and outreach efforts for providers and patients should address preventative health services needed in this high-risk population.

An Umbrella Review of Diabetes Mellitus and Hearing Impairment.

This study aims to synthesize current meta-analyses to propose a potentially existing association between diabetes and hearing impairment (HI), elevating their relationship to "high" level of evidence. A systematic search was performed in 9 databases up to March 31, 2025. The pooled results were synthesized to elucidate the direction and magnitude of the effects. We used the AMSTAR-2 scale to assess study quality and the GRADE tool to assess the certainty of the evidence. Subgroup analysis was conducted according to age (PROSPERO-ID: CRD42024606416). This umbrella review comprehensively encompassed over 22 million participants from more than 226 studies. After screening, 21 studies were finally included. Primary outcomes showed that individuals with HI were at a higher risk of developing diabetes, referring to [odds ratio (OR) = 1.88, 95% confidence interval (CI): (1.01, 3.50)] with moderate evidence certainty. Simultaneously, participants with diabetes exhibited a more prevalent occurrence of HI. Higher pure tone audiometric thresholds, lower distortion product otoacoustic emission amplitudes, and increased auditory brainstem-evoked response latency time collectively indicated an increased risk of HI associated with diabetes. Subgroup analysis results revealed that in the younger population, the association between HI and diabetes risk is also high. Overall, the current body of evidence underscores a latent bidirectional association between diabetes and HI, coupled with mutually aggravating effects. Our findings suggest that HI may serve as an indicator of the risk of developing diabetes.

Development and validation of machine learning risk prediction models for detection of early-onset colorectal cancer: Data from 30 health systems in the United States.

3613 Background: Incidence of early-onset colorectal cancer (EoCRC) in patients without any family history has been increasing in recent years. Our study leveraged advanced Large Language Models (LLM), like GPT-4, to predict EoCRC in a population comprised of multiple health systems across the United States. There is potential to improve patient care by suggesting early screening for patients who are predicted to be at risk by the model. Methods: We identified a population of 5532 patients aged between 18 and 44 in the Truveta data, which is a collection of 120+ million patient journeys across 30 U.S. health systems. 1376 (24.87%) were diagnosed of CRC based on their ICD and SNOMED-CT codes. Data was split into training (80%) and testing (20%) sets. For the prediction task, we applied GPT-4o and compared with XGBoost, one of the strongest non-generative machine learning models. We used patient demographics (age, gender, race, ethnicity), conditions, and lab results within the last 2 to 7 months prior to CRC diagnosis for model training. The last month before CRC diagnosis was excluded to avoid highly predictive signals. For XGBoost, the demographics were represented as one-hot feature vectors, indicating their presence or absence. Conditions were encoded by their diagnosis frequency within the time frame, while the actual values of the lab results were used as model features. For the LLM model, all patient information was input as plain text. Both conditions and lab results were represented by the names of ICD and LOINC codes in order to capture the clinical context. A Chain-of-Thought prompting strategy, incorporating detailed instructions and CRC-specific knowledge, was employed to guide the LLM. Results: Our test set consisted of 1105 patients in which 279 (25.25%) were diagnosed with CRC. Both XGBoost and GPT-4o achieved comparable results. Despite the uneven distribution of CRC diagnoses in the test samples, the fine-tuned GPT-4o achieved the highest precision (87.43%) and recall (57.35%). This indicates that the model can accurately predict EoCRC in the near future for over half of the patients. Conclusions: This study highlights the potential of using LLM to predict EoCRC in younger population. While the GPT-4o base model contains general medical knowledge, supervised fine-tuning with explicit guideline enhances its predictive capabilities. The high precision of the model performance minimizes the burden of unnecessary screening by identifying patients with relatively high risk. As AI technologies continues to advance, with sufficient governance policy in place, predictive models can be valuable tools for clinicians to suggest early screening and mitigate EoCRC for patients. Model Precision Recall F1 score Accuracy XGBoost 83.77% 57.35% 68.09% 86.43% GPT-4o (base) 68.61% 54.84% 60.69% 82.26% GPT-4o (fine-tuned) 87.43% 57.35% 69.26% 87.15%

Multidisciplinary assessment of the impact of assisted reproductive techniques on pregnancy and long-term outcomes of mother and child: Foundation of the LE-REP (Leipzig Reproductive Health) Center.

About 8-10 % of all people of reproductive age are unable to conceive children. In recent years, an increased number of consultations for fertility treatments has been observed with a continuing positive trend. It is known that infertility itself and assisted reproductive technologies (ARTs) are frequently associated with recurrent miscarriages, pregnancy complications or psychosocial problems. In parallel, metabolic and vascular diseases and obesity are becoming a growing issue, even among the younger population, and are affecting fertility and pregnancy outcomes of mother and child. Possible interactions between these conditions and the underlying mechanisms are not well understood hitherto. Furthermore, reproductive outcomes are increasingly challenged by the potential effects of environmental pollution on key reproductive processes, including oocyte maturation and atresia, sperm quality, implantation as well as their role in recurrent miscarriages. The Leipzig reproductive health (LE-REP) project is aimed at investigating the interplay between ARTs and the aforementioned reproductive challenges, including different aspects of fertility problems, early and late pregnancy as well as long-term effects on mothers and their children born via fertility treatment. This multidisciplinary initiative is expected to provide a deep understanding of underlying mechanisms, providing a framework for future preventive strategies improving reproductive health. Finally, LE-REP aims to establish a high-level university fertility center of excellence, combining advanced clinical care, cutting-edge research and education to train future reproductive medicine specialists.

Demographics and outcomes of cancer patients on Medicaid versus private insurance admitted to the hospital in a national sample.

e13823 Background: Cancer is the second leading cause of death in the United States and one of the leading causes of hospital admissions and disability in the United States. There are also reports of rising incidence of cancer in younger population and rising costs of cancer care. We undertook this study to understand the differences in outcomes in patients with cancer admitted to the hospital on Medicaid versus Private insurance using a national sample. Methods: Methods: Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) was queried to identify all admissions in adult patients < 65 years old with cancer between 2016-2021. The patients on Medicaid and Private insurance were identified from this sample and compared for socio-demographic differences, medical comorbidities, all-cause mortality, mean length of stay (LOS) and mean total hospital charges (THC). Statistics were performed using the t-test, univariate and multinomial logistic regression. Results: Results: A total of 5,478,819 admissions occurred in patients with cancer of which 1,284,380 were on Medicaid while 2,843,950 were on Private Insurance. The Medicaid patients were significantly younger (50.9 vs 52.9 years, p < 0.001), more women (50.4% vs 49.6%, p < 0.0001) and more likely to be Black (22.7 vs 11.3%), Hispanic (18.1 vs 8.6%) and less likely to be White (50.4 vs 71.9), all p < 0.0001. Medicaid patients were more likely to be treated at rural and urban non-teaching hospitals compared to Private Insurance (19.2 vs 17.2%, p < 0.0001) and were two times more likely to be from lowest quartile income zip codes (40.2% vs 20.1%, < 0.0001). Medicaid patients also had a higher Charlson Comorbidity index with 75% having index of 3 or higher compared to 64% for Private Insurance (p < 0.0001). Patients on Medicaid had a high mean LOS (7.1 vs 5.9 days, p < 0.0001) and total charges ($87,470 vs $85,163, p < 0.0001) both of which remained significant after adjustment for all demographics and comorbidities. There were more deaths in Medicaid group (5.1% vs 4.2%, p < 0.0001) that also remained significant after adjustment for demographics and comorbid conditions including hypertension, diabetes, COPD, CKD, dialysis dependence, dyslipidemia, heart failure and obesity. Conclusions: Medicaid shoulders a significantly larger burden of sicker, poorer and younger cancer patients compared to Private Insurance. Such patients have higher cost of care and poorer outcomes when admitted to the hospital. More studies are needed to see why cancer patients on Medicaid have poorer outcomes and if they require more supportive services to improve their cancer outcomes.