New Covenant International

660 Background: Rapid advances in 1L therapy for locally advanced/metastatic urothelial carcinoma (la/mUC) have shifted standards and offer new opportunities to improve outcomes. These advances also introduce complexities in clinical decision-making including eligibility, sequencing, and AE management. In the community setting, these challenges are amplified by variations in resources, infrastructure, and care coordination. To address these challenges and support adoption of evolving standards of care, a targeted educational initiative was developed for GU oncology teams. Methods: A curriculum comprising two 30-minute CME sessions and a community-based practice-pattern analysis (PPA) survey was developed in collaboration with the Large Urology Group Practice Association (LUGPA) and the Bladder Cancer Advocacy Network (BCAN). The education launched on Medlive.com in April (Session 1) and September 2025 (Session 2) and will remain available for 12 months. Session 1 focused on guideline updates, practice implications, and AE mitigation in 1L la/mUC. The PPA survey, deployed in June 2025, assessed real-world treatment patterns and barriers to integrating newer regimens and informed development of Session 2, which highlighted strategies to address identified barriers. Outcomes were measured through pre-/post-activity assessments and evaluations. Results: To date, over 1,800 clinicians have participated in Session 1, with 93% designating their specialty as oncology/urology. Session 1 demonstrated a ~25% confidence gain in both individualizing 1L treatment selection and counseling patients on newer regimens. Most learners cited sequencing as the main challenge (25%), followed by AE management and patient counseling. Intended changes included adopting EV+P in 1L–eligible patients (42%) and reevaluating the role of platinum-based chemo (32%) in this setting. PPA survey findings (n = 95; 77% community-based) revealed cisplatin eligibility as the most influential factor guiding 1L treatment selection (65%). Among cis-eligible patients, 71% preferred platinum-based chemo ± IO, indicating lagging adoption of guideline-preferred therapy. The greatest barrier to adopting ADC+IO regimens was AE management (56%). Conclusions: A tethered, two-session curriculum, augmented by a PPA survey, demonstrated broad engagement and measurable improvements in confidence for 1L decision-making in la/mUC. Survey findings highlight a transitional phase in community practice and the need for pragmatic tools to (1) operationalize ADC+IO eligibility, (2) standardize AE monitoring/mitigation strategies, and (3) clarify sequencing. These results underscore the critical role of outcomes-driven education in closing the gap between emerging evidence, guidelines, and real-world implementation.

The performance of chemically modified corn stalk waste as a low cost and environmental friendly adsorbent for the removal of copper (ii) ions was examined using batch process. Factors prompting copper removal including initial copper ion concentration (0.2 – 1.0 g/l), adsorbent dose (0.5 – 10.0 g), contact time (30 – 150 min) and pH (2 – 11) at constant temperature of 30 oC were studied. The adsorption process was quite fast and equilibrium was establish before 100 min. Maximum adsorption of 70% for copper (ii) ions was found to occur at pH 8. The equilibrium data obtained were analyzed and the results showed that Langmuir isotherm with R2 value at 0.99 best described the adsorption equilibrium data. The maximum adsorption capacity for the adsorption process calculated from the Langmuir isotherm was found to be 66.2 mg/g. This high value of the adsorption capacity indicated that the corn stalk waste can be used as a potential alternative for the removal of Cu (II) ions from wastewater.

Lake Worth, Florida The author has disclosed that he has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Restoration efforts in Florida's Everglades focus on preserving and restoring this unique wetland's natural landscape. Because most of the Everglades is a freshwater peatland, it requires surplus rainfall to remain a peatland. Restoration plans generally assume a stable climate, yet projections of altered climate over a 50-year time horizon suggest that this assumption may be inappropriate. Using a legacy regional hydrological model, we simulated combinations of a temperature rise of 1.5 °C, a ± 10% change in rainfall, and a 0.46 m sea level rise relative to base conditions. The scenario of increased evapotranspiration and increased rainfall produced a slight increase in available water. In contrast, the more likely scenario of increased evapotranspiration and decreased rainfall lowered median water depths by 5-114 cm and shortened inundation duration periods by 5-45%. Sea level rise increased stages and inundation duration in southern Everglades National Park. These ecologically significant decreases in water depths and inundation duration periods would greatly alter current ecosystems through severe droughts, peat loss and carbon emissions, wildfires, loss of the unique ridge and slough patterns, large shifts in plant and animal communities, and increased exotic species invasions. These results suggest using adaptive restoration planning, a method that explicitly incorporates large climatic and environmental uncertainties into long-term ecosystem restoration plans, structural design, and management. Anticipated water constraints necessitate alternative approaches to restoration, including maintaining critical landscapes and facilitating transitions in others. Accommodating these uncertainties may improve the likelihood of restoration success.

Hemolysis caused by flow-induced mechanical damage to red blood cells is still a problem in medical devices such as ventricular assist devices (VADs), artificial lungs, and mechanical heart valves. A number of different models have been proposed by different research groups for calculating the hemolysis, and of these, the power law-based models (HI(%)=Ct(α)τ(β)) have proved the most popular because of their ease of use and applicability to a wide range of devices. However, within this power law category of models there are a number of different implementations. The aim of this work was to evaluate different power law-based models by calculating hemolysis in a specifically designed shearing device and a clinical VAD, and comparing the estimated results with experimental measurements of the hemolysis in these two devices. Both the Eulerian scalar transport and all the Lagrangian models had fairly large percentage of errors compared with the experiments (minimum Eulerian 91% and minimum Lagrangian 57%) showing they could not accurately predict the magnitude of the hemolysis. However, the Eulerian approach had large correlation coefficients (>0.99) showing that this method can predict relative hemolysis, which would be useful in comparative analysis, for example, for ranking different devices or for design optimization studies.