Muscle-invasive bladder cancer (MIBC) is an aggressive disease with limited therapeutic options. Although immunotherapies are approved for MIBC, the majority of patients fail to respond, suggesting the existence of complementary immune evasion mechanisms underscoring the need for comprehensive immune profiling of patient tumor samples. The PPARγ pathway constitutes a tumor-intrinsic mechanism underlying immune evasion in MIBC. Immune cell-infiltration is controlled by activated PPARγ, which in turn inhibits expression/secretion of inflammatory cytokines. Clinical data sets indicate that PPARγHigh impairs CD8+ T-cell infiltration and confers partial resistance to immunotherapies. Here, we report a comprehensive biomarker study aimed at identifying a single, highly multiplexed platform for profiling the tumor microenvironment in clinical-type specimens as formalin-fixed, paraffin-embedded (FFPE) samples. A cohort of PPARγHigh and PPARγLow muscle invasive bladder cancer samples were used for the technology assessments. Gene expression patterns were measured using a combination of research use only genomics and spatial genomic technologies to determine concordance including RNA-seq, spatial in situ hybridization (GeoMx™ Digital Spatial Profiler) and IO360. We determined that multiple RNA and protein-based technologies were able to accurately characterize the immune phenotypes of PPARγHigh tumors. However, the GeoMx™ technology was ideal for precious samples since it digitally quantifies target abundance while maintaining spatial resolution in only two FFPE slides. GeoMxTM DSP technology is for Research Use Only and not for use in diagnostic procedures. Citation Format: Zhaojie Zhang, Subhasree Das, Manav Korpal, Pavan Kumar, Jingjing Gong, Yan Liang, Margaret Hoang, Joseph Beecham, Victoria Rimkunas. Integrating bulk and spatial profiling technologies for the discovery of RNA and protein biomarkers in muscle invasive bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 498.

Background: Pelvic floor dysfunction (PFD) affects women’s health and quality of life seriously. Postpartum is a crucial stage and ideal opportunity for the prevention and treatment of PFD diseases. Therefore, it is essential to promote postpartum physical recovery and effectively improve the prevention and treatment effect of PFD through a simple, non-invasive and high-compliance pelvic floor rehabilitation programme during postpartum pelvic floor rehabilitation. Methods: A literature review was conducted to develop the initial list of competencies which consisted of 23 items from six models. Two rounds of Delphi Surveys were conducted, inviting experts via email to rate the importance of each item and provide qualitative comments on their ratings. Consensus was predefined as a mean score of 4.0 or above and at least 75% agreement among the participants. Results: The postnatal pelvic floor rehabilitation exercise programme developed in this study was guided by the ‘holistic pelvic floor theory’ proposed by Petros and Ulmsten. The effective recovery rate of the two rounds of expert consultation questionnaires was 100%. In the first round, some items were changed according to experts’ opinions. In the second round, the expert authority coefficient was 0.819. The Kendall coefficient of expert opinion was 0.154 (p<0.01). The final plan included 6 modules with 23 items. The postpartum pelvic floor rehabilitation exercise programme was formed, consisting of six exercises (APBKQS-exercise) such as abdominal breathing, pelvic exercise, bridge exercise, kneeling balance, quadrupedal stretching and supine hand-and-knee confrontation. Conclusion: The postnatal pelvic floor rehabilitation exercise programme constructed in this study integrates multiple exercises (APBKQS-exercise). Theexercise programme guided by the ‘holistic pelvic floor theory’ incorporates the use of Women's Active Functional Fitness Equipment (WAFF) exercise air cushions to better achieve the purpose of alleviating joint pain, loosening contracture muscles, repairing pelvic floor muscles, strengthening abdominal core strength, and recovering body shape as soon as possible.

Background/Objectives: This study aims to develop a standardized weight management intervention program for patients with endometrial cancer (EC) undergoing fertility preservation treatment and to provide a scientific foundation for midwives to implement weight management initiatives in the domains of oncology and reproduction. Methods: The weight management intervention program for patients with EC undergoing fertility preservation treatment was crafted following the directives of the Medical Research Council framework for developing and assessing complex interventions and the World Health Organization handbook for guideline development. The development process encompassed four distinct stages: (1) establishing the intervention development group, (2) identifying a theoretical basis and forming a content framework, (3) gathering and synthesizing evidence, and (4) refining and modeling the practice program. Results: The ultimate weight management program consisted of 6 primary, 18 secondary, and 53 tertiary items. Through two rounds of Delphi consultation, a response rate of 100% was attained, with an expert authority coefficient of 0.83. Conclusions: The developed intervention demonstrates scientific robustness and clinical feasibility, presenting a structured methodology for weight management for EC patients undergoing fertility preservation therapy.

Objectives: To develop and validate an individualized prediction model for assessing the risk of illness uncertainty in patients with malignant tumors, using a cross-sectional design. Methods: Patients with malignant tumors treated at Peking University People’s Hospital from August 2024 to January 2025 were enrolled. The Mishel Uncertainty in Illness Scale (MUIS) was used to classify patients into high-risk and low-to-moderate risk groups. Patients were divided into a model development set and a time-stratified validation set. The development set was further randomly split into a training set and an internal validation set at a 7:3 ratio. Three machine learning algorithms Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), and eXtreme Gradient Boosting (XGBoost) were employed to screen for common predictors, and a nomogram was constructed based on logistic regression. The model’s performance was evaluated using the Area Under the Receiver Operating Characteristic Curve, calibration curves, and the Hosmer–Lemeshow test. Results: A total of 966 patients were included, with 676 in the development set and 290 in the time-stratified validation set. Seven predictors were ultimately identified for the nomogram: age, education level, diagnosis, depression, anxiety, medical coping modes, and social support. Notably, anxiety was the only variable jointly identified by all three algorithms, while the other six were commonly selected by both Random Forest and XGBoost. The nomogram showed good discrimination in training (AUC = 0.763, 95% CI: 0.717–0.808) and internal validation (AUC = 0.724, 95% CI: 0.645–0.803), with well-calibrated probabilities (p > 0.05). In time-stratified validation, discrimination was acceptable (AUC = 0.663, 95% CI: 0.58–0.739), but calibration revealed risk underestimation for low-to-moderate risk group (p < 0.05). Conclusions: The nomogram shows acceptable internal performance as an exploratory concurrent classifier rather than a genuine predictor, but calibration bias and modest temporal discrimination (AUC = 0.663) indicate it is not ready for clinical use. Further optimization and multi-center prospective validation are required.

Background/Objectives: Pregnancy and childbirth are independent risk factors for pelvic floor injury. The choice of delivery position, as an interventionable factor during labor, has received much attention. This study aimed to assess the impact of sitting delivery on pelvic floor function by observing the outcomes of the perineum, duration of the second stage of labor, integrity of pelvic floor structure, and postpartum pelvic floor function. The goal was to provide scientific evidence for optimizing delivery management and reducing the risk of pelvic floor injury. Methods: This was a non-randomized study (based on patient choice). A total of 222 primiparous women who delivered at our hospital from February to August 2023 were selected and divided into the control group (n = 88) and the sitting group (n = 134). The second stage of labor in the control group was delivered in the traditional bladder lithotomy position, while the sitting group delivered in a sitting position. The duration of the second stage of labor, delivery method, degree of perineal laceration, postpartum 2 h bleeding volume, and the occurrence of urinary incontinence and sexual dysfunction 1 year after delivery were observed in both groups. Results: The rate of perineal lateral incision in the sitting group was lower than that in the control group (24.6% vs. 48.9%, aOR = 0.37, p < 0.001); the adjusted mean difference in second-stage duration was −11.65 min (95% CI: −25.35 to 2.05, p = 0.095), indicating no statistically significant difference after adjustment. In unadjusted subgroup analysis, a larger point estimate for reduction was observed in women aged < 30 years (median difference −16.0 min, p = 0.033), but the interaction test was not significant. For urinary incontinence and sexual dysfunction, there were no statistically significant differences between the two groups. Conclusions: Sitting delivery was associated with a lower episiotomy rate and, in unadjusted analysis, a shorter second stage (although the adjusted difference was not significant), and it did not increase the incidence of urinary incontinence or sexual dysfunction at one year postpartum.