Video chat may allow young children and grandparents to develop and maintain bonds when they are physically separated because it enables them to share experiences with each other in real time. We used an ecological model framework to examine factors associated with the development of the grandparent–grandchild relationship during the COVID-19 pandemic, when many families were experiencing reduced opportunities for in-person interaction. We analyzed survey data from grandparents (N = 855) and parents (N = 846) of children ages 0–5 years. Predictor variables included participant characteristics (age and education level), proximity variables (geographical distance and whether grandparents had met their grandchildren in person), as well as video chat-specific factors (e.g., frequency of video chats, activities used during video chats). The frequency of video chat and the variety of behaviors engaged in during the video chats predicted grandparents' feelings of closeness to their grandchild as well as grandparents' and parents' enjoyment of family video chats. These predictors were statistically significant after controlling for participant characteristics and physical proximity, suggesting that when families are separated (e.g., due to pandemics, deployment, geographic distance, etc.) family video chats may help to build and maintain grandparent–grandchild connections in an enjoyable way. One future implication is that family video chat may introduce children to the connection between screen and world, a supportive first step in understanding and using technology.

Background/Objectives: Excessive screen time and inadequate sleep are well-established developmental risk factors, yet limited research has examined the relationship between adherence to national sleep and screen time guidelines and language outcomes in children with mild language delays. This study examined sleep, screen time, and language outcomes in 765 children aged 1–5 with mild language delays enrolled in the Early Discovery Program. Methods: Sleep and screen time were categorized according to American Academy of Pediatrics and Caring for Our Children guidelines. Language outcomes were measured using standardized scores from the Preschool Language Scales–Fifth Edition. Results: Sociodemographic factors, including race, insurance status, and caregiver education, were significantly associated with sleep and screen behaviors. Excessive screen time was negatively associated with expressive language scores, while sleep duration showed no significant relationship. Conclusions: Findings highlight the need for early interventions that promote adherence to national health guidelines and address sociodemographic factors influencing language development in young children.

PURPOSE: Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy characterized by poor prognosis. The ADRIATIC trial demonstrated significant survival benefits with durvalumab as maintenance therapy for limited-stage SCLC (LS-SCLC). However, the high cost of durvalumab necessitates an evaluation of its cost-effectiveness. METHODS: A partitioned survival model was developed to assess the cost-effectiveness of durvalumab consolidation therapy compared with the standard of care (SOC). The model comprised three mutually exclusive health states: progression-free survival (PFS), progression of disease (POD)/metastasis, and death. Incremental cost-effectiveness ratio (ICER) was calculated as cost per quality-adjusted life year (QALY) gained, with a willingness-to-pay (WTP) threshold of $150,000 in US dollars (USD)/QALY. One-way and probabilistic sensitivity analyses were conducted. Analysis for POD was also stratified into intrathoracic, extrathoracic, and CNS. RESULTS: Durvalumab improved overall survival (OS) to 66.1 months and PFS to 40.2 months, compared with 57.8 and 31.8 months for SOC, respectively. The total cost of durvalumab was $163,722 USD versus $25,816 USD for placebo, resulting in an incremental cost of $137,905 USD. Durvalumab provided an incremental QALY gain of 0.36 years, yielding an ICER of $383,069 USD/QALY, exceeding WTP. On stratification, durvalumab in patients with extrathoracic progression nearly met WTP (ICER, $151,137 USD). CONCLUSION: Durvalumab remains cost-prohibitive for the overall cohort, exceeding acceptable thresholds despite favorable outcomes. Subgroup analysis, however, indicates that selective use in patients with extrathoracic progression may enhance cost-effectiveness. Overcoming economic barriers will be essential for the sustainable integration of immunotherapy into routine care.

Lung cancer during pregnancy is rare, and placental metastases are exceptionally uncommon. Neuroendocrine lung tumours with RET point mutations have scarcely been reported in this setting. An early 40s G6P1031 woman at 33 weeks’ gestation presented with dyspnea and flank pain. Imaging revealed a right lower lobe lung mass with hepatic metastases. Liver biopsy confirmed lung adenocarcinoma with neuroendocrine features and next-generation sequencing identified a RET p.M918T mutation. Following multidisciplinary discussion, labor was induced at 35 weeks with uncomplicated delivery of a healthy infant. Placental pathology demonstrated metastatic carcinoma consistent with pulmonary origin. The patient was treated with selpercatinib, resulting in radiographic response and clearance of circulating RET-mutant DNA. She remains progression-free 10 months into therapy and the infant continues normal development. This is the first reported case of RET p.M918T-mutated neuroendocrine lung cancer with placental metastases diagnosed during pregnancy, highlighting the importance of molecular profiling and multidisciplinary care.

Background: People who inject drugs (PWID) are at increased risk for viral hepatitis, yet hepatitis A virus (HAV) and hepatitis B virus (HBV) screening and immunization rates remain low. Although offering HAV and HBV services at syringe services programs (SSPs) is effective, few U.S. SSPs currently offer them. Limited qualitative research exists on the advantages and optimization of these services at SSPs. This study explored PWID and SSP staff perspectives regarding barriers to HAV and HBV prevention and care services in traditional healthcare, facilitators for SSP-based provision, and opportunities to improve service delivery. Methods: This study was conducted at an SSP in Miami, Florida serving over 2500 PWID annually. Quantitative data on vaccine administration from August 2023 to May 2025 were abstracted from the SSP database. Prior to implementation, in May 2022, we conducted in-depth interviews with 15 PWID and 11 SSP staff. Transcripts were analyzed using codebook thematic analysis in Dedoose. Results: From August 2023 to May 2025, the SSP administered 114 HAV and 176 HBV vaccine doses. Qualitative interviews from May 2022 revealed several key findings. Barriers included limited knowledge, stigma and discrimination, resource and transportation challenges, navigation difficulties, and limited prioritization. Facilitators for SSP-based services included the benefits of co-located, on-demand care, and non-stigmatizing and supportive environment. Opportunities for improvement included offering incentives, expanding outreach, and increasing communication. Conclusion: PWID face significant barriers to HAV and HBV services in traditional healthcare, including stigma, logistical challenges, and limited awareness of viral hepatitis. Integrating these services into SSPs enhanced accessibility and uptake by leveraging trust, convenience, and harm reduction principles.

Background: SCLC remains an aggressive malignancy with limited therapeutic options after progression. Tarlatamab, a DLL3-directed bispecific T-cell engager, has a demonstrated survival benefit in clinical trials, but real-world data remain limited. We evaluated the safety, radiographic response, and treatment durability of Tarlatamab in a real-world cohort treated at a single academic center. Methods: We performed a retrospective review of patients with extensive-stage SCLC who received Tarlatamab at the University of Miami Sylvester Comprehensive Cancer Center between 2024 and 31 October 2025. Demographic, clinical, radiographic, and toxicity data were abstracted from electronic medical records. Radiographic response was defined as partial response or stable disease on follow-up imaging. PFS and overall survival OS were estimated using the Kaplan–Meier method. Results: Twenty-three patients were included (median age 72 years), of whom 61% were Hispanic and 61% had brain metastases prior to treatment. Forty-three percent had received two or more prior lines of therapy. CRS and ICANS occurred primarily during Cycle 1 and were limited to grade 1–2 events, with no grade ≥3 toxicities. Median time on treatment was 92 days with a median of four cycles. Among 18 evaluable patients, partial response was observed in 27.7% and stable disease in 16.7%, yielding a disease control rate of 44.4%. Median PFS was 139 days and median OS was 323 days (95% CI, 31–614). Conclusions: In a predominantly Hispanic, heavily pre-treated real-world population with high CNS disease burden, Tarlatamab demonstrated feasible administration, manageable immune-mediated toxicity, and clinically meaningful antitumor activity.