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[This corrects the article DOI: 10.31662/jmaj.2024-0331.].
To evaluate the clinical efficacy of prostheses designed using mandibular motion analysis in maxillary full-arch implant rehabilitation. Twenty patients were assigned to a study group (n = 10), receiving prostheses designed with dynamic occlusal data from an electronic jaw motion analyzer (JMA), or a control group (n = 10) using conventional static digital workflows. Between-group differences in occlusal adjustment depth (MAE), area, and chairside time were analyzed by independent t-tests. Within the study group, the stability of mandibular movement paths (provisional vs. post-restoration) was assessed using paired t-tests. Oral health-related quality of life (OHRQoL) was evaluated using the OHIP-14 questionnaire. Effect sizes were calculated as Hedges' g. The study group exhibited significantly lower occlusal adjustment depth (163.26 ± 31.42 μm vs. 213.99 ± 56.38 μm; p = 0.030, Hedges' g = 1.06) and adjustment area (95.93 ± 30.27 mm2 vs. 129.86 ± 25.82 mm2; p = 0.020, g = 1.16) compared to the control group. Chairside adjustment time was reduced by approximately 30% (23.8 ± 7.8 min vs. 33.8 ± 8.0 min; p = 0.074, g = 1.15). No significant changes in parameters of mandibular movement paths were observed within the study group post-restoration (all p > 0.05). OHIP-14 scores were significantly better in the study group for "Meal interruption", "Relaxation difficulty" (p = 0.041), reflecting improved OHRQoL. Integrating dynamic mandibular motion data into prosthesis design reduces clinical adjustments, improves OHRQoL, and preserves inherent movement patterns, demonstrating a promising approach to optimize functional outcomes in full-arch implant rehabilitation. Integrating dynamic mandibular motion data into digital prosthesis design offers a clinically valuable strategy that minimizes occlusal adjustments, supports functional stability, and enhances patient-reported quality of life in full-arch implant rehabilitation.
This study aimed to evaluate and compare the condylar distraction potential and joint space dimensions between patients with unilateral disc displacement without reduction (DDwoR) and asymptomatic individuals, using dynamic jaw tracking and MRI imaging. A total of 47 participants were included: 34 patients diagnosed with unilateral DDwoR and 11 asymptomatic volunteers. Dynamic mandibular movements were recorded using the Zebris JMA 3D ultrasonic jaw tracking system. The amount of condylar distraction was measured using the Electronic Position Analysis (EPA) module. Additionally, MRI scans were performed to assess joint space distances. Statistical comparisons were conducted using appropriate parametric and non-parametric tests, with significance set at p < 0.05. The findings provide insight into the differences in condylar distraction between patients with unilateral DDwoR and healthy volunteers. Patients with DDwoR showed significantly reduced condylar distraction potential an on the affected side compared to controls (p < 0.05). MRI analysis revealed a narrower anterior joint space and limited increase in superior joint space in the DDwoR group. No significant differences were found on the non-affected side compared to the control group. Patients with unilateral DDwoR demonstrate limited condylar distraction capacity and altered joint space dynamics compared to asymptomatic individuals. These findings highlight the mechanical constraints associated with disc displacement and emphasize the importance of functional and morphological evaluation in temporomandibular joint disorders.
New insecticides for indoor residual spraying (IRS) are being developed to manage resistance. Chlorfenapyr (Sylando® 240SC), a pro-insecticide, is metabolized by active mosquitoes into the toxic metabolite tralopyril. This mode of action requires adapted "free flying" bioassays (because chlorfenapyr is converted to its toxic metabolite tralopyril when mosquitoes are metabolically active). A miniature-experimental hut (MEH) assay was developed within the Ifakara Ambient Chamber Test (I-ACT) with a rabbit as a host to measure residual efficacy under controlled conditions. Sylando® 240SC was compared with SumiShield® 50WG (clothianidin) for 12-month residual efficacy against malaria and arbovirus vectors. Residual activity was assessed on mud, wood and concrete with two huts per substrate treated with Sylando® 240SC, one with SumiShield® 50WG, and one with untreated control. Five replicates of 20 mosquitoes per strain (malaria vectors: pyrethroid-susceptible Anopheles gambiae and -resistant An. arabiensis and An. funestus; culicines Aedes aegypti and Culex quinquefasciatus) were exposed overnight at one-week post spraying and monthly thereafter. Multivariable mixed-effect logistic regression with binomial errors and log link function assessed non-inferiority with a 7% margin on mosquito mortality as the primary outcome for malaria vectors. Both products induced delayed mortality, with higher effects on malaria vectors than culicines. Across all substrates and malaria species combined over the full 12 months of observation, Sylando® 240SC was non-inferior to SumiShield® 50WG on mortality measured at 72 h (76% vs. 67%, OR = 0.86, 95% CI: 0.77-0.97) and 168 h (89% vs. 82%, OR = 0.74, 95% CI: 0.63-0.87). Sylando® 240SC performed comparably to SumiShield® 50WG, supporting its use as an IRS additional option. The new I-ACT mini-experimental-hut assay provides a practical tool for evaluating pro-insecticides. The importance of free-flight evaluation methods for pro-insecticides is discussed.
Nitrous oxide (N2O) is a strong greenhouse gas that contributes significantly to global warming and causes depletion of ozone in the stratosphere. Recent observational records show an unprecedented acceleration in atmospheric N₂O growth, reaching 1.15 ppb yr- 1 in 2019-2023, a significant increase compared to 0.68 ppb yr- 1 in 2001-2005. This surge in growth rate is particularly pronounced over tropical regions, and has been measured most prominently at the southern-most island of Japan (Hateruma). In this study, we use N2O observations from globally distributed multi-institutional networks and the MIROC4-ACTM inversion framework to quantify N2O emissions and identify key regions that are driving the recent acceleration. Our results suggest that the major Asian countries, Brazil, Central and Northern Africa, and the Contiguous United States have increased emission sources in the recent 2.5 decades (1998-2023). Further, there has been an increase in land N2O emissions, at a rate of 106 GgN yr- 1 per year during 1998-2002 to 2019-2023 (1Gg = 109g). The inversion inferred trends are consistent with increased fertiliser use and manure production to support extensive agriculture, and terrestrial ecosystem model results. The emissions from oceanic regions did not show significant increases in N2O (rate: 7 ± 2 GgN yr- 1 per year) in our inverse model setup. Our results underscore the importance for improved climate mitigation strategies and emissions reduction policies by increasing nitrogen-fertiliser use efficiency in agricultural land. The online version contains supplementary material available at 10.1186/s40562-026-00476-z.
Chronic obstructive pulmonary disease (COPD) is a complex, multi-component disorder characterized by a long-lasting, irreversible airflow limitation due to inflammation, which leads to narrowing of the airway lumen. A variety of influencing factors may cause cognitive impairment (CI) in patients with COPD, including age, disease duration, severity, hypercapnia, smoking, and vascular dysfunction. This study assessed cognitive functions in non-hypoxic stable COPD patients. An observational study was conducted in the Department of Physiology and Medicine, Rajasthan University of Health Sciences College of Medical Sciences (RUHS CMS). A total of 120 subjects were recruited. The cases (group A) were selected according to the Global Initiative for Obstructive Lung Disease (GOLD) classification. GOLD stage 1 and 2 patients confirmed by spirometry. Controls (group B) were selected as age-matched healthy volunteers(HVs) from the society. The Mini-Mental State Examination (MMSE) and event-related potential (P300) were used to assess cognitive functions in both groups. Data was analyzed using appropriate tests, and p < 0.05 was considered significant. The mean MMSE score was found to decrease in Group A compared to Group B. The mean MMSE score in group A was 24.65 with an standard deviation of ± 2.05; in group B, it was detected as 27.56 ± 2.15 (p < 0.00001). The mean latency of the P300 wave was prolonged in some cases, and a decrease in the Amplitude of the P300 wave was observed in some cases compared to the control group. Mean latency in case group 298.48 ± 21.98 milliseconds compared to control group 265.89 ± 15.80 milliseconds, with a significant p-value <0.0001. The mean amplitude in group A was detected as 4.25 ± 1.502 μV, compared to a mean of 6.06 ± 1.94 μV in group B. Patients with COPD have a higher risk of CI compared to the age-matched healthy volunteer group.
Antigen-specific immunoglobulin-G (IgG) antibodies cause or contribute to the pathogenesis of a wide spectrum of human diseases and conditions. Multiple therapeutic approaches have been developed, yet they are limited by variable safety and efficacy, patient inconvenience, and cost. IdeS, a cysteine protease derived from S. pyogenes, specifically cleaves IgG antibodies, representing a unique opportunity for the treatment of IgG-mediated diseases. However, clinical utilization of IdeS is limited by the immunogenic nature of bacterial proteases and short half-life. Using Seismic's IMPACT platform, we engineered S-1117, an IgG cleaving enzyme fused to a human effectorless IgG1 Fc domain for an extended half-life. S-1117 is being developed to address the limitations of existing therapies in IgG-mediated diseases. In vitro and in vivo pharmacology studies demonstrate that S-1117 exhibits reduced B and T cell immunogenicity, a superior pharmacokinetic profile, and manufacturability and developability properties resembling those of monoclonal antibodies. S-1117 cleavage of IgG reduces circulating levels of IgG, including pathogenic IgG autoantibodies and IgG immune-complexes, and reduces IgG antibody effector functions, such as complement fixation, antibody-dependent cellular cytotoxicity, and antibody-dependent cell phagocytosis. The polypharmacology of S-1117 further extends to cleaving the antigen receptor on IgG-positive memory B cells, thereby modulating activation of memory B cells.
Phenocopies are leukemias that mirror the transcriptional programs, signaling dependencies and often the clinical behavior of established genetic entities, yet lack their defining lesions. In acute lymphoblastic leukemia (ALL), RNA sequencing (RNAseq) classifiers identify phenocopy subtypes including BCR::ABL1-like, ETV6::RUNX1-like, ZNF384-rearranged-like and KMT2A-rearranged-like, which reproduce canonical expression patterns and may share drug vulnerabilities. Their emergence is reshaping taxonomy, but World Health Organization and International Consensus Classifications differ on which phenocopies merit entity status. Phenocopies can refine risk stratification within "B-other" ALL by integrating expression with genotype, copy-number alterations and measurable residual disease assessment. It may also broaden access to pathway-directed therapies (ABL, JAK-STAT, menin) for patients without sentinel fusions but with convergent circuitry. Adoption remains constrained by RNAseq availability, expertise and lesion-centric regulation. Prospective studies are needed to establish the clinical utility of newly described phenocopies, extending the advances made in subclassification and targeted treatment of BCR::ABL1-like ALL.
Accurate identification of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) remains a key clinical challenge. Clinical complete response is an imperfect surrogate, and pCR can only be definitively established after surgery. We developed a fully automated, segmentation-free deep learning model to support post-treatment response assessment using routine T2-weighted MRI. A longitudinal three-dimensional (3D) siamese convolutional neural network was trained using paired pre- and post-nCRT axial T2-weighted MRI volumes and a normalized signed voxel-wise difference map. The multitask framework simultaneously predicted rectal wall response (good response: modified Ryan score 0-1 vs poor response ≥ 2) and nodal status (ypN0 vs ypN +), from which pCR probability (ypT0N0) was derived. A retrospective single-center cohort of 195 patients was divided into training and independent test sets stratified by pCR status. Performance was evaluated using AUC-ROC and standard classification metrics with bootstrap-derived 95% confidence intervals. In the independent test set (n = 49; pCR prevalence 18.5%), the model achieved an AUC-ROC of 0.71 (95% CI: 0.55-0.85) for pCR prediction. At the selected operating threshold, sensitivity was 100% (95% CI: 70.1-100) and negative predictive value (NPV) was 100% (95% CI: 81.6-100), with a specificity of 42.5% (95% CI: 28.5-57.8). The high NPV reflects the low prevalence of pCR in the study cohort and may vary across external populations. This fully automated longitudinal deep learning model demonstrated moderate discrimination and a high-sensitivity profile for pCR detection. Its performance suggests potential utility as a screening or triage tool to support multidisciplinary assessment, rather than to directly guide organ-preserving strategies. External multicenter validation is required before clinical implementation.
To demonstrate the step-by-step application of intraluminal indocyanine green (ICG) in endometriosis and adenomyosis surgery, including mucosa-sparing shaving of deep bladder and rectal nodules and excision of superficial tubal endometriosis. Description of surgical technique with narrated video footage. First case was a 36-year-old patient with chronic pelvic pain, urinary frequency, and dysuria. Preoperative magnetic resonance imaging revealed a bladder endometriosis nodule measuring 1.7 cm × 1.5 cm. The patient underwent robotic-assisted excision of endometriosis with total hysterectomy. Second case was a 34-year-old patient with chronic pelvic pain and dyschezia. Preoperative magnetic resonance imaging revealed a rectal endometriosis nodule measuring 2.7 cm × 1.8 cm, located 8 cm from the anal verge. The patient underwent robotic-assisted excision of endometriosis with total hysterectomy. Additional applications of intraluminal ICG highlighted in the video include superficial tubal endometriosis and intrauterine ICG use during adenomyosis excision. In the first case, cystoscopy was performed to exclude bladder mucosal involvement. The bladder was backfilled with diluted ICG, and mucosa-sparing shaving of the bladder nodule was performed under fluorescence guidance. In the second case, ICG was administered transrectally, and the rectal nodule was shaved using monopolar energy under fluorescence guidance. In the third case, ICG was used for real-time identification of the tubal lumen during excision of tubal endometriosis. In the fourth case, intrauterine ICG was used to guide the depth of excision during adenomyosis resection. Demonstration of robotic-assisted excision of endometriosis and adenomyosis using intraluminal ICG guidance. All procedures were completed without intraoperative or postoperative complications, and patients were discharged on the same day of surgery. Bladder mucosal integrity was preserved, allowing avoidance of prolonged catheterization. A voiding trial was successfully completed before discharge. At 6-week follow-up, patients reported no complaints. Intravenous ICG is well established for assessing bowel perfusion and anastomotic viability (1). Its use for ureteral perfusion has been described in limited reports, whereas pelvic nerve visualization has only been reported in isolated case reports (2, 3). Intraluminal injection of ICG into the ureters is commonly used to aid ureteral identification (4). In this video, we highlight intraluminal ICG as a valuable adjunct in advanced endometriosis and adenomyosis surgery. When combined with the advantages of robotic surgery, it enables precise mucosa-sparing excision of deep endometriotic lesions and may reduce surgical morbidity.
The purpose of this study was to assess visual photosensitivity using the Ocular Photosensitivity Analyzer (OPA) with and without light filtering lenses in individuals with traumatic brain injury (TBI) and non-TBI controls. This cohort study included 46 individuals with TBI (n = 46) and without TBI (n = 46) assessed from May 2021 to August 2023 at a large academic tertiary center. Visual photosensitivity thresholds (VPTs) were measured at two visits (≥1 month apart) under four lens conditions: no lens (NL), plano lenses (PLs), FL-41 lenses (FLs), and gray-filtering lenses (GLs). Lower VPTs indicate greater visual photosensitivity. Participants with TBI had significantly lower VPTs compared with non-TBI controls across all lens conditions at the initial visit (TBI: PL = 1.6 ± 0.9, FL = 1.9 ± 0.9, and GL = 1.9 ± 1.0; and non-TBI: PL = 2.5 ± 0.9, FL = 2.8 ± 0.9, and GL = 2.8 ± 0.9 log lux, P < 0.05). Both groups showed improved (higher) VPTs with FLs and GLs compared with NL and PL conditions. Results were repeatable at the second visit (intraclass correlation coefficient [ICC] = >0.80 for all conditions). Individuals with TBI consistently demonstrated greater visual photosensitivity compared with controls. FL and GL light filtering lenses improved light tolerance for both groups. These results highlight visual photosensitivity as a TBI sequela and suggest that these light filtering lenses may serve as effective treatment options.
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Japan, the world's third-largest pharmaceutical market, introduced new guidelines in 2019 to address ethical concerns in pharmaceutical company-physician relationships. This study aimed to analyze Japanese physicians' attitudes toward these strengthened regulations. An online survey of 1,203 Japanese physicians was conducted in November 2019. Respondents were categorized based on their frequency of interaction with pharmaceutical companies: frequent (82, 6.8%), moderate (930, 77.3%), or rare (191, 15.9%). The survey assessed awareness of the new guidelines, perceived changes in promotional activities, and attitudes toward stricter regulations. Multivariable modified Poisson regression was used to identify factors associated with opposition to the regulations. A total of 640 (53.3%) respondents opposed stricter regulations, while 325 (27.1%) were in favor. Physicians with frequent (adjusted Incidence Rate Ratio [aIRR] 1.61, 95% confidence interval [CI] 1.24-2.10) or moderate (aIRR 1.53, 95% CI 1.24-1.89) interactions were more likely to oppose regulations compared with those with rare interactions. Hospital directors/managers, those affiliated with private institutions, and recent graduates also showed higher opposition. The main reason for favoring regulations was to promote healthy industry relationships (38, 9.3%), while the primary concern among those opposed was related to information gathering or potential patient disadvantages (88, 21.6%). The study reveals diverse views on industry-physician relations in Japan. Frequent interactions and leadership roles correlate with opposition to stricter regulations. The results suggest a need for balanced policies that consider varied perspectives.
Dpep is a cell-penetrating peptide that targets transcription factors ATF5, CEBPB and CEBPD to selectively suppress growth and survival of diverse tumor cell types in vitro and in vivo. Due to these actions and its apparent safety, the peptide has potential as a cancer therapeutic. How Dpep might be combined with other anti-cancer agents to achieve synergistic efficacy and to overcome possible peptide resistance has not been assessed in depth. Based on prior work indicating that Dpep promotes apoptotic cancer cell death and up-regulates multiple pro-apoptotic and tumor suppressor genes, we studied combinations of Dpep with ABT-263, a pro-apoptotic BCL2 family inhibitor, and decitabine, a hypomethylating drug. Combining Dpep with each agent alone or together synergistically suppressed the growth of a range of solid and liquid tumor cell types. Moreover, the combinations synergistically inhibited the growth of cells lines that were selected either in vivo or in vitro for Dpep resistance. Finally, we tested the combination of Dpep with ABT-263 in a mouse melanoma xenograft model. The combination more effectively inhibited tumor growth than either agent alone and, in contrast to vehicle or ABT-263, produced a 40% durable survival rate. Taken together, these observations highlight potential drug partners for the therapeutic development of Dpep.
Circulating tumor cells (CTCs) are cancer cells found in the bloodstream that serve as biomarkers for early cancer detection, prognostication, and disease monitoring. However, CTC detection remains challenging due to low cell abundance and heterogeneity. Digital holographic microscopy (DHM) offers a promising, label-free method for high-throughput CTC identification by capturing superior morphological information compared to traditional imaging methods, while remaining compatible with in-flow data acquisition. We present a streamlined DHM-based system that integrates microfluidic enrichment with deep learning-driven image analysis, supplemented by immunofluorescent profiling, to improve sensitivity and specificity of CTC enumeration. Specifically, our platform combines inertial microfluidic preprocessing with dual-modality imaging, integrating holography with fluorescence sensing of up to two markers. A deep learning model, trained on a diverse set of healthy blood samples and cancer cell lines, and executed in real-time, provides a morphological confidence on a cell-by-cell basis that may then be combined with immunofluorescence criteria for enumeration. In a pilot study, we demonstrate higher CTC counts in patients with late-stage prostate cancer (n = 13) compared to healthy controls (n = 8), with a patient-level false positive rate of 1 cell/mL. Notably, nearly two-thirds of identified CTCs were EpCAM-negative but PSMA positive (a prostate specific epithelial marker), suggesting that traditional use of EpCAM as an epithelial marker for CTCs may lead to false negatives. These findings highlight the potential of DHM for applications including but not limited to screening, diagnostics, and precision oncology.
Digital, self-guided, single-session interventions (SSIs) deliver structured psychological support within one interaction. Here we crowdsourced 66 diverse 10-min SSIs for depression and, with input from researchers and lived-experience experts, selected 11 for testing in a preregistered online randomized controlled trial (ClinicalTrials.gov ID: NCT06856668 ). US adults (N = 7,505) experiencing elevated depressive symptoms were randomly assigned to 1 of the 11 crowdsourced SSIs, a validated behavioural activation SSI (active comparator) or a control condition without intervention content. Nearly all SSIs improved psychological outcomes immediately after completion (d ≤ 0.37). However, only two SSIs significantly reduced depression at 4-week follow-up (d = 0.14 and 0.15). Unexpectedly, completing an SSI made participants feel less confident and less interested in making changes to overcome depression at 4 weeks, on average (d = 0.05). Future work should aim to leverage SSIs' immediate benefits to promote sustained behaviour change or service engagement.
The expansion of genetic medicine in Japan has created an urgent need for regionally-adaptable systems to ensure equitable implementation. This study examines challenges in developing a sustainable framework for regional genetic medicine, using Shizuoka Prefecture-a non-metropolitan area with average socioeconomic indicators-as a case model. A two-phase survey was conducted between December 2023 and January 2024. The first phase involved a questionnaire sent to 44 major medical institutions and all board-certified clinical genetics specialists in the prefecture. In the second phase, 20 of the responding institutions completed a more detailed follow-up survey. The surveys assessed human resource capacity, institutional collaboration, and the adoption of digital infrastructure. The results revealed critical shortages in clinical geneticists, certified genetic counselors, and genetic nursing specialists. Inter-institutional collaboration was limited, with few systems in place for data sharing or regional coordination. Digital tools, such as remote consultation systems and information platforms, were underutilized. Respondents identified the need for shared infrastructure, better communication among institutions, and flexible strategies to address geographic and systemic barriers. This study highlights the urgent need for network-based infrastructure and a specialized workforce to support the expansion of genetic medicine in regional settings. The findings from Shizuoka are likely reflective of broader national challenges and underscore the importance of policy and system-level interventions to promote equitable access to genetic healthcare across Japan.
Astrocytes are the most abundant cell type in the central nervous system and are major players in brain homeostasis and inflammation. Astrocytes form a syncytial three-dimensional (3D) network across the brain tissue. Establishing a 3D network allows astrocytes to communicate with each other by a variety of mechanisms, including Ca2+ transients. Conversely, spatial and temporal disruption of the astrocyte network can have detrimental effects on brain biology. However, traditional in vitro models have struggled to generate astrocyte networks that can be spatially and temporally perturbed, which limits our capacity to understand astrocyte group dynamics. To address this, we developed a microphysiological platform to investigate both the ways in which 3D astrocyte networks form over time and how they are affected by localized perturbations in the biochemical milieu. We observed that extracellular matrix composition played a critical role in the development of astrocyte network structure, leading to fully interconnected networks within 48 h in optimal conditions. Furthermore, we observed that transient exposure to reactive oxygen species led to long-term disruption of the astrocyte network. This network collapse was accompanied by a decrease in astrocyte redox potential and loss of mitochondrial architecture, which transitioned from an organized filamentous pattern to small and fragmented mitochondria. Additionally, exposure to reactive oxygen species immediately led to disruption of Ca2+ transients. Interestingly, even following transient exposure, astrocytes exhibited persistent disruption of the network architecture, with individual cells still exhibiting fragmented mitochondria and Ca2+ signaling impairment. These findings highlight how temporary perturbations of the biochemical milieu can result in long-term changes in astrocyte behavior.
Synaptic neurotransmission is a critical hallmark of brain activity and one of the first processes affected in neural diseases. Monitoring this process, particularly synaptic vesicle recycling, in living cells has been instrumental in revealing the mechanisms responsible for neurotransmitter release. However, currently available reporters suffer from limitations, such as large probe sizes or limited compatibility for human neurons, hampering the quantitative analysis of synaptic pathophysiology. Here, we describe the NbLumSyt1 toolkit, a panel of nanobody-based affinity probes that target the luminal domain of the synaptic vesicle protein Synaptotagmin 1 (Syt1). These new tools enable quantitative, noninvasive imaging and functional interrogation of Syt1 exo-endocytosis and trafficking in human neurons, with unprecedented precision, versatility and cost efficiency, in technologies ranging from fixed- and live-cell super-resolution imaging to electron microscopy and mass spectrometry. Overall, NbLumSyt1 nanobinders provide a valuable platform for studying synaptic physiology and pathophysiology, benefiting fundamental neuroscience and translational efforts to study and develop treatments for brain-related disorders.
Pancreatic cancer (PC) is associated with a high symptom burden that contributes to reduced health-related quality of life (HRQoL) and adverse clinical outcomes. Supportive care medications (SCMs) are essential for symptom management. Prior studies have documented racial disparities in the use of stigmatized medication classes such as opioids and psychotropics. However, less is known about whether similar disparities exist for non-stigmatized SCMs. This study examined racial and ethnic differences in the use of non-stigmatized SCMs during end-of-life care among patients with PC. We conducted a retrospective cohort study using SEER-Medicare data from 2005 to 2017. Patients with PC who had continuous Medicare Parts A, B, and D coverage and died within 12 months of diagnosis were included. SCM use was defined as at least one outpatient prescription claim for antiemetics, appetite stimulants, cognitive aids, headache aids, or sleep aids. Multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) for SCM use by race and ethnicity, controlling for demographic, clinical, and socioeconomic factors. The final cohort included 74,309 patients (Non-Hispanic White: 72.5%, Black: 11.0%, Hispanic: 9.6%, Asian/Pacific Islander: 6.6%). Compared to Non-Hispanic White patients, Black patients had lower use of antiemetics (aOR 0.77; 95% CI: 0.73-0.81), headache aids (aOR 0.68; 95% CI: 0.63-0.74), and sleep aids (aOR 0.68; 95% CI: 0.64-0.72), but higher use of appetite stimulants (aOR 1.06; 95% CI: 1.01-1.11) and cognitive aids (aOR 1.38; 95% CI: 1.25-1.53). Similar patterns were observed for other racial and ethnic minority groups, though findings varied by medication class. Racial and ethnic disparities persist in the use of non-stigmatized SCMs among patients with PC at the end of life. These findings extend prior evidence on inequities in cancer symptom management and underscore the need for interventions that promote equitable access to SCMs across diverse populations.