Friday, June 13, 2025

New JNCCN study showcases how telehealth helps overcome geographic and resource gaps in cancer care globally

Older adults with cancer in Brazil showed better outcomes with telehealth in first-ever randomized trial of comprehensive geriatric assessment and management outside a high-income country.

National Comprehensive Cancer Network

June 2025 cover, JNCCN — image:
JNCCN Cover, June 2025. New study in JNCCN showcases how telehealth helps overcome geographic and resource gaps in cancer care globally. Learn more at JNCCN.org.
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Credit: NCCN

PLYMOUTH MEETING, PA [June 11, 2025] — New research in the June 2025 issue of JNCCN—Journal of the National Comprehensive Cancer Network found that older people with cancer had better daily functioning, improved mood, stronger illness understanding, and a higher quality of life if they participated in a telehealth-based care program called Geriatric Assessment-Guided Intervention-Supportive Care (GAIN-S). GAIN-S’ supportive care services included personalized fitness training, nutritional support, psychiatric care, and psychosocial assistance, all delivered remotely.

The randomized clinical trial focused on 77 adults aged 65-and-older undergoing treatment for a metastatic solid tumor between June 2022 and July 2023 in Brazil. The care providers in the study were primarily located in high-population urban areas, while most patients lived in remote or underserved parts of the country. The patients who participated in the GAIN-S telehealth program demonstrated significant improvement in all measured areas after three months.

“Instead of requiring older patients to travel long distances for tailored and specialized care, we brought the expertise to them—ensuring equity in access regardless of geography,” said senior author William Dale, MD, PhD, City of Hope, a national U.S. cancer research and treatment organization headquartered in Los Angeles. “It was a win-win for patients, families, and providers, bringing this growing standard of care to many more people using the available resources in an efficient way.”

“This is especially important in countries with substantial geographic and resource gaps, like Brazil and remote areas in any country,” said lead author Cristiane Decat Bergerot, PhD, Oncoclinicas&Co of Sao Paulo. “By bringing supportive care approaches to patients at the beginning of their cancer care journey, we can significantly improve the experience, communication, and outcomes of patients’ lives.”

WhatsApp was used for scheduling appointments and obtaining informed consent for the GAIN-S group. This enabled the team to automatically encrypt messages and have the option to make them disappear after 24 hours for added security.

“Social media can be used for anything, including now Comprehensive Geriatric Assessment and Management (CGAM),” commented Martine Extermann, MD, PhD, Moffitt Cancer Center, who was not involved with this research. “Randomized clinical trials have established CGAM as the standard of care approach for optimal outcomes in older patients with cancer and are recommended in the NCCN Guidelines® and others. But CGAM has long been considered a ‘niche’ activity limited to large academic cancer centers. An increasing number of studies show it can be implemented in a broader practice setting, and now in low- and middle-Income countries as well. Let us spread the benefits of it!”

Dr. Extermann wrote a full response to this study, which is also running in the June issue of JNCCN. To read the entire study “Telehealth Geriatric Assessment and Supportive Care Intervention (GAIN-S) Program: A Randomized Clinical Trial” and the corresponding “The Last Word” commentary, visit JNCCN.org.

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About JNCCN—Journal of the National Comprehensive Cancer Network

More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside/BroadcastMed. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. Follow JNCCN at x.com/JNCCN.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is marking 30 years as a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to defining and advancing quality, effective, equitable, and accessible cancer care and prevention so all people can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus-driven recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit NCCN.org for more information.

Journal

Journal of the National Comprehensive Cancer Network

DOI

10.6004/jnccn.2025.7020

Subject of Research

People

Article Title

Telehealth Geriatric Assessment and Supportive Care Intervention (GAIN-S) Program: A Randomized Clinical Trial

Article Publication Date

11-Jun-2025

How we really judge AI

Forget optimists vs. Luddites. Most people evaluate AI based on its perceived capability and their need for personalization.

Massachusetts Institute of Technology

Suppose you were shown that an artificial intelligence tool offers accurate predictions about some stocks you own. How would you feel about using it? Now, suppose you are applying for a job at a company where the HR department uses an AI system to screen resumes. Would you be comfortable with that?

A new study finds that people are neither entirely enthusiastic nor totally averse to AI. Rather than falling into camps of techno-optimists and Luddites, people are discerning about the practical upshot of using AI, case by case.

“We propose that AI appreciation occurs when AI is perceived as being more capable than humans and personalization is perceived as being unnecessary in a given decision context,” says MIT Professor Jackson Lu, co-author of a newly published paper detailing the study’s results. “AI aversion occurs when either of these conditions is not met, and AI appreciation occurs only when both conditions are satisfied.”

The paper, “AI Aversion or Appreciation? A Capability-Personalization Framework and a Meta-Analytic Review,” appears in Psychological Bulletin. The paper has eight co-authors, including Lu, who is the Career Development Associate Professor of Work and Organization Studies at the MIT Sloan School of Management.

New framework adds insight

People’s reactions to AI have long been subject to extensive debate, often producing seemingly disparate findings. An influential 2015 paper on “algorithm aversion” found that people are less forgiving of AI-generated errors than of human errors, whereas a widely noted 2019 paper on “algorithm appreciation” found that people preferred advice from AI, compared to advice from humans.

To reconcile these mixed findings, Lu and his co-authors conducted a meta-analysis of 163 prior studies that compared people’s preferences for AI versus humans. The researchers tested whether the data supported their proposed “Capability–Personalization Framework” — the idea that in a given context, both the perceived capability of AI and the perceived necessity for personalization shape our preferences for either AI or humans.

Across the 163 studies, the research team analyzed over 82,000 reactions to 93 distinct “decision contexts” — for instance, whether or not participants would feel comfortable with AI being used in cancer diagnoses. The analysis confirmed that the Capability–Personalization Framework indeed helps account for people’s preferences.

“The meta-analysis supported our theoretical framework,” Lu says. “Both dimensions are important: Individuals evaluate whether or not AI is more capable than people at a given task, and whether the task calls for personalization. People will prefer AI only if they think the AI is more capable than humans and the task is nonpersonal.”

He adds: “The key idea here is that high perceived capability alone does not guarantee AI appreciation. Personalization matters too.”

For example, people tend to favor AI when it comes to detecting fraud or sorting large datasets — areas where AI’s abilities exceed those of humans in speed and scale, and personalization is not required. But they are more resistant to AI in contexts like therapy, job interviews, or medical diagnoses, where they feel a human is better able to recognize their unique circumstances.

“People have a fundamental desire to see themselves as unique and distinct from other people,” Lu says. “AI is often viewed as impersonal and operating in a rote manner. Even if the AI is trained on a wealth of data, people feel AI can’t grasp their personal situations. They want a human recruiter, a human doctor who can see them as distinct from other people.”

Context also matters: From tangibility to unemployment

The study also uncovered other factors that influence individuals’ preferences for AI. For instance, AI appreciation is more pronounced for tangible robots than for intangible algorithms.

Economic context also matters. In countries with lower unemployment, AI appreciation is more pronounced.

“It makes intuitive sense,” Lu says. “If you worry about being replaced by AI, you’re less likely to embrace it.”

Lu is continuing to examine people’s complex and evolving attitudes toward AI. While he does not view the current meta-analysis as the last word on the matter, he hopes the Capability–Personalization Framework offers a valuable lens for understanding how people evaluate AI across different contexts.

“We’re not claiming perceived capability and personalization are the only two dimensions that matter, but according to our meta-analysis, these two dimensions capture much of what shapes people’s preferences for AI versus humans across a wide range of studies,” Lu concludes.

In addition to Lu, the paper’s co-authors are Xin Qin, Chen Chen, Hansen Zhou, Xiaowei Dong, and Limei Cao of Sun Yat-sen University; Xiang Zhou of Shenzhen University; and Dongyuan Wu of Fudan University.

The research was supported, in part, by grants to Qin and Wu from the National Natural Science Foundation of China.

###

Written by Peter Dizikes, MIT News

Journal

Psychological Bulletin

DOI

10.1037/bul0000477

Article Title

“AI Aversion or Appreciation? A Capability-Personalization Framework and a Meta-Analytic Review”

Study finds pitchers have thicker UCLs in elbows than other baseball players, factors that risk common injury

Arm slot not factor in who might suffer injury that leads to Tommy John surgery

University of Kansas

LAWRENCE — Every baseball season, players from major leagues to youth levels lose time because of injuries to the ulnar collateral ligament in the elbow. A University of Kansas researcher is co-author of a new study that used advanced technology to measure the thickness of baseball players’ UCLs, finding the ligaments were thicker in pitchers versus position players and that the common assumption of certain arm slots being less stressful on the elbow was not supported.

The findings, published in the Orthopaedic Journal of Sports Medicine, help demonstrate risks for the injury and how athletes, trainers and coaches can prevent them.

The researchers conducted a study with 22 NCAA Division I college baseball players over the course of a preseason. The players wore a sleeve with an embedded accelerometer that measured elbow torque and other variables while the players completed at least 1,000 throws during data collection. Ultrasounds were taken of their elbows.

Results showed that pitchers had thicker UCLs than nonpitchers and that all players had thicker UCLs in their throwing arm versus nonthrowing arm. Additionally, the study found that a player’s arm slot, or the angle of the arm during their throwing motion, did not differ between pitchers and nonpitchers.

Pitchers routinely make more throws — and more high-intensity throws — than other players. That their UCL thickness was greater was not a surprise. But better understanding how factors like elbow torque contribute to the condition of UCLs can help players develop better mechanics and trainers develop players with attributes that can reduce their risk of injury, said Quincy Johnson, assistant professor of health, sport & exercise science and assistant director of the Jayhawk Athletic Performance Laboratory at KU, and one of the study’s authors.

Prevention is valuable as players suffer UCL injuries at a high rate. In fact, the condition is even known as “Little League elbow” in youth sports.

“The purpose of this study came from members of the coaching and sports medicine staff who wanted to know if we could measure things like ligament size, and if we could include factors like height, weight and throwing mechanics to see if they make a difference,” Johnson said.

Pitchers more commonly suffer UCL injuries, and the procedure that repairs it is commonly known as “Tommy John surgery,” named after one of the first major league pitchers to undergo the procedure. But positional players have experienced both the injuries and surgeries as well. Previous research has indicated a positive relationship between UCL morphology, such as thickness, and increased UCL injury risk in 70 professional baseball pitchers. And ultrasound technology has shown to potentially be able to detect changes in the UCL prior to injury, hence better understanding what factors contribute to UCL thickness is valuable, Johnson said.

Conventional baseball wisdom has also long held that arm slot contributes to injury risk, with certain angles believed to be more dangerous or easier on the throwing arm.

“There are a lot of kids being told that there is an optimal arm slot for a pitcher, or others are harder on the arm, but it did not show that it had an effect on players’ UCL thickness in our study,” Johnson said.

Factors including higher elbow torque, higher-effort throws, volume of throws and speed of the arm during throws all correlated with a thicker UCL.

The study was co-written by Calvin Smith of Syracuse University, Brittany Dowling of Sports Performance Center, Chicago; Elias Williams of Oklahoma State University; Mitchel Magrini of Creighton University; Kase Pennartz of the University of North Texas; and Micheal Luera of Tarleton State University.

The study participants had to meet criteria of not having injuries to their throwing arm or current symptoms in the arm. Eleven were pitchers, and 11 were nonpitchers.

Johnson said the findings accomplish several things, including confirming thicker UCLs in pitchers versus nonpitchers and which factors did contribute to UCL morphology. They also can help coaches, athletes and athletic trainers develop strength and conditioning routines that help players enhance athletic performance, minimize their risk for injury and use better throwing mechanics.

Additionally, the findings refute the common belief factors such as height, weight and even-handedness as predictors for a proper arm slot for a given player.

A former strength and conditioning coach, Johnson hopes to continue research into UCL injury risk factors such as how the type of pitch thrown affects UCL morphology. The Jayhawk Athletic Performance Laboratory is part of the Wu Tsai Human Performance Alliance, which examines human health through understanding peak performance.

Johnson also recently published research on the specific body composition, strength and power characteristics key to different positions on the football field.

Ultimately, the UCL research can help coaches and players reduce injury risk, which can save money and recovery time as well as careers, as many young players never fully come back from UCL injuries. Teams have developed approaches such as maximum pitch counts to reduce risk, but more can be done.

“Is this the best way to go forward, where we’re routinely going through arms?” Johnson said. “We need to continue with a set of questions and ideas about things like throw volume and max effort throws to see if we can come up with better throwing development at lower levels of the sport.”

Journal

Orthopaedic Journal of Sports Medicine

DOI

10.1177/23259671251326030

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Influence of Throwing Kinematics on Ulnar Collateral Ligament Thickness in Collegiate Baseball Players

Characteristics of primary care physicians providing low-value care in japan

University of Tsukuba

Tsukuba, Japan—Low-value care refers to health care services that have little or no net clinical benefit to the patient. Reducing such care is essential for avoiding unnecessary examinations and treatments, reducing healthcare costs, and reallocating limited medical resources--both financial and human--to more effective services. Despite the significance of this issue, the characteristics of the physicians who are provide such care more frequently have not been thoroughly investigated.

Using records of approximately 2.5 million patients from a large-scale clinic claim database, the researchers analyzed the provision of 10 types of low-value care service provided in primary care. They found that approximately 1 in 10 patients received at least one low-value care instance annually, with an overall rate of 17.2 episodes per 100 patients per year.

Further, nearly half of all low-value care services were provided by 10% of the physicians, where older physicians, physicians who were not board certified, and physicians having higher patient volumes being more likely to provide low-value care. Regional variation was also observed, where rates were higher in western Japan. These findings suggest that policy interventions that target a small number of certain types of physicians providing large quantities of low-value care may be more effective and efficient than interventions targeting all physicians uniformly.

Reducing the frequency of low-value and ineffective medical interventions is important to ensure the sustainability of healthcare systems while maintaining patient safety and the quality of care. The insights that are gained from this study can help inform future policy and improvements in clinical practice to optimize healthcare delivery.

###
This study was supported by grants from the Health Care Science Institute (to Dr Miyawaki), the Japan Society for the Promotion of Science (grant 24K02701 to Dr Miyawaki), and Gregory Annenberg Weingarten GRoW @ Annenberg (to Dr Tsugawa).

Original Paper

Title of original paper:
Primary Care Physician Characteristics and Low-Value Care Provision in Japan

Journal:
JAMA Health Forum

DOI:
10.1001/jamahealthforum.2025.1430

Correspondence

Associate Professor MIYAWAKI, Atsushi
Institute of Medicine, University of Tsukuba

Digital Twin technology simulates strawberry farm, boosts AI tools and cuts costs

University of Florida

While strawberry production runs from November through April in Florida, digital twin technology lets scientists simulate the growth of the fruit year-round, allowing research to proceed year-round.

Digital twins are virtual replicas of objects, systems or processes that can predict system behavior as they interact in a simulated environment.

Dana Choi and her team of University of Florida scientists have now shown that that the robotic system, powered by artificial intelligence (AI), is accurate and that it saves time and labor. That’s critical for the $500 million-a-year Florida strawberry industry and could also be crucial for an industry worth $2 billion annually across the United States.

A few years ago, Choi’s team built a digital twin of a strawberry field that copies every row, leaf and berry at life-size. Within that virtual field, scientists let the robot drive around and take thousands of photos of a simulated commercial farm in Hillsborough County.

Newly published research shows that AI trained exclusively in a digital twin environment using simulated strawberry fields achieved 92% accuracy in detecting fruit, without relying on real-world training data.

“Because the computer-simulated field never goes out of season, new berry-spotting tools can be prototyped even in the summer – speeding innovation,” Choi said. “The findings also mean lower development costs. Companies can test robotic pickers or smart sprayer designs in the digital twin, first, ironing out bugs before real-life trials. That ultimately lowers the price of new technology.”

The robot trained entirely on synthetic images also estimated real-world fruit diameter with only 1.2 millimeters of error – “good enough for commercial grading, using only synthetic, simulated data,” said Choi, a UF/IFAS assistant professor of agricultural and biological engineering.

This demonstrates the potential of AI models trained in virtual environments to support commercial decision-making tasks, such as classifying fruit based on characteristics like size or quality.

If growers know precise fruit size and volume, they can predict their yields and know when to harvest.

“The study shows that a realistic digital twin can jump-start AI tool development for strawberry farms, enabling faster, more cost-effective robotics innovation,” said Choi, a faculty member at the UF/IFAS Gulf Coast Research and Education Center.

“Normally, we’d have to take thousands of photos in real fields, label each one and wait for the right season,” she said. “That takes a lot of time and money. But with a digital twin, we can create and label these photos instantly.”

Furthermore, training in the virtual world eliminates the need to handle or label real images, saving weeks of field work.

Why does all this matter? It takes less money and time to build and improve new tools because scientists can test and fix them in a virtual setting before trying them in real life.

The digital twin platform could also support operator training and rapid prototyping of autonomous machinery, helping move agricultural technology from concept to field faster and more cost-effectively.

Journal

AgriEngineering

DOI

10.3390/agriengineering7030081

Article Title

From Simulation to Field Validation: A Digital Twin-Driven Sim2real Transfer Approach for Strawberry Fruit Detection and Sizing

Scientific collaboration between São Paulo and France increases the impact of research conducted in both regions

The assessment was made by participants in the opening session of FAPESP Week France in Toulouse.

Fundação de Amparo à Pesquisa do Estado de São Paulo

Scientific collaboration between researchers from France and the state of São Paulo in various fields has intensified and expanded in recent years, contributing to the increased impact of research in both regions.

This assessment was made by participants in the opening session of FAPESP Week France, which takes place from June 10th to 12th in Toulouse, the capital of the Occitanie region in southern France.

“France, along with the United States, the United Kingdom, and Germany, is one of the most important long-term partners of the scientific community in São Paulo. Scientific and technological cooperation between the two regions has been strong and growing. Over the past six years, researchers from France and São Paulo have published 9,800 scientific articles together, representing 52% of all articles published in international collaborations during this period,” said Marco Antonio Zago, President of FAPESP.

According to data presented by the Foundation’s director, the average citation impact of all articles published by French scientists who do not collaborate with São Paulo colleagues is 1.37. The average for São Paulo researchers is 1.02, which is above the world average. However, articles published last year by researchers from both regions in partnership had an average impact of 5.2.

“Collaboration is very good for both regions. That’s why we’re here today – to expand and strengthen this collaboration, which can take many different forms,” he emphasized.

The FAPESP Week France program features lectures by researchers affiliated with universities and research institutions, as well as science and technology-based companies and startups in the fields of health and aeronautics from the state of São Paulo and France.

The aeronautics session will take place at the Higher Institute of Aeronautics and Space (ISAE-SUPAERO). The health session will take place simultaneously with the aeronautics session at the Hôtel-Dieu Saint-Jacques. It was organized in partnership with the Cancer Research Center of the French National Institute of Health and Medical Research (INSERM), the National Center for Scientific Research (CNRS), and the University of Toulouse.

The scientific relationship between French and Brazilian researchers began in the mid-19th century, recalled Vahan Agopyan, Secretary of Science, Technology, and Innovation for the State of São Paulo.

“We have a very long relationship, which was strengthened during the 1930s and resumed with greater force at the beginning of this century,” he said.

The secretary emphasized that events such as FAPESP Weeks are crucial for fostering these historical relationships and promoting the globalization of research in São Paulo. “This type of activity not only provides an opportunity for São Paulo researchers to interact with colleagues from other countries but also helps train better scientists and exposes them to an international research environment,” he said.

Opportunities for collaboration

According to Marie-Hélène Baroux, President of ISAE-SUPAERO, one of the areas with great potential for expanding scientific collaboration between Brazil and France is aeronautics.

“France and São Paulo have common interests in strategic sectors such as aviation, which include topics such as artificial intelligence, drone development, and sustainability in aviation. On both sides of the Atlantic, we’re united by the common goal of making aviation more sustainable by reducing greenhouse gas emissions in this sector by 2030,” she said.

“This meeting between the two regions at FAPESP Week France is important and natural because the state of São Paulo has the highest concentration of aerospace activities in Brazil, and Toulouse is the European capital of aeronautics and space, where more than 100,000 people work in the sector,” she emphasized.

During the opening of the event, the institution renewed its cooperation agreements with the Technological Institute of Aeronautics (ITA) and the São Carlos School of Engineering at the University of São Paulo (EESC-USP).

“FAPESP Week gives us an opportunity to renew cooperation agreements with these institutions, building on the existing collaboration with USP and UNICAMP [State University of Campinas]. And the vitality of our knowledge exchange with the state of São Paulo certainly paves the way for new opportunities for collaboration in the future,” said Baroux.

The opening ceremony was also attended by the President of Toulouse III – Paul Sabatier University, Odile Rauzy.

“This meeting in Toulouse seeks excellence in research and higher education to address social and environmental challenges. Together, moving in the same direction, we’ll be stronger at a crucial moment for science,” she said.

For more information about FAPESP Week France, visit fapesp.br/week/2025/france.

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Friday, June 13, 2025

New JNCCN study showcases how telehealth helps overcome geographic and resource gaps in cancer care globally

Journal

DOI

Subject of Research

Article Title

Article Publication Date

How we really judge AI

Journal

DOI

Article Title

Study finds pitchers have thicker UCLs in elbows than other baseball players, factors that risk common injury

Journal

DOI

Method of Research

Subject of Research

Article Title

Characteristics of primary care physicians providing low-value care in japan

Original Paper

Correspondence

Related Link

Journal

DOI

Article Title

Article Publication Date

Digital Twin technology simulates strawberry farm, boosts AI tools and cuts costs

Journal

DOI

Article Title

Scientific collaboration between São Paulo and France increases the impact of research conducted in both regions

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