US cancer centers continue to see chemotherapy shortages, according to update from NCCN

The National Comprehensive Cancer Network found access to carboplatin and cisplatin has improved, but only slightly since the organization released initial survey results in June; other anti-cancer drugs remain scarce as well

Reports and Proceedings

NATIONAL COMPREHENSIVE CANCER NETWORK

PLYMOUTH MEETING, PA [October 5, 2023] — The National Comprehensive Cancer Network® (NCCN®)—a non-profit alliance of leading cancer centers across the United States—has released a follow-up survey on the ongoing chemotherapy shortages: 72% of the centers surveyed continue to experience a shortage of carboplatin and 59% are still seeing a shortage of cisplatin. Overall, 86% of centers surveyed reported experiencing a shortage of at least one type of anti-cancer drug.

View the updated survey results at NCCN.org/platinum-update.

The NCCN Best Practices Committee originally shared survey results in June 2023, which found that 93% of cancer centers surveyed at that time were experiencing a shortage of carboplatin and 70% lacked a steady supply of cisplatin. NCCN’s follow-up survey was conducted September 6 – 27, 2023.

Both surveys focused on two platinum-based generic chemotherapy medications that are recommended for treating hundreds of different cancer scenarios according to the NCCN Drugs & Biologics Compendium (NCCN Compendium®). The searchable database features every recommended use for cancer medication found in any of the evidence-based, expert consensus recommendations in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®)—the recognized standard for clinical direction and policy in cancer management.

“Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines,” said Robert W. Carlson, MD, Chief Executive Officer for NCCN. “Drug shortages aren’t new, but the widespread impact makes this one particularly alarming. It is extremely concerning that this situation continues despite significant attention and effort over the past few months. We need enduring solutions in order to safeguard people with cancer and address any disparities in care.”

The September 2023 survey included responses from 29 out of NCCN’s 33 Member Institutions—all leading academic centers from across the United States, which may not reflect any additional challenges experienced by smaller community practices serving rural and marginalized patients. Nearly all reported being able to continue treating every patient who needs carboplatin or cisplatin, despite lowered supply, primarily by implementing strict waste management strategies.

The survey results also revealed several other key medications that are currently in short supply, including 66% reporting a shortage of methotrexate, 55% for 5-flourouracil, 45% for fludarabine, and 41% for hydrocortisone.

“These drug shortages are the result of decades of systemic challenges,” said Alyssa Schatz, MSW, Senior Director of Policy and Advocacy for NCCN. “We recognize that comprehensive solutions take time and we appreciate everyone who has put forth proposals to improve investment in generics and our data infrastructure. At the same time, we have to acknowledge that the cancer drug shortage has been ongoing for months, which is unacceptable for anyone impacted by cancer today. These new survey results remind us that we are still in an ongoing crisis and must respond with appropriate urgency.”

NCCN Continues to Advocate for Solutions

NCCN released a statement on the shortage in June 2023, calling for action from the Federal Government and its agencies, the pharmaceutical industry, providers, and payers to work together to ensure quality, effective, equitable, and accessible cancer care. Since then, the organization has worked with the White House, National Cancer Institute, Centers for Medicaid and Medicare, along with other oncology nonprofits to advocate for short- and long-term fixes.

“We are grateful for all of the progress that has been made since June, but we won’t rest until we know we can prevent anti-cancer drug shortages from happening in the future,” said Dr. Carlson.

View an overview of NCCN’s findings to date on drug cancer shortages at NCCN.org/policy.

# # #

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so all patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus 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.

 

UNIST student startup sets new global standard for companion animal pet registration

Business Announcement

ULSAN NATIONAL INSTITUTE OF SCIENCE AND TECHNOLOGY(UNIST)

 

IMAGE: 

PIRECO PAVES THE WAY FOR PET IDENTIFICATION TECHNOLOGY BASED ON "NOSE WRINKLES" TO BECOME AN INTERNATIONAL STANDARD.

view more 

CREDIT: UNIST

Pireco Co., Ltd., a student-led venture company of UNIST, has accomplished a remarkable feat in establishing an international standard for their multi-biometrics identification solution designed for companion animals. This groundbreaking solution simplifies the process of accurately identifying and registering companion animals by simply scanning the distinctive patterns of ridges and creases on their noses using smartphones. The advent of this pioneering technology sets the stage for global registration and identification of companion animals.

On September 8, UNIST made an official announcement regarding the consent of the “Multi-biometric Identification and Registration Technology Standards for Companion Animals” developed by Pireco. This consent was granted during a meeting held at KINTEX in Ilsan by the International Telecommunication Union (ITU), the United Nations specialized agency for information and communication technologies. Following a four-week period to gather opinions from ITU members, the consented standard will be officially approved as an ITU international standard. Since April 2020, Pireco has worked in collaboration with Dr. Jae-Sung Kim of the Korea Internet & Security Agency (KISA) to develop international standards for their multi-biometrics identification solution, focusing on nose patterns.

The current Enforcement of Decree of Animal Protection Act only acknowledges the use of an RFID-based system for registering companion and does not consider nose print-based registration as a valid method. However, as international standards for assessing the reliability of technology have been established, there is an anticipation that the revision of the current law to include nose print-based registration will gain traction. Presently, the registration process for companion dogs involves the insertion of a microchip, ensuring lifelong identification. Nevertheless, with the amendment of the legislation, the pet registration process can be simplified by employing nose print-based registration as an alternative approach. This modification is projected to streamline the process and facilitate an enhancement in the current low pet registration rate, which currently stands at approximately 50%. The low registration rate has been identified as a significant impediment to the advancement of pet insurance, a matter of utmost national importance.

Tae-Heon Kim, the CEO of Pireco, has expressed his utmost satisfaction in spearheading the establishment of the world’s first international standard for pet identification technology. He emphasized the company’s commitment to actively promoting global expansion, by saying “We are actively promoting overseas expansion to ensure that technologically advanced countries in the pet industry can readily adopt Korean innovations.”

Established in 2018, Pireco specializes in providing registration solutions for companion animals through the utilization of unique biometric traits, such as iris and nose prints. With the adoption of this international standard, Pireco has gained a significant advantage in securing intellectual property rights related to this cutting-edge technology. In the latter half of this year, the company plans to initiate a pilot project for issuing dog ID cards, leveraging the regulatory sandbox demonstration special case designation.

 

Digitizing UK natural history collections is vital to understand life on earth, reports the Natural History Museum

Modest estimates report a saving of £18 million in efficiencies by researchers accessing digital data rather than physical collections

Peer-Reviewed Publication

PENSOFT PUBLISHER

 

IMAGE: 

SPECIMENS FROM THE NATURAL HISTORY MUSEUM

view more 

CREDIT: TRUSTEES OF THE NATURAL HISTORY MUSEUM, LONDON

• 
  

• Scientists from the Natural History Museum (NHM) deep dive into the uses and users of natural history collections held in the UK

• Today, software can complete in a week what it would take a human two years to achieve

• Call for investment to secure the UK’s stance as a world superpower in science and tech, and for a future in which both people and planet thrive

A new report has evaluated the use and impact of digitised natural science collections held in the UK and how they contribute to scientific, commercial and societal benefits. 

UK natural science collections hold more than 137 million items spanning an incredible 4.56-billion-year history of life on Earth. These collections have emerged as a pivotal data resource to understanding the Earth in its past and current state - and will continue to inform the investors and policy-makers of the future. 

UK natural science data in demand

GBIF—the Global Biodiversity Information Facility—is an international database providing open access data on all types of life on Earth. In this paper led by the NHM, scientists report that there are 7.6 million specimens, less than 6% of total UK natural science collections sampled, freely accessible on GBIF. 

They found that 12% of the total peer-reviewed journal articles citing GBIF data specifically cite UK natural science collections. These data currently make up just 0.3% of total occurrences on GBIF, meaning they punch an incredible 40 times above their weight.

When asked previously, over 90% of GBIF users linked their use of these data to advancing the UN Sustainable Development Goals which look to reduce hunger, poverty and inequality, and spur economic growth while tackling climate change and protecting the oceans and forests.

The case for digitising UK natural science collections  

The introduction of these collections onto a digital platform has revolutionised scientific research. In this paper published in the journal Research Ideas and Outcomes, the authors estimate £18 million has been saved in efficiencies by researchers accessing digital specimens rather than physical collections, assuming a minimal single physical visit replaced per citation. Of this, £1.4 million has been attributed to UK researchers, money which can be reinvested back into UK science institutions – those at the forefront of finding solutions to real world problems.

Lead author and Deputy Head of Digital, Data and Informatics, Helen Hardy says, ‘The advancement of digitisation has been truly transformational to the scientific community. Today it’s possible to use software that takes a week to achieve the type of information gathering it would take a human over 3,000 hours, or two years, to complete - individuals realising an entire life’s work in just a few months! Anticipation is high for further innovations such as the further integration of artificial intelligence into taxonomic work.’

UK government want the UK to be a science and technology superpower, and natural science collections provide a unique opportunity to achieve this. To unlock the true potential of collections data, UK Natural Science collections are joining forces through the Distributed System of Scientific Collections UK (DiSSCo) to make the case for investment of £155 million in a research infrastructure which is expected to unlock at least a seven- to ten- fold economic return on investment. 

Working alongside the Arts & Humanities Research Council (AHRC) and UK Research and Innovation (UKRI) to digitise the critical mass of collections, the data will be available through a robust technological infrastructure and continually developed in line with recent innovations. 

Ken Norris, Deputy Director of Science at the NHM says, ‘In the midst of a planetary emergency, and what some experts believe to be the Earth’s sixth mass extinction event, estimates say that over 50% of the world’s GDP, which equates to approx. 44 trillion dollars, is dependent on the natural world. By understanding what is in collections now, both on a national and international scale, we can identify trends, actions and what we need to collect to underpin policy and investment decisions for a future where people and planet thrive.’

ENDS

Natural History Media contact: Tel: +44 (0)20 7942 5654 / 07799690151  
Email: press@nhm.ac.uk

Images available here.  

Hardy H, Livermore L, Kersey P, Norris K, Smith V, Pullar J (2023) Users and uses of UK Natural History Collections – a Summary, https://doi.org/10.5281/zenodo.8369299

A longer paper on this study including further detail on the methodology and findings is also available: 

Hardy H, Livermore L, Kersey P, Norris K, Smith V (2023) Understanding the users and uses of UK Natural History Collections. Research Ideas and Outcomes 8: e113378 https://doi.org/10.3897/rio.9.e113378

About the Natural History Museum:

The Natural History Museum is a world-leading science centre and one of the most visited attractions in the UK. A global source of curiosity, inspiration and joy.

Our vision is to build a future in which both people and the planet thrive.

We aim to be a catalyst for change, engaging advocates for the planet in everything that we do. Our 350 scientists are finding solutions to the planetary emergency in all aspects of life.

Visit, join and support the Natural History Museum today. Protecting the planet. It's in our nature.

Specimens from the Natural History Museum

CREDIT

Trustees of the Natural History Museum, London

---

JOURNAL

Research Ideas and Outcomes

DOI

10.3897/rio.9.e113378 

ARTICLE TITLE

Understanding the users and uses of UK Natural History Collections

ARTICLE PUBLICATION DATE

2-Oct-2023

 

Employing artificial intelligence in the transition to healthy soils

Business Announcement

INTERNATIONAL INSTITUTE FOR APPLIED SYSTEMS ANALYSIS

IIASA researchers are collaborating on a new Horizon Europe project, which will use artificial intelligence to help farmers and land managers analyze their soil health without the need for a laboratory.

The AI4SoilHealth project aims to create a digital platform using artificial intelligence (AI) to provide a comprehensive assessment of soil health across Europe and support the European Commission’s objective of transitioning towards healthy soils by 2030.

Today, it is estimated that between 60 and 70% of the EU’s soils are unhealthy. Healthy soils capture carbon, improve yields, help reduce flooding, and boosts biodiversity, but they are under pressure from current farming practices and the increasing demand for food. To reverse this trend, we need to understand which farming practices work and which do not to restore soil health. The climate crisis leaves little room for mistakes as soil is complex and we need to map changes into the future so we can make and implement the right strategies in the right places. To do this, land managers and policymakers have to be equipped with the appropriate tools to give them the confidence to make the required changes to their farming practices to improve soil health and resilience.

"We are at a crossroads. We need to do something if we are to preserve European and global soil resources. It is a paradox that on the one hand soil is part of the solution to reduce greenhouse gas emissions, and at the same time 60-70% of Europe's soil is not doing well. It is therefore imperative that we have better monitoring of soil quality,” explains Mogens H. Greve from the Department of Agroecology at Aarhus University, who coordinates the AI4SoilHealth project.

The project will provide an effective soil health index certification system to support landowners and policymakers under the European Green Deal and a free app developed as part of the project, will help farmers and growers make changes in their farming practices.

Researchers from the Agriculture, Forestry, and Ecosystem Services (AFE) Research Group of the IIASA Biodiversity and Natural Resources Program will contribute expertise to the project by providing pan-European predictions of future soil organic carbon status and dynamics in response to climate change, taking into account crop varieties, soil management, and land use interventions. They will use the IIASA Environmental Policy Integrated Climate-based Global Gridded Crop Model (EPIC-IIASA) to simulate complex relationships in the system. The future soil health indicators resulting from the IIASA team’s modeling efforts, will be approximated for end-users by AI-based solutions and will eventually feed into a European Soil Health Data Cube – a data service for a variety of stakeholders operated in close collaboration with the European Commission’s Joint Research Center.

“Being part of this project is a great opportunity for the EPIC-IIASA team to get involved in the European Union’s plans for transitioning towards healthy soils by 2030. It is also a chance for us to put our existing knowledge on crop systems into practice in a novel way, including the application of advanced data and statistical modeling with AI-based tools,” notes Rastislav Skalsky, a researcher in the AFE Research Group at IIASA.

The project will create and maintain an open access Europe-wide digital infrastructure, compiled using state-of-the-art AI methods combined with new and deep soil health understanding and measures. Over the next three years, the 28 partners spanning 11 EU countries will collect data from farms and pilot sites across Europe to build a model to work from. Along the way they will share their learnings, educating people about the latest soil health measurement techniques and sharing stories from the soil practitioner community.

AI4SOILHealth demands a multi-layered approach with seven key work-streams including policy and stakeholder engagement, development of soil health methodology and standards, developing field and laboratory solutions for observations and measurement, and harmonization across EU-wide soil monitoring services. It will also utilize pilot models in several countries running field trials to establish user testing and feedback, and building communication tools to develop campaign and educational to promote awareness and adoption.

Horizon Europe is the EU’s key funding program for research and innovation with a budget of €95.5 billion. It tackles climate change, helps to achieve the UN’s Sustainable Development Goals, and boosts the EU’s competitiveness and growth by funding different types of collaborative projects. AI4SOILHealth is one of Horizon’s key Research and Innovation Action (RIA) projects which seeks to fund the establishment of new knowledge, and explore new or improved technology and solutions.

Further info:
Visit the official project website at https://ai4soilhealth.eu/

 

About IIASA:
The International Institute for Applied Systems Analysis (IIASA) is an international scientific institute that conducts research into the critical issues of global environmental, economic, technological, and social change that we face in the twenty-first century. Our findings provide valuable options to policymakers to shape the future of our changing world. IIASA is independent and funded by prestigious research funding agencies in Africa, the Americas, Asia, and Europe. www.iiasa.ac.at

 

Guarantees of optimality: a new model to help the manufacturing industry transition to renewables

Solar thermal technology has huge, untapped potential, and UConn researchers are making tools to help manufacturers realize the possibilities and take the plunge for renewable energy

Peer-Reviewed Publication

UNIVERSITY OF CONNECTICUT

The sixth UN Intergovernmental Panel on Climate Change report, which came out in the spring of 2022, was clear: technologies are available now to make the transition away from a fossil-fueled economy. However, making these swift changes is not as simple as flipping a switch.

For industry, rigorous guarantees are needed before decisions and costly investments are made, and UConn engineering researchers have developed a dynamical model to help companies determine if renewables make economic sense.

Pratt & Whitney Associate Professor in Advanced Systems Engineering Matthew Stuber worked with two undergraduate students and co-lead authors Justin Rastinejad ’22 (ENG) and Sloane Putnam ’22 (ENG) answer this question in their recent paper published in Renewable Energy.

Stuber explains that this research answers a question he has been thinking about for several years now, “How do we start incorporating renewable energy into conventional industrial processes? Is it always worth it? The alternative is to buy energy in the form of fossil fuels, invest in renewables, or generate energy onsite through renewable means.”

The answers require accounting for many variables, including costs, power inputs and outputs, and determining which renewable technologies to adopt in lieu of fossil fuels. It is complex and non-linear, says Stuber, and must account for fluctuations in generation, since renewables are reliant on conditions like the sun and wind. The most accurate estimations require a rigorous evaluation process, and oftentimes manufacturers simply do not have the time and resources to perform these complicated assessments.

“My original work in this area was focused on desalination and water treatment in applications for agriculture where there is a lot of wastewater, a lot of water scarcity, and a lot of water consumption,” Stuber says. “This is at the heart of the food, energy, and water nexus. The one thing I was trying to answer was how do you do this sustainably? If it is a very energy or resource-intensive process, maybe we can use renewable energy to help reduce our climate impact, and stop this feedback loop from happening, because basically, water scarcity and drought are tied to climate change, and burning fossil fuels is contributing to climate change. This research is a holistic approach to the problem.”

The new paper focuses on questions surrounding incorporating renewable solar energy and determining which kind would be feasible to use in manufacturing processes. The solar technology that most people can recognize is photovoltaic (PV), which generates electricity using solar panels that collect sunlight and convert solar energy to electricity. The other technology is solar thermal, where the sun’s rays are concentrated (akin to a magnifying glass) and the energy is transferred to fluid within pipes, where it can be stored or transferred further in the form of heat. Though solar thermal has been used for years in many other areas of the world, and it has great promise for use in industrial applications, it was largely forgotten in the U.S. after the price for natural gas plummeted alongside increased rates of fracking.

“Most manufacturing processes require heat in some form, they might be using steam to sterilize or drive something, or they might use other kinds of thermal sources in their manufacturing process,” says Stuber. “Manufacturing is a huge chunk of the economy and it’s a huge energy consumer. Recent releases from the Department of Energy announce projects to electrify everything.”

Electrification can seem daunting, but renewables like solar thermal start to make more sense than “conventional” power sources in some scenarios. Stuber says that if you approach the problem from a power plant perspective, currently the process essentially turns fuel (fossil or nuclear) into thermal energy, and thermal energy into electricity (by powering turbines), which sends electricity to the grid. Manufacturers then take the electricity and convert it back to thermal energy for their needs.

To look for a better process, researchers set out to see if solar power generated on-site was a feasible option.

“A decade ago, when we were looking at this problem, we argued that thermal would be better for certain applications,” says Stuber. “However, with the massive reduction in the cost of photovoltaics, we were seeing photovoltaic prices plummeting, and everyone was saying PV is the way to go for everything. Now we’re 10 years on and I was wondering where we are today.”

The researchers performed a formal analysis of a hypothetical manufacturing process that requires heat in different regions of the United States, including California, Massachusetts, and Colorado, to test different solar resource availability and holistically assess economic viability.

They created a mathematical model, and the results were promising.

“The main takeaway is that batteries are extremely expensive, and they don’t make sense in the manufacturing sector right now, but solar thermal wins. If you have a manufacturing process that needs heat within a certain temperature range, solar thermal is going to be the choice for you,” Says Stuber.

The results showed that solar thermal is a viable choice to reduce fossil fuel reliance for industries that rely on low to medium heat for processes, regardless of location or scale.

“This model is highly adaptable. It can account for changes in location, process size, natural gas price, and many other specifications. This helps companies decide where and how to install a solar-powered industrial site,” says Rastinejad.

The model is available on GitHub to be used by anyone hoping to perform their own assessments. Stuber says this model can be helpful not just for companies but for anyone looking to do this type of rigorous analysis.

“The model simulates the exact performance of the system on an hourly basis over an entire year. It’s taking in near real-time solar data and simulating if the technology would be sending energy to the process, storing it, discharging the storage, or using backup energy if there is cloud cover. The model represents the performance of the system and can help with accurate design and more accurate economic estimates of the cost or cost savings of implementing renewable technology.”

Without a rigorous and accurate analysis, it is not possible to know for certain if these kinds of upgrades are economically viable. We need to quickly transition away from fossil fuels, the researchers hope this tool will help.

“My goal with this paper is to convince companies, policy makers, and the general public that they now have the tools to make costly decisions with confidence; I want the reader to understand that anyone can adapt this model to find the best configuration of hybrid solar thermal power for their own site-specific conditions,” says Putnam.

Stuber is now working with a team of undergrads as part of the Clean Energy and Sustainability Innovation Program (CESIP) to look at strategies to decarbonize UConn using some of the same ideas from this paper,

“Can we install renewable energy around campus to offset energy needs? I see this assessment as an important tool in addressing those concerns,” says Stuber.

---

JOURNAL

Renewable Energy

DOI

10.1016/j.renene.2023.119069 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Technoeconomic assessment of solar technologies for the hybridization of industrial process heat systems using deterministic global dynamic optimization

 WHITE SUPREMACIST MEDICINE

Factors linked to racial disparities in chronic pain after injury

Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA

Chronic pain is a top cause of disability in the United States, with the costs of medical care and lost productivity exceeding $500 billion, according to an Institute of Medicine report. Many people who suffer an acute traumatic injury—such as from a car crash or violence—continue to experience pain in the year after injury.

Past research has independently established the existence of racial disparities in injury outcomes and in the severity and treatment of chronic pain but not which factors impact chronic pain after an injury. But a collaborative new study led by researchers at the University of Pennsylvania School of Nursing and published in the journal Injury Prevention provides new insights into when and why an injury progresses to chronic pain. 

The study enrolled a cohort of 650 adult participants—38% white, 33% Black, and 26% Hispanic—from two Level 1 trauma centers in Pennsylvania and Texas. Researchers collected data from medical records and patient interviews within days of injury, three months after injury, and 12 months postinjury. The researchers also assessed preinjury pain, perceived pain control, post-traumatic stress disorder symptoms, depression symptoms, discharge with an opioid prescription and follow-up provider visits.

The study found that among seriously injured adults, racial and ethnicity-based disparities in chronic pain may be most driven by differences in the nature of and health care response to acute injuries. Factors associated with disparities include mechanism of injury, severity of injury, pain in the hospital, and length of hospital stay. As an example of differences in mechanisms of injury, Black participants—who reported the highest chronic pain severity in the year after injury—were more likely to be injured by violence when compared to white and Hispanic participants.

“I think that the takeaway, for me, was that you can’t take prevention out of the picture when thinking about intervening on racialized disparities in long-term recovery,” says Sara Jacoby, associate professor of nursing and the first author on the study. 

“The absolute best targeted response is to prevent the injury from happening, and that is our responsibility. Just like we want to do preventative care to prevent a heart attack or stroke, we want to prevent injury from happening,” says senior author Therese Richmond, the Andrea B. Laporte Professor of Nursing. She says the second-best targeted response is optimally and equitably treating acute pain during hospitalization.

Jacoby notes that stereotypes and stigma can play into whether patients are believed about their pain and what treatment they receive. The paper cites recent research showing that minority patients in the U.S. receive less analgesia for acute pain, regardless of condition, when receiving emergency medical care.

Preinjury pain did not differ across race and ethnicity, but Black participants had higher pain severity on average relative to white participants three and 12 months after injury. The group of factors most associated with outcome disparities at three and 12 months were those related to acute hospitalization: injury mechanism and severity, pain in the hospital, and length of hospital stay.

Richmond says that, while this research is a big step forward, it does not fully explain the disparities, and other factors remain unknown, so there is still more work to be done.

Sara F. Jacoby is an associate professor of nursing, Calvin Bland Fellow in the University of Pennsylvania School of Nursing, and senior fellow at Penn’s Leonard Davis Institute of Health Economics.

Therese S. Richmond is the Andrea B. Laporte Professor of Nursing in the University of Pennsylvania School of Nursing and a senior fellow at Penn’s Leonard Davis Institute of Health Economics.

Other co-authors on the paper include Eunice C. Wong and Terry L. Schell from the RAND Corporation and Mark B. Powers and Ann Marie Warren from Baylor University Medical Center.

Funding for this research came from the National Institute of Minority Health and Health Disparities (R01MD010372).

---

JOURNAL

Injury Prevention

DOI

10.1136/ip-2023-044876 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Factors associated with racial and ethnic disparities in chronic pain after acute traumatic injury

Racial and ethnic disparities in glycemic control among insured adults

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this study of 4,070 insured adults with diabetes, disparities in poor glycemic control persisted despite adjustment for social, health care, and behavioral factors. Research is needed to identify the barriers contributing to poor control even in populations with access to care. 

Authors: Sandra S. Albrecht, Ph.D., M.P.H., of the Columbia University Mailman School of Public Health in New York, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.36307)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article

http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2023.36307?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100523

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

---

JOURNAL

JAMA Network Open

Botox improves chronic nausea and vomiting in children with disorder of gut-brain interaction

Could be used as targeted therapy for pyloric dysfunction

Peer-Reviewed Publication

ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO

A study from Ann & Robert H. Lurie Children’s Hospital of Chicago demonstrated that Botulinum toxin (Botox) injected in the pylorus (sphincter where the stomach exits into the small intestine) during endoscopy improves chronic nausea and vomiting in children who have a disorder of gut-brain interaction (DGBI). These debilitating symptoms not attributed to a defined illness have previously been called functional gastrointestinal disorders before the newer DGBI classification. The study’s findings point to a novel understanding of the condition’s pathology – pylorus that is failing to relax and allow food to effectively pass into the small intestine resulting in symptoms of nausea, vomiting, stomach fullness (early satiety), and bloating. Results were published in the Journal of Pediatric Gastroenterology and Nutrition.

“Our results suggest that chronic nausea and vomiting might be caused by pyloric dysfunction, rather than abnormal peristalsis, which is the rhythmic contraction and relaxation of digestive tract muscles needed to move foods and liquids through the gastrointestinal system,” said lead author Peter Osgood, MD, gastroenterologist at Lurie Children’s and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “This is a paradigm shift in our understanding of mechanistic pathology. Importantly, it opens the door to a more targeted use of Botox specifically in children who are found to have pyloric dysfunction during endoscopy, and for whom the current medications are not effective.”

In the study that included 25 patients, Dr. Osgood and colleagues looked for evidence of abnormal peristalsis. They found that in the majority of patients, this process was normal. They also found that most patients responded favorably to pyloric Botox injection, even when they did not have delayed gastric emptying.

“Pyloric dysfunction has been underexplored in the context of chronic nausea and vomiting in children,” said senior author John Fortunato, Jr, MD, Director of Neurointestinal and Motility Program at Lurie Children’s and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “We are pursuing further research to better understand pyloric pathology and its response to Botox therapy. Our study is a promising first step toward offering much needed relief to children suffering from these challenging symptoms.”

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is a nonprofit organization committed to providing access to exceptional care for every child. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine.

---

DOI

10.1097/MPG.0000000000003954