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Danielle Noreika, Margaret Konecny Department of Risk Management, VCUHealth, Richmond, VA, USACorrespondence: Danielle Noreika, Department of Internal Medicine, VCUHealth, Richmond, VA, USA, Email Danielle.noreika@vcuhealth.orgAbstract: The opioid epidemic has caused major morbidity and mortality to Americans. Although there are multiple sources of this staggering issue, one inciting factor has been the use of opioids to manage pain. Although recent efforts have changed care pathways for patients with chronic pain, the first-line management of cancer pain remains opioids. Despite this, there is very little evidence and no guidelines/regulations to assist in the management of these patients. Although the literature suggests a number of current barriers to identifying and managing the challenges (such as the preferred management of patients with opioid use disorder (OUD), the optimal approach to taperering, or approaches to disparities), there are no concrete strategies for providers to manage these circumstances. Investing in further research utilizing the national opioid settlement funding, exploring the equity gaps using community based participatory research and community health worker models, and increasing provider education pathways are all potential approaches to improving this issue. These solutions could help identify and address some of the gaps that affect cancer patients taking opioids for pain.Keywords: opioids, cancer pain, disparities, education

The ABC and ACMG variant classification systems were compared by asking mainly European clinical laboratories to classify variants in 10 challenging cases using both systems, and to state if the variant in question would be reported as a relevant result or not as a measure of clinical utility. In contrast to the ABC system, the ACMG system was not made to guide variant reporting but to determine the likelihood of pathogenicity. Nevertheless, this comparison is justified since the ACMG class determines variant reporting in many laboratories. Forty-three laboratories participated in the survey. In seven cases, the classification system used did not influence the reporting likelihood when variants labeled as "maybe report" after ACMG-based classification were included. In three cases of population frequent but disease-associated variants, there was a difference in favor of reporting after ABC classification. A possible reason is that ABC step C (standard variant comments) allows a variant to be reported in one clinical setting but not another, e.g., based on Bayesian-based likelihood calculation of clinical relevance. Finally, the selection of ACMG criteria was compared between 36 laboratories. When excluding criteria used by less than four laboratories (<10%), the average concordance rate was 46%. Taken together, ABC-based classification is more clear-cut than ACMG-based classification since molecular and clinical information is handled separately, and variant reporting can be adapted to the clinical question and phenotype. Furthermore, variants do not get a clinically inappropriate label, like pathogenic when not pathogenic in a clinical context, or variant of unknown significance when the significance is known., (© 2024. The Author(s).)

Sustainable development goals (SDGs) in the United Nations 2030 Agenda call for action by all nations to promote economic prosperity while protecting the planet. Projection of future land-use change under SDG scenarios is a new attempt to scientifically achieve the SDGs. Herein, we proposed four scenario assumptions based on the SDGs, including the sustainable economy (ECO), sustainable grain (GRA), sustainable environment (ENV), and reference (REF) scenarios. We forecasted land-use change along the Silk Road (resolution: 300 m) and compared the impacts of urban expansion and forest conversion on terrestrial carbon pools. There were significant differences in future land use change and carbon stocks, under the four SDG scenarios, by 2030. In the ENV scenario, the trend of decreasing forest land was mitigated, and forest carbon stocks in China increased by approximately 0.60% compared to 2020. In the GRA scenario, the decreasing rate of cultivated land area has slowed down. Cultivated land area in South and Southeast Asia only shows an increasing trend in the GRA scenario, while it shows a decreasing trend in other SDG scenarios. The ECO scenario showed highest carbon losses associated with increased urban expansion. The study enhances our understanding of how SDGs can contribute to mitigate future environmental degradation via accurate simulations that can be applied on a global scale., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2023 Science China Press. Published by Elsevier B.V. All rights reserved.)