Supply Shortages Research Articles

The use of an automatic remote weight management system to track treatment response, identified drugs supply shortage and its consequences: A pilot study.

The objective of this pilot study is to evaluate the feasibility of using an automatic weight management system to follow patients' response to weight reduction medications and to identify early deviations from weight trajectories. The pilot study involved 11 participants using Semaglutide for weight management, monitored over a 12-month period. A cloud-based, Wi-Fi-enabled remote weight management system collected and analyzed daily weight data from smart scales. The system's performance was evaluated during a period marked by a Semaglutide supply shortage. Participants achieved a cumulative weight loss of 85 kg until a supply shortage-induced trough in October 2022. This was followed by a 6-8 week plateau and a subsequent 13 kg cumulative weight gain. The study demonstrated the feasibility of digitally monitoring weight without attrition over 12 months and highlighted the impact of anti-obesity drug (AOD) supply constraints on weight trajectories. The remote weight management system proved important for improving clinic efficacy and identifying trends impacting obesity outcomes through electronic data monitoring. The system's potential in increasing medication compliance and enhancing overall clinical outcomes warrants further research, particularly in light of the challenges posed by AOD supply fluctuations.

Mitigating freshwater supply shortages in regions of high demand in Ethiopia: integrated water resources management approach

Mitigating freshwater supply shortages in regions of high demand in Ethiopia: integrated water resources management approach

P-633. Implementation and Uptake of Nirsevimab within Nemours Children’s Health Delaware Healthcare System

Abstract Background Nirsevimab, the first FDA approved monoclonal antibody to protect against Respiratory Syncytial Virus (RSV), became available for the 2023-2024 RSV season. Distribution of nirsevimab was affected by cost and a supply shortage, limiting overall uptake. Nemour’s Children’s Hospital in Delaware (NCH) implemented several strategic measures to promote immunization despite these barriers, including educational series and periodic communication of regional supply chain status. The purpose of this project was to analyze characteristics of patients who received nirsevimab at NCH and corresponding trends over the 2023-2024 season. Methods We report descriptive summaries of patients who received nirsevimab at NCH from October 2023 to March 2024. Variables analyzed included age, timing of immunization, clinical site and setting, race, sex, insurance status, and state where the patient received the immunization (PA or DE). We compared the distributions of these characteristics by vaccination month using chi-square tests. Results 1,842 infants received nirsevimab, most of which were under 8 months of age (95.7%) at time of immunization (Table 1). Nirsevimab uptake varied by month (Figure 1), with most patients receiving the immunization in November and December. The distribution of immunizations across visit type (outpatient/inpatient, p< 0.001), insurance type (public/private, p< 0.001), and state (DE/PA) varied significantly across months. The distributions of patient-reported sex and race did not vary significantly by month (Table 2). Conclusion Unpredictable supplies of nirsevimab and varying immunization strategies among clinic sites affected distribution and uptake among patients. Some clinics were faced with prioritizing high-risk populations or were restricted by patient insurance policies. These challenges resulted in differing populations having access to nirsevimab based on time of year. Further efforts can focus on unifying immunization promotion techniques and identifying ways to ensure equitable distribution to our target populations. Disclosures All Authors: No reported disclosures

Saving gas through cross-border renewable and nuclear electricity generation

Abstract In fossil fuel-driven electricity markets, gas power plants are mostly the price setting technology in peak demand hours. At the same time, gas technology has the role of balancing out the volatility of increasing shares of intermittent renewable generation. This interdependence, coupled with recent fears of supply shortages, raises the question how gas-fired generation can be replaced with carbon-free technologies. Controlling for fundamental supply and demand in the interconnected markets, we quantify the effect of intermittent renewable and nuclear generation in neighboring markets on the use of natural gas for electricity generation in Germany. Findings indicate that cross-border intermittent wind, PV, and nuclear generation significantly reduce the need for German gas. We further show Germany’s dependency on French cross-border nuclear energy to supplement the gas unavailability during the gas crisis period. We argue for larger market coupling and flexible generation alternatives and adaptive demand solutions including cross-border capacities for substituting gas when renewable generation is low across Europe.

Diversity of biomass usage pathways to achieve emissions targets in the European energy system

Abstract Biomass is a versatile renewable energy source with applications across the energy system, but it is a limited resource and its usage needs prioritization. We use a sector-coupled European energy system model to explore near-optimal solutions for achieving emissions targets. We find that provision of biogenic carbon has higher value than bioenergy provision. Energy system costs increase by 20% if biomass is excluded at a net-negative (−110%) emissions target and by 14% at a net-zero target. Dispatchable bioelectricity covering ~1% of total electricity generation strengthens supply reliability. Otherwise, it is not crucial in which sector biomass is used, if combined with carbon capture to enable negative emissions and feedstock for e-fuel production. A shortage of renewable electricity or hydrogen supply primarily increases the value of using biomass for fuel production. Results are sensitive to upstream emissions of biomass, carbon sequestration capacity and costs of direct air capture.

Have crops already reached peak suitability: assessing global climatic suitability decreases for crop cultivation

Abstract Crop yield and the availability of arable land are impacted by climate change, leading to effects on global patterns of production and trading. To gain more precise insights in how future climate change might lead to redistributing productive crop areas, we developed a new method to assess climatic crop suitability, which combines temperature and precipitation suitability through water balance calculations. We applied the method to evaluate the effects of climate change under two climatic scenarios (SSP2-4.5 and SSP5-8.5), using an ensemble of five GCMs, for nine crops (Arabica coffee, cassava, common beans, common wheat, maize, plantain, rice, sorghum and sugarcane) for four periods of time: past (1995-2014), present day (2015-2034), medium term (2040-2059), long term (2080-2099. We observed that the fraction of area with optimal suitability might be on a downward trajectory for coffee, cassava, beans, wheat and plantain, and could be halved by the end of the century. The tropics and sub-tropics are negatively affected for all crops, while mid-latitudes see large decreases in suitability for beans, wheat and maize. Global patterns show that suitability decreases at local levels (in about 30% of the global area for bean and wheat) are not compensated by increases in suitability elsewhere (in about 19% of the area for bean and wheat). As relocation and expansion of production areas are constrained by available arable land, other strategies might be considered to improve suitability, such as irrigation, which would increase the area of optimal suitability from 5-25% to 40-50% of total arable land for the nine crops. Drainage could improve the optimal suitability area fivefold for maize and sorghum, while shading increases suitability for coffee (by up to 20% in both cases). The increased risk of food supply shortages led by climatic suitability loss may trigger increased deforestation if adaptation measures are not implemented.

Supply and Demand of Rice in Indonesia: A Critical Review

The demand and supply of rice as a staple food is a crucial factor in the food supply chain and food security in Indonesia. Indonesia still faces a deficit in domestic rice supply, which leads the government to adopt import policies to fill this shortage. Therefore, there is a need to understand the dynamics of rice supply and demand, as the interaction between the two is complex, to address food security concerns. This research aims to critically assess the dynamics of rice supply and demand in Indonesia, highlighting the key challenges and opportunities to improve food security. Using a critical review methodology, the study analyzes and critiques recent linear studies, literature, government policies, and statistical data to highlight their strengths, weaknesses, and challenges, providing a comprehensive understanding of the rice production supply and demand. The conclusion of this research is that a holistic approach is needed to achieve food security. The findings suggest that Indonesia must implement a comprehensive approach, incorporating environmental, political, and socioeconomic factors in food security. Future research should explore the role of climate resilience and global trade dynamics in shaping Indonesia’s rice sector. This comprehensive perspective can help decision-makers create a more sustainable food system.

Impact of electric vehicle battery recycling on reducing raw material demand and battery life-cycle carbon emissions in China

The rapid growth of electric vehicles (EVs) in China challenges raw material demand. This study evaluates the impact of recycling and reusing EV batteries on reducing material demand and carbon emissions. Integrating a national-level vehicle stock turnover model with life-cycle carbon emission assessment, we found that replacing nickel-cobalt-manganese batteries with lithium iron phosphate batteries with battery recycling can reduce lithium, cobalt, and nickel demand between 2021 and 2060 by up to 7.8 million tons (Mt) (67%), 12.4 Mt (96%), and 37.2 Mt (93%), respectively, significantly decreasing reliance on import. Moreover, battery recycling coupled with reuse can reduce carbon emissions by up to 6,532-6,864 Mt (36.0-37.9%), depending on four recycling methods employed. However, this reuse strategy delays battery recycling and risks lithium supply shortage, necessitating trade-offs between carbon reduction and material supply. Future technologies, such as lithium-sulfur and all-solid-state batteries, despite their energy efficiency, might exacerbate lithium shortage, underscoring the crucial need for increased lithium supply.

WHO public health laboratories webinar series - an online platform to disseminate testing recommendations and best practices during health emergencies.

Laboratories play a central role in managing public health emergencies. The COVID-19 pandemic imposed unique challenges on global laboratory systems, including testing protocol uncertainties, supply shortages, rapid need for information dissemination, and disruptions to traditional training methods. In response, the WHO established the Public Health Laboratories (PHL) knowledge sharing webinar series whose goals were to respond to the increased demand in up-to-date and reliable information, which WHO is in a unique position to provide. It also aimed to enhance peer-to-peer exchanges across laboratories. This article outlines the PHL webinar series delivery format and presents how the webinar series was received and perceived by participants and how it evolved to support the response to other health emergencies. Contents of the knowledge sharing sessions, as well as attendance, participants' satisfaction and application of learning were monitored over time using registration forms, satisfaction polls, an annual survey and focus group discussions. From May 2020 to December 2023, 48 sessions attracted 58,688 registrations from 204 countries and territories. Thirty-five sessions featured presentations of WHO guidance, tools or documents and 39 sessions featured country experience sharing. Initially focused on COVID-19, the series became a tool to rapidly disseminate guidance and best practices during new health emergencies and to address cross-cutting topics relevant to the laboratory workforce. Feedback data shows participants found the webinars very useful (86% respondents), reporting knowledge gains in biosafety, quality management, and laboratory practices. The series facilitated knowledge application, with foreseen changes in workplace procedures and training activities (43% respondents). Barriers such as resource limitations, additional training needs, and connectivity issues were frequently identified. Evidence that this knowledge was subsequently applied by participants, such as through changes in workflow, onwards training events and procedural changes further reinforces the efficacy with which the series was able support the laboratory workforce globally in addressing challenges of the COVID-19 pandemic and other health emergencies. The series utilized sessions on cross-cutting topics to run routinely and to keep a high level of engagement with laboratory professionals globally. This enabled it to act as an adaptable tool that was leveraged effectively and quickly during health emergencies for just-in-time learning.

Attribution of a record-breaking cold event in the historically warmest year of 2023 and assessing future risks

An unexpected record-breaking cold event struck eastern China in December 2023, causing widespread transportation shutdowns, power supply shortages, and agricultural crop damage. The manner in which such an extraordinary cold event was formed under global warming is unclear, as is the way in which anthropogenic climate change may affect the present and future frequency and intensity of similar cold events. Here, we show that the large-scale atmospheric circulation associated with the warm Arctic was the main event driver, explaining 83 ± 2% of the intensity of the 2023 cold event, whereas the thermodynamic effect of climate change suppressed the event intensity by −6 ± 3% in ERA5 and −22 ± 2% in HadGEM3-A-N216. An attribution analysis based on coupled model simulations shows that, due to anthropogenic climate change, the frequency and intensity of 2023-like events decrease by 92.5 ± 2.5% and 1.9 ± 0.2 °C, respectively, under the 2023 climate state. The thermodynamic effect of anthropogenic climate change outweighs its dynamic effect. Future projections indicate that the frequency and intensity of these 2023-like events will further decrease by 95 ± 3% and 2.05 ± 0.25 °C by the end of this century under an intermediate-emissions scenario compared with estimates made under the present climate. In contrast, 2023-like events will be similar to present events when the 1.5 °C target of the Paris Agreement is achieved. These findings highlight the dampening effect of anthropogenic climate change on cold events, but adaptation measures for future risks of 2023-like cold events will be needed by the end of the century if carbon neutrality is achieved.

Generalization of the location method of ashi points

Through analyzing the every textual research literature on the origin of the location method of ashi points, it is pointed out that the location method of ashi points has been generalized. It is known through systematic research and theoretical identification that this method refers to the simple way to locate the points, originated from the folk, and it is widely used to find the sites for pain relief when compared to the official education of meridians and acupoints, as well as treatment. At the time with the shortage of medical services and supplies, the poor people had no alternative, which results in a certain limitation. Modern acupuncture practitioners must associate ashi points with the acupoints of fourteen meridians and the extraordinary points in clinical practice, and deepen the exploration with modern medical knowledge and technology adopted.

Orthopedic War-Related Injuries in Gaza: In-Depth Insights from within the Strip

Gaza has been under continuous attack for over a year, resulting in widespread destruction and a severe humanitarian crisis. The bombings have caused mass casualties and devastating injuries, with buildings collapsing and overwhelming the healthcare system. Attacks on hospitals, arrests of medical staff, and severe shortages of medical supplies have hindered the delivery of life-saving treatments, forcing hospitals to provide only basic care. Due to a lack of specialized staff and equipment, treatment delays and infection risks have increased, and emergency measures such as amputations are often used. This review highlights the critical medical situation in Gaza, focusing on the challenges faced by medical staff, the impact of war-related injuries, and the broader health consequences caused by infrastructure damage and limited access to healthcare.

Challenges and Opportunities of Universal Health Coverage in Africa: A Scoping Review.

Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature to map out the evidence on UHC adoption, roll out, implementation, challenges, and opportunities in the African countries. Literature searches of the Cochrane database of systematic reviews, PUBMED, EBSCO, Eldis, SCOPUS, CINHAL, TRIP, and Google Scholar were conducted in 2023. Using predefined inclusion criteria, we focused on UHC adoption, rollout, implementation, and challenges and opportunities in African countries. Primary qualitative, quantitative, and mixed-methods evidence was included, as well as original analyses of secondary data. We employed thematic analysis to synthesize the evidence. We found 9633 documents published between May 2005 and December 2023, of which 167 papers were included for analysis. A significant portion of UHC implementation in Africa has focused on establishing social health protection schemes, while others have focused on strengthening primary healthcare systems, and a few have taken integrated approaches. While progress has been made in some areas, considerable obstacles still exist. Financial constraints and supply-side challenges, such as a shortage of healthcare workers, limited infrastructure, and insufficient medical supplies, remain significant barriers to UHC implementation throughout Africa. Some of the promising solutions include boosting public funding for healthcare systems, strengthening public health systems, ensuring equity and inclusion in access to healthcare services, and strengthening governance and community engagement mechanisms. Successful UHC implementation in Africa will require a multifaceted approach. This includes strengthening public health systems in addition to the health insurance schemes and exploring innovative financing mechanisms. Additionally, addressing the challenges of the informal sector, inequity in healthcare access, and ensuring political commitment and community engagement will be crucial in achieving sustainable and comprehensive healthcare coverage for all African citizens.

An ARDL Study on Wastewater, Carbon Dioxide, and Blue Economy Impacts in Türkiye

Pollution of water resources results in the degradation of aquatic ecosystems and poses a threat to the global Blue Economy. Water pollutants, especially in water source like oceans, seas, rivers, and lakes where aquaculture is prevalent, can lead to species alterations, reduced food quality, decreased tourism opportunities in coastal areas, reduced employment in the sector, and declining incomes. This study aims to capture the impact of municipal wastewater and carbon dioxide on income in Türkiye between 1994 and 2022 using the ARDL approach. It examines the relationship between municipal wastewater and carbon dioxide discharged into rivers, lakes, and seas, and the income generated from aquatic resources, with the objective of guiding Blue Economy policy actions. The results of the ARDL long-term estimates indicate that (i) wastewater discharged by municipalities and (ii) carbon dioxide have adverse effects on income derived from aquatic resources. In the long-term forecast, carbon dioxide is expected to cause supply shortages due to increasing pollution in seas and rivers, while in the short term, it affects resources in lakes. The findings also suggest a long-term decrease in product quantities due to wastewater in water sources. Based on these results, the study recommends changes in policies addressing factors that disrupt the aquatic ecosystem, and suggests that municipalities develop new methods to combat wastewater discharge.

Impact of dronabinol shortage on a population of chronic pain patients: A retrospective observational study

A supply shortage of dronabinol occurred between December 2023 and February 2024, forcing chronic pain patients to discontinue this treatment. We assessed the impact of this shortage on patients in our hospital. A retrospective observational study of patients treated with dronabinol was conducted. Collected data included socio-demographic, pharmacological and clinical data. Pain intensity and its interference, the intensity of other pain dimensions (mood, relationship with others, etc.) and quality of sleep were collected before discontinuation (dronabinol dosage balanced, M0) and at the end of discontinuation (dronabinol stopped for several weeks, M3). The patient's perception of his state of health evolution was collected at the end of the shortage. Health deterioration was reported by 86% of patients after 3months of rupture. Pain intensity and its interference with patients' daily lives increased significantly. Patients' sleep deteriorated significantly. The number of patients with permanent pain increased 5-fold (n=2 at M0 and n=10 at M3). The number of patients with more than 20painful attacks per 24hours increased 2-fold (n=2 at M0 and n=4 at M3). Although data on the efficiency of dronabinol are currently limited, this supply disruption has had negative clinical consequences for our patients. With drug shortages multiplying in recent years, the marketing of new specialties and therefore the availability of therapeutic alternatives could help reduce the clinical impact of a possible new dronabinol shortage in these refractory chronic pain patients.

Statistical Overview of Drug Shortage in Syria

Access to medications is a fundamental aspect of healthcare and vital for human well-being. Medicine shortages are widespread and impact countries across all income levels. This research aimed to monitor the characteristics of drug shortages in Syria through a distributed survey. 76% of the sample were females. 88.9% of the sample were 20-29 years old. A high percentage of the participants were single (86.6%). 62% were students. Pharmacy is the profession or field of study for most participants (83.4%). Half of the participants live in the city (51%). Most participants work at a local pharmacy. The majority (79.5%) have fewer than 5 years of experience. Most participants were well-informed about medication shortages and personally experienced the impact of this issue in their professional or personal lives. A shortage of baby supplies, specifically baby milk, was reported by 70.33% of the surveyed parents. Tablets and capsules are the pharmaceutical formulations that experience shortages most commonly. Shortages were reported in all categories of medications. Participants identified the shortage of raw materials and low profit margins as significant factors contributing to drug shortages. Further research into drug shortages in Syria is warranted to address this issue.

Internal and External Factors in Developing Farmer Businesses in Pinrang Regency, South Sulawesi Province, Indonesia (Case Study)

This study aimed to identify external and internal factors in community businesses in Alitta Village. The study was conducted in Alitta Village, Mattiro Bulu District, Pinrang Regency in May 2024. The analysis used in this study was a SWOT analysis. The results of the study showed that internal factors are management, finance, human resources, facilities and infrastructure, and legal umbrella while external factors are technology, business partners, government, village potential, community participation and competitors. BUMDes development is carried out with a focus on three main aspects: improving the village economy, developing existing potential, and managing this potential to meet the needs of the local community. Meanwhile, the lack of human resources for BUMDes management, the difficulty of maintaining the agricultural machinery owned and the supply of raw material inputs that are not smooth. Efforts to overcome obstacles through strategy development can be an option to be implemented, namely Increasing product availability, recruiting new members to run each business division and opening independent outlets. Significant impact because gasoline is an important commodity needed by rural communities. Most farmers who rely heavily on water pumps to irrigate their agricultural land. Gasoline supply shortages cause delays and disruptions in the operation of such equipment, hampering agricultural productivity.

Perbandingan Akurasi Metode Fuzzy Mamdani dan Fuzzy Sugeno dalam Memprediksi Kebutuhan Darah PMI Kota Medan

Blood demand prediction is important to avoid the instability of blood stocks or supplies. Too much and abundant blood stock can cause losses, because the blood will be wasted when it passes the storage expiration date. Meanwhile, too little stock can risk a shortage of blood supply. To anticipate this, it is necessary to predict the amount of blood demand that must be received in the future in order to achieve optimum blood availability. Fuzzy Mamdani and Fuzzy Sugeno methods that use the concept of fuzzy logic are considered capable of handling complexity and uncertainty in decision making, so they can be used to predict the amount of blood demand by considering the varying and uncertain amounts of blood demand and supply. The calculation results show that the Fuzzy Mamdani method has better accuracy than the Fuzzy Sugeno method with MAPE values of 16.707% and 17.987% respectively. The Fuzzy Mamdani method has an accuracy level in the good category according to the MAPE method and can be used to predict blood demand at PMI Medan.

Pneumonia Vaccines: Indications for Use and Current Safety Data in Pregnancy.

Streptococcus pneumoniae is a leading cause of pneumonia, meningitis, and invasive pneumococcal disease among adults in the United States, with higher rates of disease occurring among individuals with chronic medical and immunocompromising conditions. Pregnant individuals, especially those with co-morbid conditions, are also at increased risk of infection due to S. pneumoniae due to physiologic and immunologic changes in pregnancy. Vaccination against pneumococcus is recommended for adults living with HIV aged 19-49, congenital or acquired immunodeficiency, asplenia, chronic renal failure, sickle cell disease, alcohol abuse, cerebrospinal fluid leaks, congestive heart failure and cardiomyopathies, chronic lung disease, chronic liver disease, and diabetes mellitus. During pregnancy, the American College of Obstetricians and Gynecologists (ACOG) recommends vaccination against S. pneumoniae for individuals meeting criteria for immunization outside of pregnancy. Pneumococcal vaccine uptake has been low. There are no data available for vaccine uptake in pregnancy, but we suspect it is lower than non-pregnant populations. Low uptake of immunization rates in pregnancy is likely multifactorial and includes general vaccine hesitancy among pregnant individuals, cost, access to care, and supply shortages. While data in support of pneumococcal vaccines during pregnancy are limited, sufficient evidence exists to support the safety and efficacy of vaccination in the antepartum period. Pregnancy provides an opportunity to continuously engage individuals in care, allowing obstetricians and gynecologists to establish rapport, work to reduce vaccine hesitancy, and to provide pneumococcal immunization to those who are eligible. Medical indications for pneumococcal vaccination will increasingly apply to pregnant persons as the population acquires co-morbidities and there is a need for improved education among obstetricians on the topic of antenatal pneumococcal vaccination.

The Utilisation of Solar-Powered Boreholes for Groundwater Supply: Addressing Water Scarcity in the Polokwane Municipality, Mankweng Cluster

In many African countries, including South Africa, groundwater remains vital for rural communities, yet sustainable methods of its supply still require improvement. The purpose of this study is to enhance groundwater supply through an innovative and sustainable borehole system that improves reliability and ensures a consistent water supply. This study was motivated by the need to provide sustainable water access in rural communities by addressing critical gaps in existing groundwater supply systems, thereby enhancing community resilience. This study identified a problem of water scarcity in the Polokwane Municipality, Mankweng Cluster, where the existing borehole systems are inadequate to supply groundwater. Handpumps demand significant physical effort, grid-powered boreholes cease to operate during frequent power cuts, and the inconsistent diesel supply further limits borehole operation. The study was conducted using a qualitative approach, involving data collection through interviews that were analysed using content analysis. Findings indicate several challenges, including power cuts, diesel supply shortages, poor infrastructure maintenance, vandalism, and theft of equipment, which affect the proper operation of boreholes. The study concludes that water scarcity in the Mankweng Cluster stems from inadequate water infrastructure. The study recommends implementing a solar-powered borehole system that uses photovoltaic energy to pump water from underground aquifers.