National Collaborative Efforts Research Articles

Improving goal-concordant care via a uniquely collaborative and multi-site PFAC model.

265 Background: Studies reveal a mismatch between the goals of care (GOC) of cancer patients and actual care received. The 10 members of the Alliance of Dedicated Cancer Centers (ADCC) convened the Improving Goal Concordant Care (IGCC) initiative to address system gaps. IGCC was led by palliative care and oncology experts, with guidance from patient and family advisors. Uniquely, the advisors were identified from patient family advisory councils (PFAC) at each center, forming a collaborative Advisory Group (AG) with the lived experience of each center and the knowledge of advocating for the patient/family voice locally. Methods: PFAC members were recruited from each site to serve on the AG. The 19 member AG met quarterly, with minutes shared with the IGCC oversight group, the Implementation Workgroup (IWG). In September 2023, all AG members were surveyed about perceptions of PFAC engagement and local impact of IGCC. In May 2024, 20 IWG members were surveyed about implementation successes and barriers, including items related to PFAC engagement. Results: AG evaluation and recommendations altered IGCC planned core implementation and evaluation actions meaningfully; for example in 1) selection of structured fields in electronic health record (EHR) and universally accessible GOC documentation and in 2) centering patients in the GOC measure set, including incorporating “Heard & Understood” survey into IGCC evaluation. Other AG guidance around direct patient engagement readiness for GOC conversations and implementing patient GOC surveys was left to individual sites to consider with variable adoption. AG Survey: 63% response rate. 80% noted that the GOC program was discussed with their local PFAC and 92% experienced changed routine patient care after GOC implementation. IWG Survey: 100% response rate. 68% agreed that their center sought guidance from their PFAC during GOC implementation and that leadership presented to their PFAC about their GOC implementation. 26% indicated reporting data to their PFAC; of those that did, 80% agreed that this positively impacted their GOC implementation. Conclusions: While PFACs are occasionally included in quality interventions, this model centered the patient/family voice by supporting a PFAC stakeholder feedback loop working collaboratively and locally to support implementation and evaluation of IGCC objectives. While not all AG recommendations were formally integrated into IGCC, all were considered and many adopted at individual centers. Despite ongoing IGCC-level involvement, center-specific engagement of PFACs varied. Future efforts can track this during process evaluation as local PFAC engagement was highly valued. Consensus building for national best practice implementation and evaluation by recruiting local experts including PFAC members into national collaborative efforts is a successful model for local change.

Biomarkers in Duchenne Muscular Dystrophy: Current Status and Future Directions.

Duchenne muscular dystrophy is a severe, X-linked disease characterized by decreased muscle mass and function in children. Genetic and biochemical research over the years has led to the characterization of the cause and the pathophysiology of the disease. Moreover, the elucidation of genetic mechanisms underlining Duchenne muscular dystrophy has allowed for the design of innovative personalized therapies.The identification of specific, accurate, and sensitive biomarkers is becoming crucial for evaluating muscle disease progression and response to therapies, disease monitoring, and the acceleration of drug development and related regulatory processes.This review illustrated the up-to-date progress in the development of candidate biomarkers in DMD at the level of proteins, metabolites, micro-RNAs (miRNAs) and genetic modifiers also highlighting the complexity of translating research results to clinical practice.We highlighted the challenges encountered in translating biomarkers into the clinical context and the existing bottlenecks hampering the adoption of biomarkers as surrogate endpoints. These challenges could be overcome by national and international collaborative efforts, multicenter data sharing, definition of public biobanks and patients' registries, and creation of large cohorts of patients. Novel statistical tools/ models suitable to analyze small patient numbers are also required.Finally, collaborations with pharmaceutical companies would greatly benefit biomarker discovery and their translation in clinical trials.

Thromboprophylaxis in Patients Admitted to the Surgical Ward: Clinical Audit.

Hospital-acquired thrombosis (HAT) is associated with significant morbidity, mortality, and financial burden globally. Following trusted guidelines for VTE prevention has shown effective, safe, and satisfactory results. This prompts national collaborative efforts to maintain a consensus approach for the safe risk assessment of inpatients and the prescription of thromboprophylaxis. This study aimed to detect and estimate deviations from international thromboprophylaxis protocols. The study also aimed to raise the quality of practice and adherence to evidence-based protocols in Alshuhada Teaching Hospital. A cross-sectional audit of general surgical inpatients was performed from October 2021 to May 2022. The first cycle was from 1/10/2021 to 21/10/2021, and the second cycle was from 13/5/2022 to 31/5/2022. The target population was adults aged >18 years. Data were collected via an online checklist on two separate occasions. The criteria were based on the NICE guideline for venous thromboembolism in individuals aged over 16 years: "Reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism NG89". Forty-five surgical inpatients were included in this study: 20 in the first cycle and 25 in the second cycle. The first-cycle report showed that only 25% of VTE candidates received this regimen. In the second cycle, practice significantly improved, with 92% of admitted patients having their risk assessment tool completed within 24 h of admission. 79% of VTE prophylaxis candidates were prescribed adequate pharmacological prophylaxis within 14 h of admission. The rate of adequate thromboprophylaxis for inpatients undergoing surgery was very low before clinicians received education on VTE prevention, whereas was evidently high after they had received them. The cause of non-adherence in the pre-intervention phase was a lack of adequate knowledge regarding the magnitude and burden of HAT and the importance of thromboprophylaxis, which has a potential role in preventing the majority of HAT.

Innovations in Disaster Preparedness Training: An Emergency Preparedness Curriculum within a Pediatric Emergency Medicine Fellowship

Introduction:Improved understanding of pediatric emergency preparedness can ensure the safety of children during disaster events, a population that is often overlooked.1 2 One method to minimize disparities is to increase the pediatric preparedness workforce by providing education to trainees about the foundations of this field.Method:A pediatric emergency preparedness curriculum was created as part of an elective prehospital track within a pediatric emergency medicine fellowship program at a quaternary pediatric hospital.Results:The curriculum focuses on three domains: education, research, and administration. The trainee is required to participate in local and regional educational opportunities. Locally, trainees create and facilitate at least one tabletop exercise about a preparedness topic of their choice. They also attend regional and state-wide preparedness drills to foster better understanding of integrated system processes. Additional educational opportunities involve the creation of asynchronous learning modules for their division and development of just-in-time resources for disaster events. For research, they have the opportunity to pursue an original project in the field and participate in other research activities with the track director. The administration domain prepares the trainee to be a leader in the field. Trainees are active participants within the emergency department’s preparedness committee and during hospital-wide preparedness meetings. These meetings develop protocols and policies as well as educational initiatives. Fellows are also encouraged to join national collaborative preparedness efforts through the American Academy of Pediatrics and the EMSC innovation and Improvement Center (EIIC).Conclusion:This curriculum provides an introduction to and continued education about disaster preparedness to pediatric emergency fellows early in their career. Completion of the sub-track fosters future leaders in the disaster medicine field. In the future, this curriculum can be adopted by other medical training programs to expand understanding of pediatric preparedness concepts.

Studies of plant hydraulics and water relations in Mexican environments: adaptation, physiology, and applications

Given the outstanding global progress of research on the hydraulic pathway in plants, and its important role as an indicator of plant mortality risk, we reviewed: (1) the adaptive basis of hydraulic traits and their importance for overall plant function; (2) the number of primary scientific articles on plant hydraulics that have been produced in Mexico in the last 40 years, (3) research related to specific environments in Mexico, and (4) the possible applications of plant hydraulics to natural resource management. Our systematic review included 83 articles. The number of publications per year steadily increased over time, reaching its maximum in 2021. Veracruz and Yucatán are the states where the majority of scientific articles on plant hydraulics have been produced, but for most states less than two publications on this subject appeared in ca. 40 years, and none was found for Oaxaca and Chiapas, the most biodiverse states. In plant hydraulics, the most studied biome in Mexico was the tropical dry forest, followed by crops; trees were the most studied growth-form, followed by herbaceous crops and epiphytes. We point to the need of enhancing research in the interface between plant hydraulic function and remote sensing, as well as developing applications in adaptive forest management and ecological restoration. We hope that this review may ignite a national collaborative effort to quantify critical traits that could inform the hydraulic functioning of Mexican ecosystems, particularly in the underrepresented and highly diverse states of Mexico.

Rhabdomyosarcoma in children: Retrospective analysis from a single tertiary care center in Saudi Arabia.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children occurring most commonly in the head and neck region. The treatment involves using a multimodality approach including chemotherapy, surgery, and radiation therapy. Survival for patients with localized disease has improved markedly, but the treatment of advanced disease remains a challenge. We report the clinical characteristics and outcome for patients treated at a tertiary care center in Saudi Arabia. Patients aged 0-14 years diagnosed with RMS between 2005 and 2018 were included. Statistical analysis was performed using SPSS software. Kaplan-Meier method was used to calculate overall and event free survival. Cox proportional hazards model was used for multivariate analysis. One hundred and twenty-four patients were analyzed. The median age was 5.7 years with male predominance (2.4:1). The most common primary sites were head/neck (30%) and the genitourinary tract (25%). Embryonal RMS was present in 81%; alveolar in 19%. Most patients had intermediate risk disease (60%). The 5-year overall and event free survivals were 64.3% and 53.3%, respectively. Survival was influenced by primary tumor site, histology, and clinical risk group. Unfavorable primary site, high risk stratification, and poor initial response to therapy predicted a poor outcome. This study provides an insight on the current management outcomes for our patients with RMS. Cytogenetics and molecular diagnostics need to be incorporated as standard of care in the therapeutic approach of our patients. In addition, there is a need for national collaborative efforts to improve the outcome of RMS in children and adolescents.

Analysis of the Clinical Advancements for BRCA-Related Malignancies Highlights the Lack of Treatment Evidence for BRCA-Positive Male Breast Cancer.

Simple SummaryMale breast cancer (MBC) is an orphan disease that is on the rise but remains understudied. Mutations in genes sensitive to DNA damage response, BRCA1 and BRCA2, are strongly implicated in MBC development. Evidence-based guidance for the treatment of MBC that have BRCA mutations is lacking with most published data arising from retrospective or case studies with small patient cohorts. Here, we review the lack of treatment evidence for BRCA-related MBC. We also highlight the impact of poly(ADP-ribose) polymerase (PARP) inhibitors which are used in the clinical management of BRCA-related female breast cancer and prostate cancer. In turn, we demonstrate the requirement for national and global collaborative efforts to address the striking unmet need for dedicated BRCA-related MBC research, including studies to better understand disease trajectory and improve clinical outcomes.Male breast cancer (MBC) is a rare disease that accounts for less than 1% of all breast cancers and male malignancies. Despite recognised clinico-pathological and molecular differences to female breast cancer (FBC), the clinical management of MBC follows established FBC treatment strategies. Loss of function mutations in the DNA damage response genes BRCA1 and BRCA2, have been strongly implicated in the pathogenesis of MBC. While there have been extensive clinical advancements in other BRCA-related malignancies, including FBC, improvements in MBC remain stagnant. Here we present a review that highlights the lack of treatment evidence for BRCA-related MBC and the required national and global collaborative effort to address this unmet need. In doing so, we summarise the transformative clinical advancements with poly(ADP-ribose) polymerase (PARP) inhibitors in other BRCA-related cancers namely, FBC and prostate cancer.

Bibliometric analysis of peer-reviewed literature on the Patos Lagoon, southern Brazil.

Coastal lagoons provide several ecological resources and services with their functioning being mainly investigated in temperate areas. The Patos Lagoon, a subtropical system in southern Brazil, is one of the largest chocked coastal lagoons in the world. It provides habitat for numerous organisms and a range of ecosystem services. We performed a bibliometric analysis to identify and analyze the characteristics of studies carried out in the Patos Lagoon based on articles published in peer-reviewed journals indexed in the Science Citation Index Expanded database of Clarivate Analytics Web of Science and Scopus database. We found 360 articles published between 1965 and 2019 in 150 journals. The number of articles has increased in the last decades mainly resulting from national collaborative efforts. Most articles were published by Brazilian research institutions. Most studies were performed in the Patos Lagoon estuary, a Long-term Ecological Research program´s study site. Our study thus highlights the importance of long-term projects to the comprehension of subtropical coastal lagoons functioning and indicates knowledge gaps that must be addressed in future studies.

The Canadian Glomerulonephritis Registry (CGNR) and Translational Research Initiative: Rationale and Clinical Research Protocol.

Background:Glomerulonephritis (GN) is a leading cause of kidney failure and accounts for 20% of incident cases of end-stage kidney disease (ESKD) in Canada annually. Reversal of kidney injury and prevention of progression to kidney failure is possible; however, limited knowledge of underlying disease mechanisms and lack of noninvasive biomarkers and therapeutic targets are major barriers to successful therapeutic intervention. Multicenter approaches that link longitudinal clinical and outcomes data with serial biologic specimen collection would help bridge this gap.Objective:To establish a national, patient-centered, multidimensional web-based clinical database and federated virtual biobank to conduct human-based molecular and clinical research in GN in Canada.Design:Multicenter, prospective observational registry, starting in 2019.Setting:Nine participating Canadian tertiary care centers.Patients:Adult patients with a histopathologic pattern of injury consistent with IgA nephropathy, focal and segmental glomerulosclerosis, minimal change disease, membranous nephropathy, C3 glomerulopathy, and membranoproliferative GN recruited within 24 months of biopsy.Measurements:Initial visits include detailed clinical, histopathological, and laboratory data collection, blood, urine, and tonsil swab biospecimen collection, and a self-administered quality of life questionnaire. Follow-up clinical and laboratory data collection, biospecimen collection, and questionnaires are obtained every 6 months thereafter.Methods:Patients receive care as defined by their physician, with study visits scheduled every 6 months. Patients are followed until death, dialysis, transplantation, or withdrawal from the study. Key outcomes include a composite of ESKD or a 40% decline in estimated glomerular filtration rate (eGFR) at 2 years, rate of kidney function decline, and remission of proteinuria. Clinical and molecular phenotypical data will be analyzed by GN subtype to identify disease predictors and discover therapeutic targets.Limitations:Given the relative rarity of individual glomerular diseases, one of the major challenges is patient recruitment. Initial registry studies may be underpowered to detect small differences in clinically meaningful outcomes such as ESKD or death due to small sample sizes and short duration of follow-up in the initial 2-year phase of the study.Conclusions:The Canadian Glomerulonephritis Registry (CGNR) supports national collaborative efforts to study glomerular disease patients and their outcomes.Trial registration:NCT03460054.

Education of Radiologists in Healthcare Disparities

Disparities exist in access to a multitude of screening and diagnostic imaging examinations and procedures. To address these disparities within radiology, emphasis so far has been placed upon diversifying the workforce and formally educating trainees on healthcare disparities. Currently, there is no organized and nationally accepted educational program or content for practicing radiologists specific to diversity and healthcare disparity. This void can be addressed by providing an educational curriculum framework for practicing radiologists based on three key factors: individual efforts, calling for institutional change, and national collaboration. Individual efforts should focus on acknowledging the existence of disparities, understanding the contribution of one's implicit bias in perpetuating disparities, understanding and highlighting issues related to insurance coverage of radiology examinations, and participating in radiology political action committees. These efforts can be facilitated by a consolidated web-based training program for practicing radiologists. To pave the way for meaningful systemic change, the implementation of institutional change like that initiated by the Culture of Safety movement in 2002 is needed. A national collaborative effort initiated by radiology organizations to empower radiologists and recognize positive changes would further provide support. SummaryA three-pronged educational framework combining individual radiologist education, institutional change, and national collaboration will enable radiologists to play a role in addressing imaging-related disparities in healthcare.

Molecular landscape of DYSF mutations in dysferlinopathy: From a Chinese multicenter analysis to a worldwide perspective.

Dysferlinopathy is one of the most common subgroup of autosomal recessive limb-girdle muscular dystrophies that is caused by mutations in DYSF gene. However, there is currently no worldwide comprehensive genetic analysis of DYSF variants. Through a national multicenter collaborative effort in China, we identified 222 DYSF variants with 40 novel variants from 245 patients. We then integrated DYSF variants from disease-related genetic databases including LOVD (n = 1020) and Clinvar (n = 1179), to depict the global landscape of disease-related DYSF variants. Normal-population-derived DSYF variants from gnomAD (n = 4318) and ChinaMAP (n = 13,330) were also analyzed in comparison. In Chinese patients, gender instead of genotype showed influence on the onset age of dysferlinopathy, with males showing an earlier age of onset. After integrative analysis, we identified two hotspot DYSF mutations, c.2997G>T in world patients and c.1375dup in Chinese patients, respectively. Both the pathogenic and likely pathogenic variants scattered on the whole gene length of DYSF. However, three specific domains (C2F-C2G-TM, DysF, and C2B-Ferl-C2C) contained variants at higher frequencies than reported in both the databases and Chinese patients. This study comprehensively collected available DYSF variant data, which may pave way for genetic counselling and future clinical trial design for gene therapies in dysferlinopathy.

Biomarkers in rare neuromuscular diseases

Duchenne muscular dystrophy (DMD) is a severe, X-linked disease, affecting 1:5000 males, and characterized by progressive muscle weakness and muscle mass loss in children. Genetic and biochemical research over the years has led to the characterization of the genetic cause and pathophysiology of the disease. Moreover, the elucidation of genetic mechanisms underlining Duchenne muscular dystrophy has allowed the design of innovative personalized molecular therapies. The identification of specific, accurate, and sensitive biomarkers is becoming crucial for evaluating muscle disease progression and response to therapies, for disease monitoring, and to accelerate drug development and related regulatory processes. Several exploratory biomarkers have been discovered by analyzing DMD patients' cohorts and provided clues about tissue or fluid proteins and RNA biomarkers (Table 1), as well as allowed the identification of SNPs acting as DMD genetic modifiers (Table 2). Nevertheless, challenges were encountered in translating biomarkers into the clinical context and many bottlenecks still exist, hampering their adoption as surrogate endpoints. These issues could be overcome by national and international collaborative efforts, multicenter data sharing, and by the creation of large cohorts of patients as well as by the application of novel statistical tools, that can be effective also when patient numbers are small. Being DMD a Mendelian disease, building up “biomarker heatmaps” might help making multiple biomarkers applicable to clinical practice and possibly to clinical trials.

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020

ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to...

Neurological, neuropsychiatric and neurodevelopmental complications of COVID-19.

Although COVID-19 is predominantly a respiratory disease, it is known to affect multiple organ systems. In this article, we highlight the impact of SARS-CoV-2 (the coronavirus causing COVID-19) on the central nervous system as there is an urgent need to understand the longitudinal impacts of COVID-19 on brain function, behaviour and cognition. Furthermore, we address the possibility of intergenerational impacts of COVID-19 on the brain, potentially via both maternal and paternal routes. Evidence from preclinical models of earlier coronaviruses has shown direct viral infiltration across the blood–brain barrier and indirect secondary effects due to other organ pathology and inflammation. In the most severely ill patients with pneumonia requiring intensive care, there appears to be additional severe inflammatory response and associated thrombophilia with widespread organ damage, including the brain. Maternal viral (and other) infections during pregnancy can affect the offspring, with greater incidence of neurodevelopmental disorders, such as autism, schizophrenia and epilepsy. Available reports suggest possible vertical transmission of SARS-CoV-2, although longitudinal cohort studies of such offspring are needed. The impact of paternal infection on the offspring and intergenerational effects should also be considered. Research targeted at mechanistic insights into all aspects of pathogenesis, including neurological, neuropsychiatric and haematological systems alongside pulmonary pathology, will be critical in informing future therapeutic approaches. With these future challenges in mind, we highlight the importance of national and international collaborative efforts to gather the required clinical and preclinical data to effectively address the possible long-term sequelae of this global pandemic, particularly with respect to the brain and mental health.

Is It Time for Precision Dialysis?

In 2015, President Obama announced funding for precision medicine to augment personalized medicine, which has been described as “the right treatment for the right patient in the right place at the right time.” Patients with ESKD experience high symptom burden and mortality, necessitating more

Modelling kidney disease using ontology: insights from the Kidney Precision Medicine Project.

An important need exists to better understand and stratify kidney disease according to its underlying pathophysiology in order to develop more precise and effective therapeutic agents. National collaborative efforts such as the Kidney Precision Medicine Project are working towards this goal through the collection and integration of large, disparate clinical, biological and imaging data from patients with kidney disease. Ontologies are powerful tools that facilitate these efforts by enabling researchers to organize and make sense of different data elements and the relationships between them. Ontologies are critical to support the types of big data analysis necessary for kidney precision medicine, where heterogeneous clinical, imaging and biopsy data from diverse sources must be combined to define a patient's phenotype. The development of two new ontologies - the Kidney Tissue Atlas Ontology and the Ontology of Precision Medicine and Investigation - will support the creation of the Kidney Tissue Atlas, which aims to provide a comprehensive molecular, cellular and anatomical map of the kidney. These ontologies will improve the annotation of kidney-relevant data, and eventually lead to new definitions of kidney disease in support of precision medicine.

The Collaborative Development of Active Learning at Loyola University Chicago as Part of the SEMINAL Network

ABSTRACT In the context of national collaborative efforts to increase the prevalence of active learning strategies in undergraduate precalculus and calculus classrooms, we discuss the context, strategy, and processes used at one university to create change within a mathematics department. We highlight the use of a unified active learning approach and the importance of collaborative practices as leverage for departmental change. We conclude with lessons learned from the first year of implementation.

Practical strategies to manage cancer patients during the COVID-19 pandemic: Saudi Oncology Pharmacy Assembly Experts recommendations.

PurposeDuring COVID-19 pandemic, cancer patients are considered one of the most vulnerable to infection since they tend to have advanced age, multiple comorbidities, and are often immunosuppressed by their cancer or therapy. Hence, the Saudi Oncology Pharmacy Assembly has issued recommendations to reduce the frequency of cancer patients’ visits to oncology centers during the pandemic while maintaining the access to cancer therapy and minimize the risk of exposure to coronavirus disease.Materials and methodsA qualitative methodological approach was conducted in April 2020 using a virtual panel discussion for collection of recommendations.ResultsA total of 12 expert oncology pharmacy practitioners shared their knowledge and experiences in managing oncology patients during the COVID-19 pandemic. The participants recognized many fundamental recommendations that were already applied in many cancer centers since the start of the COVID-19 outbreak. On that basis, the panelists developed eight practice-related recommendations for action, with a main focus on cancer treatment modification.ConclusionsIn conclusion, delivering cancer care during the COVID-19 pandemic carries significant challenges. This paper addressed suggestions to properly manage cancer patients during difficult times. Implementing changes in practice mandates a national collaborative effort from different sectors to guarantee the quality and continuity of care. The SOPA expert panel developed these recommendations, to ultimately contribute in maintaining access to cancer therapy while minimizing the risk of COVID-19 exposure.

Laying an Early Foundation: Lifestyle Medicine Pre-Professional Education (LMPP) Member Interest Group.

Just as lifestyle medicine is the necessary foundation for true health care reform, lifestyle medicine competencies should be the foundation for health education. Although lifestyle medicine education may benefit a health professional at any stage in their education or career, evidence-based undergraduate lifestyle medicine education for future health professionals shifts the perspective of health and health care delivery. Educating health preprofessionals in associate, bachelor's, master's, and other preprofessional healthcare training programs is of paramount importance due to the interdisciplinary nature of lifestyle medicine. To accomplish this, American College of Lifestyle Medicine (ACLM) members can work collaboratively through committees, projects, and working groups-becoming leadership champions of change. An ACLM Pre-Professional Member Interest Group (LMPP) was created in 2018. LMPP has been working to build a national collaborative effort to amass, create, and distribute resources for educators in this pre-professional arena. Educating college students planning to become professionals outside the medical sphere, for example, lawyers, business people, artists, and engineers, will also benefit the field by introducing the power of nutrition, exercise, sleep, social connection, and stress resiliency during this formative state of career development. Pre-professional educational programs provide learners the opportunity to personally experience the power of lifestyle medicine.

Arthropod Pests and Tomato Value Chain: Review of Research Cocktails in Nigeria

Background: Tomato is an essential and remunerative staple food widely grown and consumed in all parts of Nigeria. The northern parts of the country produce ninety-eighth percent of the tomatoes consumed annually. However, higher percentages of tomatoes produced in these regions are lost due to gaps recorded in its value chain.
 Principal Findings: Tomato value chain needs to be strengthened from production to processing, preservation and good marketing structure. Challenges bedevilling tomato value chain in Nigeria include poor accessibility to production inputs such as seeds, nurseries, fertilizers; poor packing systems and transportation problems; marketing challenges and yield reduction caused by a complex of arthropod pests attacking the crop. The major arthropod pests inflicting economic damage on tomato include fruit borer, whitefly, aphid, thrips and leaf miners.
 Interventions: Considering the Nigerian Government’s recent interventions: “close border”, increased tariffs on the importation, and different incentives such as “tax holiday” and introduction of zero percent import duty on greenhouse equipment, soft loans through Bank of Agriculture as well as a national collaborative effort against the menace of tomato leaf miner (Tuta absoluta) invasion; How much of these interjectory efforts have translated to the realization of national self-sufficiency in the tomato value chain?
 Conclusion: This paper highlights the general introduction of tomato, its botany, nutritional benefits, tomato value chain in Nigeria, Nigerian government interventions towards its sustainability with particular focus on research cocktails at combating the problems of arthropod pests on the tomato to identify the probable critical solutions to these harmful pests.