Institutional Career Development Core

这项拟议的KL2补充奖将为布莱克·兰利博士，ND，MS，Lac提供必要的 受保护的时间、资源、授课培训和跨学科团队的指导指导 成为一名独立的研究人员。完成流行病学硕士学位的计划是一个关键 作为一名研究人员，这是实现独立性的重要组成部分。密集的指导，务实的经验，以及 超过三年的临床教学培训将为临床医生-学者提供设计方面的基础培训， 收集、分析和解释机械性生物标记物数据和患者报告的结果。这个 拟议的研究项目将为未来针对预防的拨款申请生成初步数据 以及一种严重疾病的治疗：厌食症，即对食物的反常食欲丧失。厌食症导致 营养不良，是癌症、慢性疾病恶病质(体重减轻占总体重的5%)的前身 阻塞性肺疾病、慢性肾脏疾病和充血性心力衰竭。恶病质与 高达20%的癌症相关死亡，对估计60%-70%的胰腺癌和癌症患者构成风险 胃癌，并与对生活质量、治疗依从性和总体的负面影响有关 生死存亡。越来越多的研究支持针灸是治疗厌食症的有效干预措施，而 耳穴按压，一种使用Vaccaria种子的无感染风险的针灸技术 千层草，可能针对多种作用机制，解决恶病质的风险因素。耳穴 穴位按摩干预必须考虑对特定人群的可行性和可接受性，包括 患者和提供者。这位学者的研究项目的主要目标是培养早期的职业生涯 耳穴按压中试和可行性试验的设计、实施和分析的调查员 在多学科门诊环境中提供的干预。建议的研究是一项为期8周的随机、 耳穴按压加标准护理(主动臂)与标准护理的对照试验和可行性试验 仅限(控制臂)。耳穴贴压耳籽每周施药一次，之后维持5天 每项申请为期8周。参与者将轻轻地刺激每个种子，持续三分钟，三分钟 每天一次。试验的主要目的是评估耳穴的可行性和可接受性。 穴位按压干预改善食欲预防66例成人胰腺癌患者体重减轻 食欲不振的胃食道癌。第二个目标是估计影响的大小和方差 体重减轻和食欲变化--关于耳穴按压对癌症患者疗效的未来研究 食欲不振。探索性的目的将检查潜在的炎症机制，通过 穴位按摩影响减肥和食欲，以及干预对生活质量的影响。结果是 这项试验将为未来关于此类干预效果的研究提供信息，并应适用于未来 癌症和非癌症人群中厌食症和恶病质的研究。

This proposed KL2 supplement award will provide Dr. Blake Langley, ND, MS, LAc with the necessary protected time, resources, didactic training, and mentored guidance from an interdisciplinary team to develop into an independent researcher. The planned completion of a master's degree in Epidemiology is a critical component to achieving independence as a researcher. The intensive mentorship, pragmatic experience, and clinical-didactic training over three years will provide fundamental training to a clinician-scholar in the design, collection, analysis, and interpretation of both mechanistic biomarker data and patient-reported outcomes. The proposed research project will generate preliminary data for future grant applications addressing the prevention and treatment of a serious illness: anorexia, the abnormal loss of appetite for food. Anorexia contributes to malnourishment and is a predecessor to cachexia (weight loss >5% of total body weight) in cancer, chronic obstructive pulmonary disease, chronic kidney disease, and congestive heart failure. Cachexia is implicated in up to 20% of cancer-related deaths, poses a risk to an estimated 60-70% of patients with pancreatic and gastric cancer, and is associated with negative impacts on quality of life, treatment adherence, and overall survival. A growing body of research supports acupuncture as an efficacious intervention for anorexia, while auricular acupressure, an acupuncture technique without infection risk that uses seeds from the Vaccaria segetalis plant, may target multiple mechanisms of actions that address cachexia risk factors. Auricular acupressure interventions must consider the feasibility and acceptability to specific populations, including patients and providers. The broad objective of the scholar's research project is to train an early career investigator on the design, conduct, and analysis of a pilot and feasibility trial of an auricular acupressure intervention delivered in a multidisciplinary outpatient setting. The proposed study is an 8-week randomized, controlled pilot and feasibility trial of auricular acupressure plus standard care (active arm) vs standard care only (control arm). Auricular acupressure ear seeds will be applied weekly and maintained for five days after each application for 8 weeks. Participants will gently stimulate each seed bilaterally for three minutes, three times per day. The primary aim of the trial is to assess the feasibility and acceptability of an auricular acupressure intervention to improve appetite prevent weight loss in 66 adults with pancreatic and gastroesophageal cancer with low appetite. The secondary aim is to estimate the effect size and variance in weight loss and change in appetite for future studies on the efficacy of auricular acupressure in cancer patients with low appetite. The exploratory aim will examine potential inflammatory mechanisms by which auricular acupressure impacts weight loss and appetite, and the intervention's impact on quality of life. The results of this trial will inform future studies on the efficacy of such an intervention and should be applicable to future research on anorexia and cachexia in both cancer and non-cancer populations.