Coping with Water Scarcity: What Role for Biotechnologies?

At a conference of the FAO Biotechnology Forum in 2007, 78 participants from 24 countries offered their views on agricultural biotechnologies and water scarcity, addressing the pros and cons of various methods and their potential application. These viewpoints are represented in this discussion paper, along with an introductory section that defines the issues to be discussed. Funders in the WASH sector can use this document to educate themselves about the potential gains to be made in supporting different types of scientific research and agricultural technology development

Following Patients with Severe Coronary Artery Calcifications Detected by Low-Dose CT Scan for Lung Cancer Screening

Introduction: Recommendations for lose-dose CT screening for lung cancer (LC) targets a population at concomitant risk for coronary disease. Coronary artery calcifications (CAC) are an independent predictor of cardiovascular events among screening patients, and atherosclerotic cardiovascular disease (ASCVD) was the leading cause of death in the National Lung Screening Trial. In this study, we tested the hypothesis that patients with severe CAC undergo more risk factor modification when seen by a cardiologist. Methods: A chart review assessing patients found to have severe CAC on screening LDCT between January 2018 and April 2019 was conducted. Patient demographics, medical history, and cardiology data were obtained from the electronic medical record. Results: Of 580 patients who underwent LC screening, forty patients (6.9%) had severe CAC. 70% of these patients (28/40) had ASCVD at baseline. Twenty-three patients (57.5%) were subsequently seen by a cardiologist. Of these patients, 12 (52.2%) were started on or had a dose increase in cardiac medications; 9 (39.1%) underwent stress testing; 12 (52.2%) had an echocardiogram; and 3 patients (13.0%) underwent coronary angiography. Among the 17 patients not seen by a cardiologist, 2 patients (11.8%) had an increase in cardiac medications, and none underwent cardiac procedures. Discussion: Patients with severe CAC detected on LDCT screening have a high incidence of known ASCVD. Those who are referred to Cardiology undergo procedures and medication changes at a higher rate than patients not seen by a cardiologist. Future directions should include examining the impact of cardiac interventions on ASCVD mortality in this population

Incidental Findings on LDCT for Lung Cancer Screening: Prevalence and Clinical Management

Objectives To define the frequency of incidental findings on low-dose CT (LDCT) scans among patients undergoing lung cancer screening. To determine the current reporting methods for incidental findings and measure the frequency of clinical follow-up

Individual- And Neighborhood-Level Characteristics of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making

BACKGROUND: Although lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine Shared Decision Making (SDM) for LCS. METHODS: This retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 - March 18, 2021 in a centralized LCS program. Individuals were categorized into Complete Screening vs. Incomplete Screening subgroups based on the status of subsequent LDCT completion. A multi-level, multivariate model was constructed to identify factors associated with incomplete screening. RESULTS: Among individuals undergoing telemedicine SDM during the study period, 20.6% did not complete a LDCT scan. Bivariate analysis demonstrated that Black/African-American race, Medicaid insurance status, and new patient type were associated with greater odds of incomplete screening. On multi-level, multivariate analysis, individuals who were new patients undergoing baseline LDCT or resided in a census tract with a high level of socioeconomic deprivation had significantly higher odds of incomplete screening. Individuals with a greater level of education experienced lower odds of incomplete screening. CONCLUSIONS: Among high-risk individuals undergoing telemedicine SDM for LCS, predictors of incomplete screening included low education, high neighborhood-level deprivation, and new patient type. Future research should focus on testing implementation strategies to improve LDCT completion rates while leveraging telemedicine for high-quality LCS