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"Knox, J. W. (Jerry W.)"
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Barriers to mutational testing in patients with gastrointestinal stromal tumors (GIST) – a survey of life raft group members
Abstract
Background
Due to the low mutational testing rate in patients with Gastrointestinal Stromal Tumors (GIST), The Life Raft Group (LRG), a non-profit organization that provides support, advocacy and conducts research for patients with GIST, analyzed various factors that may have an impact on patients’ ability to receive mutational testing.
Methods
A survey about mutational testing for patients with GIST or their caregivers, was conducted in June 2020. The survey, sent to 1004 GIST patients and caregivers through email, was promoted through social media with instructions to contact the LRG to participate. The survey was designed by the LRG Patient Registry Department. Members of the LRG, regardless of Patient Registry status, were eligible to participate.
Results
A total of 295 patients/caregivers participated in this study (response rate: 29.4%). The percentage of patients who indicated they had received mutational testing was much higher in this survey (80%) than in the general GIST community (26.7%).
Several reasons were cited for having a test, including: “My doctor ordered/suggested that I have it done” (54%); “The Life Raft Group advised/suggested I have it done” (25%); “I asked my doctor to have it done” (22%); “I had it done as part of a clinical trial” (5%); “I am not sure” (3%) and “Other” (14%). Mutational testing resulted in a treatment change in 25% of cases. Patients were able to select more than one option when completing this question resulting in a percentage greater than 100.
Conclusions
The LRG membership is voluntary and proactive; patients who join are more likely to participate in surveys and mutational testing, as well as more likely to have a GIST specialist. Mutational testing can influence understanding of a patient’s GIST and the treatment best suited to each case. These are extremely important findings, as it helps ensure that patients are on the proper treatment, which should lead to better outcomes.
Journal Article
Modelling water fluxes to improve banana irrigation scheduling and management in Magdalena, Colombia
In this paper, an irrigation scheduling model for banana (
Musa
sp.) was developed to simulate crop growth and water fluxes under typical commercial plantation conditions. Whilst generic models exist for scheduling irrigation for many crops, their suitability for bananas are limited because of the asynchronous nature of crop growth. Individual fields on banana plantations typically contain trees at varying stages in their development cycle, so it is important for scheduling to account for this heterogeneity in simulating crop production. A crop modelling approach was developed using field data from Magdalena, an economically important region of banana production in Colombia. Following model development and calibration, irrigation water demand was estimated and weekly irrigation scheduling advice then transmitted by SMS to individual farmers in the region. The model also takes into account farmer feedback on actual irrigation practices to compare against estimated irrigation demands and to train model performance. Despite good model calibration, analysis of irrigation practices from farmer feedback showed only moderate to poor correlation between actual irrigation applications and the scheduling guidance. This implies a reluctance of farmers to change long-established traditional irrigation management practices, despite awareness of the impacts of systematic over-irrigation on yields and increased nutrient leaching risks. Significant ongoing research efforts will be needed to support improved knowledge and practical water management for key plantation crops.
Journal Article
Advances in Irrigation Agronomy
Irrigation has been used for thousands of years to maximize the performance, efficiency and profitability of crops and it is a science that is constantly evolving. This potential for improved crop yields has never been more important as population levels and demand for food continue to grow. Recognising the need for a coherent and accessible review of international irrigation research, this book examines the factors influencing water productivity in individual crops. It focuses on nine key plantation/industrial crops on which millions of people in the tropics and subtropics depend for their livelihoods (banana, cocoa, coconut, coffee, oil palm, rubber, sisal, sugar cane and tea). Linking crop physiology, agronomy and irrigation practices, this is a valuable resource for planners, irrigation engineers, agronomists and producers concerned with the international need to improve water productivity in agriculture in the face of increased pressure on water resources.
eBook
Climate change and water in the UK – past changes and future prospects
Climate change is expected to modify rainfall, temperature and catchment hydrological responses across the world, and adapting to these water-related changes is a pressing challenge. This paper reviews the impact of anthropogenic climate change on water in the UK and looks at projections of future change. The natural variability of the UK climate makes change hard to detect; only historical increases in air temperature can be attributed to anthropogenic climate forcing, but over the last 50 years more winter rainfall has been falling in intense events. Future changes in rainfall and evapotranspiration could lead to changed flow regimes and impacts on water quality, aquatic ecosystems and water availability. Summer flows may decrease on average, but floods may become larger and more frequent. River and lake water quality may decline as a result of higher water temperatures, lower river flows and increased algal blooms in summer, and because of higher flows in the winter. In communicating this important work, researchers should pay particular attention to explaining confidence and uncertainty clearly. Much of the relevant research is either global or highly localized: decision-makers would benefit from more studies that address water and climate change at a spatial and temporal scale appropriate for the decisions they make.
Journal Article