Abstract:Increasing concerns about global environmental change and food security have focused attention on the need for environmentally sustainable agriculture. This is agriculture that makes efficient use of natural resources and does not degrade the environmental systems that underpin it, or deplete natural capital stocks. We convened a group of 29 'practitioners' and 17 environmental scientists with direct involvement or expertise in the environmental sustainability of agriculture. The practitioners included representatives from UK industry, non-government organizations and government agencies. We collaboratively developed a long list of 264 knowledge needs to help enhance the environmental sustainability of agriculture within the UK or for the UK market. We refined and selected the most important knowledge needs through a three-stage process of voting, discussion and scoring. Scientists and practitioners identified similar priorities. We present the 26 highest priority knowledge needs. Many of them demand integration of knowledge from different disciplines to inform policy and practice. The top five are about sustainability of livestock feed, trade-offs between ecosystem services at farm or landscape scale, phosphorus recycling and metrics to measure sustainability. The outcomes will be used to guide ongoing knowledge exchange work, future science policy and funding.
IntroductionIn emphysema patients, being evaluated for bronchoscopic lung volume reduction (BLVR), accurate measurement of lung volumes is important. Total Lung Capacity (TLC) and Residual Volume (RV) are commonly measured by body-plethysmography, but can also be derived from chest computed tomography (CT). Spirometry-gated CT scanning potentially improves the agreement of CT and body-plethysmography.ObjectiveTo compare lung volumes derived from spirometry-gated CT and “breath-hold-coached” CT to the reference standard: body-plethysmography.MethodsIn this single centre retrospective cohort study, emphysema patients, evaluated for BLVR, underwent body-plethysmography, inspiration (TLC) and expiration (RV) CT-scan with spirometer guidance (“gated group”) or with breath-hold-coaching (“non-gated group”). Quantitative analysis was used to calculate lung volumes from the CT.ResultsWe included 200 patients (age 62±8 years, FEV1 29.2±8.7%, TLC 7.50±1.46 L, RV 4.54±1.07 L). The mean CT-derived TLC was 280(±340)ml lower compared to body-plethysmography in the gated group (n=100), and 590(±430)ml lower for the non-gated group (n=100) (both p<0.001). The mean CT-derived RV was 300(±470)ml higher in the gated group and 700(±720)ml higher in the non-gated group (both p<0.001). Pearson correlation factors were 0.947 for TLC gated, 0.917 for TLC non-gated, 0.823 for RV gated, 0.693 for RV non-gated, 0.539 for %RV/TLC gated and 0.204 for %RV/TLC non-gated. The differences between the gated and non-gated CT results for TLC and RV were significant for all measurements (p<0.001).ConclusionIn severe COPD patients with emphysema, CT-derived lung volumes are strongly correlated to body-plethysmography lung volumes, and especially for RV, more accurate when using spirometry-gating.
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