Farmland abandonment and its determinants in the different ecological villages of the Koshi river basin, central Himalayas: Synergy of high-resolution remote sensing and social surveys.

Globally, there is a noticeable increasing trend in farmland abandonment, which directly affects farmers' livelihood and food security. The abandonment status, its determinants and impact vary by spatial and socioeconomic context. In order to study this important issue, we selected three different villages representing three ecological regions (Mountain, Hill, and Tarai) in the Koshi River Basin (KRB), and applied two methods: the Unmanned Aerial Vehicle (UAV) and a social survey. The UAV captured 3711 images and we carried out 162 households' survey with structured questionnaires. Pix4Dmapper and ArcGIS tools were used for combining and processing the images. On-screen digitalization and binary logistic regression (BLR) were applied to examine the status and determinants of farmland abandonment. The results show a higher proportion of farmland abandonment in the villages located in the Hill and Mountain regions compared to those in the Tarai region. Almost 10.3% area of total land and 22.3% area of total farmland was abandoned in the Hill village. The Tarai village had the least farm abandonment (3.7%). Farmers perceived that climate change (less precipitation, increasing temperatures, and drought), shifting occupations, crops damaged by wildlife, migration, lack of irrigation, and a labor shortage are the leading determinants of farmland abandonment. These factors varied slightly across the different ecological regions. The BLR model was a good fit with Nagelkerke's R2 = 0.776, with a correct model prediction (87.7%) and p = 0.032. The results from the regression model suggest that an increase in temperature (p = 0.000), decrease in rainfall (p = 0.001), lack of machinery used for farm-work (p = 0.000), lack of irrigation (p = 0.000), and reduction of labor-force (p = 0.000) are the main contributing determinants of farmland abandonment. This synergy of high-resolution remote sensing and farmers' perception-based findings facilitates the improvement of land-use governmental policies to improve farmers' quality of life and build sustainable farmland management.

Feasibility and efficiency of double-agent versus single-agent concurrent chemoradiotherapy in patients with nasopharyngeal carcinoma.

PURPOSE: Concurrent chemoradiotherapy (CCRT) is the mainstay of treatment for nasopharyngeal carcinoma (NPC) patients. It remains unclear whether double-agent CCRT (d-CCRT) is more effective than single-agent CCRT (s-CCRT). In this study, we compared the treatment efficiency and toxicity of d-CCRT with s-CCRT in NPC patients. METHODS AND MATERIALS: Patients with stage II-IV NPC treated with d-CCRT or s-CCRT were retrospectively reviewed. The d-CCRT group patients were compared with s-CCRT group patients for overall survival (OS), locoregional relapse-free survival (LRRFS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and toxicity. Differences in baseline characteristics were adjusted using the pair-matching method. RESULTS: In this study, 933 patients who received CCRT for NPC between 2011 and 2014 were pair-matched at a 1:2 ratio (n = 311 for d-CCRT; n = 622 for s-CCRT). The d-CCRT treated patients showed no significant advantages in terms of 4-year OS (87.2% vs. 85.5%), DFS (84.1% vs. 79.5%), LRRFS (94.6% vs. 91.8%), DMFS (87.5% vs. 85.5%) compared with s-CCRT treated patients (P = 0.450, 0.106, 0.203, 0.366, respectively). Multivariate analysis showed that CCRT regimen had no significant effects on survival. In the d-CCRT group, the incidence of grade 3-4 hematological toxicities was significantly higher. CONCLUSIONS: The d-CCRT regimen did not confer significant survival benefits compared with the s-CCRT regimen in the treatment of stage II-IV NPC patients. Furthermore, patients treated with the d-CCRT regimen experienced greater hematological toxicity.

Efficacy and safety of intensity-modulated radiotherapy alone versus intensity-modulated radiotherapy plus chemotherapy for treatment of intermediate-risk nasopharyngeal carcinoma.

BACKGROUND: This study directs to evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) alone versus IMRT plus chemotherapy in intermediate-risk NPC (stage II and T3N0M0). METHODS: A total of 124 patients with stage II and T3N0M0 NPC were pair-matched (1:1 ratio) to form two groups: an IMRT-alone group and an IMRT/chemotherapy group. Survival outcomes (overall survival [OS], disease-free survival [DFS], locoregional relapse-free survival [LRRFS], distant metastasis-free survival [DMFS]) and treatment-related grade 3-4 acute toxicity events were compared between the groups. RESULTS: Survival outcomes for patients with stage II and T3N0M0 NPC were quiet comparable between patients treated with IMRT alone versus patients treated with IMRT/chemotherapy: 5-year OS was 91.9% vs. 90.3%, respectively (P = 0.727); DFS was 87.1% vs. 88.7%, respectively (P = 0.821); LRFFS was 96.8% vs. 95.2%, respectively (P = 0.646), and DMFS was 91.9% vs. 91.5%, respectively (P = 0.955). Grade 3 acute toxicities were significantly higher with IMRT/chemotherapy than with IMRT alone: mucositis, 15% vs. 5% (P = 0.004); leukopenia/neutropenia, 8% vs. 1% (P <  0.015); and nausea/vomiting, 22% vs. 3% (P <  0.001). CONCLUSION: For intermediate-risk (stage II and T3N0M0) NPC patients, the addition of chemotherapy to IMRT does not appear to provide any survival benefit. Moreover, grade 3 acute toxicities are also more common in patients receiving IMRT plus chemotherapy.

Farmers' perceptions of agricultural land use changes in Nepal and their major drivers.

Historical trends show that the total area of agricultural land in Nepal has changed markedly over time, but few studies have addressed the causative drivers underlying this change. Evaluating the perceptions of farmers is an effective tool for addressing this issue because it reflects the full range of drivers associated with changes in land use. This study utilizes historical agricultural area, population, and climate data for 1910-2010, combined with a series of applied household surveys and focus group discussions to assess farmers' perceptions of these changes and identify the major drivers. The paired t-test was employed to measure differences between various groups of drivers. The total area of agricultural land in Nepal has expanded rapidly since 1910, more intensively in the southern (Tarai) and central (Hill) ecological regions of the country, and has decreased slightly near large cities in recent decades. Farmers' perceptions show that socioeconomic variables were considered to be the crucial drivers of changes in agricultural land use. The three other major drivers were grouped as: neighborhood, climate-topography, and policy drivers. In particular, farmers pointed to the high level of population growth (93.96%) as the main factor underlying the changes, and the majority of drivers are associated with this variable. Access to roads (77.36%), urbanization (33.77%), government policies (23.58%), and remittance impact (16.79%) are other notable triggering variables. The paired t-test results equating variables from different groups of drivers and ecological regions indicate varied significance (p-values range from 0.004 to 0.983). Our analysis confirms that the synergy between social and natural observations can be integrated to obtain research findings that identify scientific and social issues. The interplay between the drivers should be emphasized in developing plans for sustainable agricultural land use management.