The impacts of telemedicine on assisted reproduction: a systematic review and meta-analysis.

Telemedicine is being applied in assisted reproduction technology (ART) to provide remote consultations, monitoring and support for patients. This study aimed to evaluate the potential advantages of telemedicine in ART treatment in the form of virtual consultations. Studies in which patients were using telemedicine during ART treatment were identified from four scientific databases (PudMed, EMBASE, Scopus, Web of Science). The success of fertility treatments was compared between telemedicine and in-office care, and patient satisfaction with ART through telemedicine was assessed. Eleven studies, comprising 4697 patients, were identified. Quality assessment (Joanna Briggs Institute Critical Appraisal and revised Cochrane risk-of-bias tools) revealed an acceptable risk of bias for both randomized controlled trials and observational studies. Using a fixed-effects model, telemedicine was comparable to in-person care regarding the pregnancy rate achieved (odds ratio 1.02, 95% confidence intervals 0.83-1.26, P = 0.83). A Q-test suggested that all the included studies were homogeneous. Patients who received telemedicine during fertility treatment reported a high level of satisfaction (91%, 95% confidence intervals 80-96%). Egger's test confirmed that no publication bias was found. Telemedicine could serve as a complementary tool during fertility treatment to facilitate patients' satisfaction and overcome some practical problems without compromising treatment outcomes. Future studies should continue exploring the potential applications of telemedicine in assisted reproduction.

Salt-tolerant rice variety adoption in the Mekong River Delta: Farmer adaptation to sea-level rise.

Rice production in the Mekong River Delta of Vietnam (MRD) is endangered by sea-level rise and an associated increase in the incidence of salinity intrusion. This paper examines the diffusion of salt tolerant rice varieties in the MRD that were promoted through Consortium for Unfavorable Rice Environments (CURE) activities. Factors associated with adoption of CURE-related varieties are estimated using a random utilty model and a dataset of 800 farm households with rice fields in salinity prone areas of the MRD. Results suggest that there has been widespread adoption of CURE-related varieties in salinity-prone areas. Further, multivariate analysis reveals that environment and location characteristics, rather than household characteristics, are the most important determinants of adoption. In particular, CURE-related varieties are more likely to be adopted in high-salinity-risk areas that are not protected by salinity barrier gates. Neighbhors' adoption decisions also strongly influence household decisions to adopt CURE-related varieties. The contracting of mechanization, particularly for land preparation and harvest, requires the coordination of village households in timing of planting, harvest and varietal duration. This coordination appears to extend to choice of CURE-related varieties. Finally, CURE-related varieties and other varieties generate similar net revenues in a year with low salinity exposure, suggesting that CURE-related varieties are a low-cost insurance policy against salinity inundation in high risk areas. Combined, these results highlight the need to address complex factors beyond current economic profits, like environment, community choices, and risk mitigation, when designing technologies and policies that support farmer adaptation to climatic change.