Assessment of Catfish Effluents Management in Lagos State, Nigeria

Catfish is one of the major sources of dietary protein in Nigeria. Lagos State is one of culturing areas with abundant fresh water and marine environments. The aim of this study was to evaluate the catfish rearing industry and its effluents management and make appropriate recommendations. Forty fish farms were randomly selected in Lagos State for the study. Questionnaire and in-depth interview were used for data collection on water sources, equipment operations, and waste management. Data collected were analyzed using descriptive statistics. Results indicated that over 80% of water for fish rearing was from shallow wells and 95% of the waste water generated was not treated before disposal into the environment. Effluents disposals employed were open pit (12.5%), drainage canal (32.5%), bare-land (20.0%), stream (22.5%) and re-used on farm (12.5%) and these methods of disposal were not significantly different (p ≤ 0.05). Only a few farmers carried out simple treatment before disposal namely; infiltration (2.5%) and sedimentation (2.5%). If the effluent management conditions were not improved, it could pose a threat to the environment in the study areas. Pond effluent must be treated before being disposed into the environment and waste water from fish pond effluent should be reused as irrigation water

Evaluation of Inhibitive Performance of Acidic Extract of Eichornia Crassipeson Corrosion of Low Carbon Steel in 1M Sulphuric Acid Solution

Corrosion inhibition potential of Eichhornia crassipes extract on low carbon steel in 1 M sulphuric acid solution was investigated using gravimetric method and corrosion rate. The experiment was carried out for 3 hours at different concentration of Eichhornia crassipes extract and temperatures of 26.6°C, 40°C and 60°C. Arrhenius and improved Arrhenius equations were used to determine the thermodynamics properties of the reaction while the nature of the reaction was proposed by adsorption isotherms. The results showed that corrosion rate decreased in the presence of the extract except in 60oC. Inhibition efficiency also increased with extract concentration with the highest (82%) occurring at room temperature and 5% concentration. Inhibition efficiency decreased with increase in temperature with almost no inhibition at 60oC, this is associated with physisorption. Activation energy () and activation enthalpy () both had positive values and they increased in the presence of Eichhornia crassipes extract, those for inhibited solution were higher than those for uninhibited solution, these can also be attributed to physisorption. Inhibition  reaction obeyed Langmuir adsorption isotherm. Gibbs free energy () calculated for the reaction is -8.509 to -11.767 kJ mol-1

Inhibitive Action of Water Extract of Spondias Mombin on Corrosion of Low Carbon Steel in 0.5 M Sulphuric Acid

Corrosion inhibition of water extract of Spondias mombin on low carbon steel in 0.5 M sulphuric acid was investigated in this paper. Fresh leaves, fruits and bark of this plant, washed properly, ground separately using small amount of distilled water to extract the juice at a ratio of 500 ml (distilled water) to 1 kilogram of plant were used for this experiment. Corrosion inhibitors of 0.4 g/ml, 1 g/ml and 2 g/ml were made from the filterate. Low carbon steel coupons suspended with twine inside 250 ml container of 0.5 M sulphuric acid in the presence of different concentrations of the extracts at room temperature for 35 days. The coupons were retrieved at 7 days interval, and the initial and final weights were recorded.  Inhibition efficiency for the leaves extract increased with concentration and got to its peak on the 7th day, that of the fruits extract initially increased with concentration until 1 g/ml after which there was a decline, its highest value was also recorded on the 7th day. The best inhibition efficiencies (in the range of 76.32% to 83.21%) for Spondias mombin water extract were observed in 0.4 g/ml bark extract throughout the days of the experiment, the highest being recorded on the14th day. It can be concluded that Spondias mombin water extract is a good corrosion inhibitor of low carbon steel in 0.5 M sulphuric acid at room temperature, with the best being the bark extract which inhibited for up to 35 days

Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. Funding National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic.publishedVersio

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Analysis of agro-climatic parameters and their influence on maize production in South Africa

This study analyzed the variability of the agro-climatic parameters that impact maize production across different seasons in South Africa. To achieve this, four agro-climatic variables (precipitation, potential evapotranspiration, minimum, and maximum temperatures) were considered for the period spanning 1986–2015, covering the North West, Free State, Mpumalanga, and KwaZulu-Natal (KZN) provinces. Results illustrate that there is a negative trend in precipitation for North West and Free State provinces and positive trend in maximum temperature for all the provinces over the study period. Furthermore, the results showed that among other agro-climatic parameters, minimum temperature had the most influence on maize production in North West, potential evapotranspiration (combination of the agro-climatic parameters), minimum and maximum temperature influenced maize production in KZN while maximum temperature influenced maize production in Mpumalanga and Free State. In general, the agro-climatic parameters were found to contribute 7.79, 21.85, 32.52, and 44.39% to variation in maize production during the study period in North West, Free State, Mpumalanga, and KZN, respectively. The variation in maize production among the provinces under investigation could most likely attribute to the variation in the size of the cultivated land among other factors including soil type and land tenure system. There were also difference in yield per hectare between the provinces; KZN and Mpumalanga being located in the humid subtropical areas of South Africa had the highest yield per hectare 5.61 and 4.99 tons, respectively, while Free State and North West which are in the semi-arid region had the lowest yield per hectare 3.86 and 3.03 tons, respectively. Understanding the nature and interaction of the dominant agro-climatic parameters discussed in the present study as well as their impact on maize production will help farmers and agricultural policy makers to understand how climate change exerts its influence on maize production within the study area so as to better adapt to the major climate element that either increases or decreases maize production in their respective provinces.The University of Pretoria through the Animal change project and DST for providing bursary through a grant that was received by University of Pretoria.http://link.springer.com/journal/7042019-11-01hj2019Animal and Wildlife SciencesGeography, Geoinformatics and MeteorologyPlant Production and Soil Scienc