Alternate Solutions Towards Sustainable Irrigated Agriculture in Ghana: Review of Literature

Irrigated agriculture management is still not effective in Ghana. The growing recognition of irrigation problems and its impact on the economy and environment have prompted the government of Ghana to implement plans and strategies to encourage new developments and technologies to promote sustainable irrigated agriculture. The study aims at identifying sustainable ways in promoting irrigated agriculture in Ghana. literature search and thematic analysis of the literature were used and the themes identified provide the basis for the study. The results were that sustainability can be achieved if there is effective WUA management, strong irrigation facility, effective farmers training, improving extension capacity to deliver, sustainable irrigation techniques and effective collaboration. In conclusion, irrigation sectors should take full advantage of abundant water resource in Ghana and ensure that irrigation is handled in a way that protects the environment for the present generation without compromising the benefits of the future generations

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Assessment of Chemical and Microbiological Drinking Water of Beirut and Mount Lebanon

Lebanon is known for its abundant water resources, but it faces significant challenges with water supply shortages, particularly in delivering water to residential areas and public facilities. This problem is compounded by a high rate of pollution, both in pipelines and bottled water. To address the issue of water-related diseases, this research was conducted to assess the water quality of 79 drinking water samples from Beirut and Mount Lebanon using the Inductively Coupled Plasma – Optical Emission Spectrometry (ICP-OES) with Ultra Sonic Nebulizer (USN) method. The study found that most element concentrations in the water samples are within the acceptable range set by the World Health Organization (WHO). However, four elements were highlighted as areas of concern: sodium, arsenic, mercury, and calcium, as their concentrations were outside the accepted WHO range. Specifically, 23% of sites showed high mercury concentrations from various potential sources, 76% of sites had elevated arsenic levels, and 91% of sites had low calcium concentrations, indicating weak mineralization in the drinking water. Additionally, 20% of sites had high sodium concentrations, and 9% had high calcium concentrations due to the presence of carbonate rock reservoirs, particularly limestone, which increases water hardness. The microbiological analysis of water samples showed that 60.76% of the samples contained bacteria. Among the samples, 46% were contaminated by total coliform, and 33% showed contamination by fecal coliform. Additionally, 30% of the samples contained Pseudomonas aeruginosa, and 39% were contaminated with E. coli. These findings indicate that a significant percentage of the tested water samples have microbial contamination, posing potential health risks to consumers. Proper water treatment and monitoring measures are essential to ensure the safety and quality of drinking water and to reduce the incidence of waterborne diseases. Keywords: Lebanon, Drinking water, Pollution, heavy metals, treatment. DOI: 10.7176/JEES/13-6-01 Publication date:August 31st 202

Adaptation to Climate Change Effects on Water Resources: Understanding Institutional Barriers in Nigeria

Climate Change (CC) and variability are global issues that the world has been facing for a long time. Given the recent catastrophic events, such as flooding, erosion, and drought in Nigeria, many have questioned institutions&rsquo; capacity in managing CC impacts in Nigeria. This study explores emerging institutional barriers of adaptation to CC effects on water resources in Nigeria. The study data were obtained from in-depth interviews with institutional heads from water resources management and emergency management and a review of secondary literature from databases such as Google Scholar, Scopus, and Web of Science. The results show that inadequate hydrological data management, low awareness on how to adapt among the public and decision-makers, financial constraints, no political will to pass important bills into law, and inadequate institutional and legal framework are the main institutional barriers of adaptation to climate change in Nigeria. The study concludes that it is essential to strengthen the institutional and legal system, information management mechanism, public awareness, and participatory water resources management. The implications for further research are presented in the study

Providing a reliable public water service to communities living in insecure Lake Chad Islands

This record includes an extended abstract and MP4 presentation. Presented at the 42nd WEDC International Conference

A potential phosphorous fertilizer for organic farming: recovery of phosphorous resources in the course of bioenergy production through anaerobic digestion of aquatic macrophytes

Abstract Background A major problem with farming systems is the deficiencies in phosphorus (P) due to fixation in soils, erosion and run-off, and exports of herbal and animal products. P resources for the compensation of these losses will sooner or later be depleted. For this reason, innovative ideas for phosphorus recycling are highly relevant. The P excess from farming systems mostly ends up in surface waters, leads to eutrophication, and promotes the growth of aquatic plants. Particularly invasive neophytes such as western waterweed (Elodea nuttallii) can rapidly generate high levels of biomass in waters with good nutrient supply and bind relevant amounts of phosphorus. Methods In the renatured open-pit mine Goitzsche (Saxony-Anhalt, Germany), biomass from E. nuttallii was harvested (2005–2008) and the biomass dry matter and the P concentration were determined. The phosphorus recovery potential from this plant biomass was calculated by extrapolation based on the phosphorus analyses and the area potentially populated by E. nuttallii. One analysis of E. nuttallii was conducted to evaluate the content of potentially toxic elements (PTEs). Results The results showed that with 0.5 to 6.3 kg P/Mg of total solid (dry matter), E. nuttallii could have a high potential to recycle phosphorus, e.g., by anaerobic digestion and digestate fertilization. Lake Goitzsche offered an annual recovery potential from 0.5 to 1.7 Mg phosphorus in the investigation period. This could meet the needs of 114-ha organic farming land based on a 7 kg/(ha*year) regional phosphorus deficit. The digestate of E. nuttallii is very well suited as a fertilizer due to its high phosphorus concentration. The concentrations of PTEs in the current digestate (related to an individual case) are sufficient for legal admission in Germany. In this study, nickel was above the threshold values for Germany. The elevated nickel levels in the Elodea biomass correspond to the geogenic high nickel concentrations in the sediment of this lake. Conclusions Aquatic macrophytes have a significant potential for recovering phosphorus from waters and sediments of relevant phosphorus concentrations. Further studies of surface water zones, particularly with regard to the aquatic plant biomass and phosphorus concentration of sediments, are needed to assess future exploration