The Development of a Web-based Decision Support System for the Sustainable Management of Contaminated Land

Land is a finite natural resource that is increasingly getting exhausted as a result of land contamination. Land is made up of soil and groundwater, both of which have many functions for which we depend on, including provision of food and water, supporting shelter, natural flood defence, carbon sequestration, etc. Contaminants in land also pose a number of threats to public health and the environment; other natural resources; and have detrimental effects on property such as buildings, crops and livestock. The most effective method of dealing with these contaminants is to cleanup and return the sites to beneficial use. The cleanup process involves making a choice from amongst competing remediation technologies, where the wrong choice may have disastrous economic, environmental and/or social impacts. Contaminated land management is therefore much broader than the selection and implementation of remedial solutions, and requires extensive data collection and analysis at huge costs and effort. The need for decision support in contaminated land management decision-making has long been widely recognised, and in recent years a large number of Decision Support Systems (DSS) have been developed. This thesis presents the development of a Web-based knowledge-based DSS as an integrated management framework for the risk assessment of human health from, and sustainable management of, contaminated land. The developed DSS is based on the current UK contaminated land regime, published guidelines and technical reports from the UK Environment Agency (EA) and Department for Environment, Food and Rural Affairs (DEFRA) and other Government agencies and departments. The decision-making process of the developed DSS comprises of key stages in the risk assessment and management of contaminated land: (i) preliminary qualitative risk assessment; (ii) generic quantitative risk assessment; and (iii) options appraisal of remediation technologies and remediation design. The developed DSS requires site specific details and measured contaminant concentrations from site samples as input and produces a site specific report as output. The DSS output is intended to be used as information to support with contaminated land management decision-making.Great Western Researc

Guidance on evaluation and selection of sustainable water demand management technologies

This report presents guidance for the evaluation and selection of Water Demand Management (WDM) type technologies for the effective and efficient reduction of water consumption for different water stakeholders - householders, Water Service Providers (WSPs) and policy makers - in a technically sound, yet economically, environmentally and socially acceptable way for all stakeholders involved. The technical guidance is based on reviews of different WDM technologies and methodologies developed in Work Package 42 of the TRUST project. The WDM interventions considered in the report have been evaluated largely based on the their overall water saving potential, cost-effectiveness, water-related energy use as well as impact on the reliability of supply/demand balance of Water Distribution Systems (WDSs).Bello-Dambatta, A.; Kapelan, Z.; Butler, D.; Oertlé, E.; Wintgens, T.; Rozos, E.; Makropoulos, C.... (2014). Guidance on evaluation and selection of sustainable water demand management technologies. http://hdl.handle.net/10251/3534

Responding to the UN sustainability goals in transdisciplinary partnership through network action learning

The global water crisis, an enormous concern according to the World Economic Forum, poses a significant challenge to long-term sustainability, exacerbated by the high energy demand associated with water supply and treatment. As the renewable energy sector grows, the need for green technologies to support the water-energy nexus becomes evident. However, mere technological advancements are insufficient to address complex water-related challenges. This paper presents a transdisciplinary collaborative effort involving engineers, geographers, management researchers, and environmentalists working with practitioners in a cross-border network. The study explores through action learning research how, in a transdisciplinary partnership, network action learning influences the exploration and implementation of novel green technology and the development of innovation capabilities. The research is structured around three themes: green technology platforms, policy support and guidance, and dissemination and collaboration. It identifies the factors impacting technology exploration and application and how concurrently green innovation capabilities are developed. The study emphasizes the significance of transdisciplinary collaboration and offers valuable insights into addressing UN Sustainability Goals related to clean water, sustainable industry, and partnerships. It contributes to innovation capability theory and provides practical guidance to researchers, practitioners, and policymakers, emphasizing the need for holistic approaches to address the water-energy crisis and achieve sustainable development

Impact Assessment of Household Demand Saving Technologies on System Water and Energy Use

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.Climate change, population growth, migration, urbanisation, and ageing infrastructure will all impose significant strains on the urban water services in Europe, and cities across Europe will experience increasingly frequent shortfalls in supply/demand balance. It is widely accepted that the mitigation of these and other emerging challenges should be sensitive to increasing energy prices, the environment, and the desire for low carbon intensity solutions. This paper presents the development of a new methodology for assessing the impact of household water savings from different water demand management interventions based on their water-related energy use and cost, as well as their impact on the supply/demand balance. The methodology has been applied to the water distribution system of a European city to demonstrate its application using different water demand management interventions for different types of water savings. Sensitivity analysis for different population growth rates that are representative of the different growth rates across the EU was carried out. The results show different degrees of water, energy, and cost savings can be achieved depending on the type (s) and proportion of household micro-component appliances and fittings considered. In all the intervention strategies considered, there are important trade-offs to be made between the different performance indicators as not all interventions will result in water savings and/or reductions in water-related energy use and costs or have a positive impact on supply/demand balance.EU FP7 Transition to Urban water Services of Tomorrow (TRUST)University Of Applied Sciences Northwest Switzerland (FHNW

Impact Assessment of Household Demand Saving Technologies on System Water and Energy Use

Climate change, population growth, migration, urbanisation, and ageing infrastructure will all impose significant strains on the urban water services in Europe, and cities across Europe will experience increasingly frequent shortfalls in supply/demand balance. It is widely accepted that the mitigation of these and other emerging challenges should be sensitive to increasing energy prices, the environment, and the desire for low carbon intensity solutions. This paper presents the development of a new methodology for assessing the impact of household water savings from different water demand management interventions based on their water-related energy use and cost, as well as their impact on the supply/demand balance. The methodology has been applied to the water distribution system of a European city to demonstrate its application using different water demand management interventions for different types of water savings. Sensitivity analysis for different population growth rates that are representative of the different growth rates across the EU was carried out. The results show different degrees of water, energy, and cost savings can be achieved depending on the type (s) and proportion of household micro-component appliances and fittings considered. In all the intervention strategies considered, there are important trade-offs to be made between the different performance indicators as not all interventions will result in water savings and/or reductions in water-related energy use and costs or have a positive impact on supply/demand balance

Randomized controlled trial of fixed low-vs moderate-dose hydroxyurea for primary stroke prevention in Sub-Saharan Africa: Final results of the Spring Trial

Introduction: In children with sickle cell anemia (SCA) without transcranial Doppler (TCD) screening, the incidence rates of ischemic strokes is approximately the same among children living in low- and high- low-resource settings (Pediatr Neurol. 2019;95:73-78.) with a prevalence of ~ 11%. However, in high-income settings, the standard use of TCD ultrasonography, coupled initially with monthly blood transfusion therapy has dropped the stroke prevalence to < 1%. In a low-income setting, such as Nigeria, where 50% of children in the world with SCA are born (150,000 per year), initial monthly blood transfusion therapy is not practical for most children.In the Stroke Prevention in Nigeria (SPIN) Feasibility Trial (NCT01801423), fixed moderate-dose hydroxyurea was associated with a decreased rate of strokes in children with SCA and abnormal time-averaged mean of the maximum velocity (TAMMV) TCD measurements (≥200cm/sec) when compared to no treatment in the STOP Trial, 0.76 and 10.7 strokes per 100 person-years, repsectively (Am J Hematol. 2020). Based on the success of the SPIN trial, plus the challenges of real-world implementation of a government-supported primary stroke prevention programs for estimated 40,0000 children with SCA in three states in Nigeria, we tested the hypothesis that fixed-moderate dose (~20 mg/kg/day) hydroxyurea therapy for primary stroke prevention results in a 66% relative risk reduction (9 to 3 events per 100 person-years) when compared to fixed low-dose hydroxyurea (~10 mg/kg/day) therapy in a randomized controlled trial (The SPRING Trial; NCT02560935).Methods: In this partial-blind controlled phase III trial, we randomly assigned children between 5 and 12 years of age with SCA and a TCD time-averaged mean of the maximum velocity (TAMMV) ≥ 200 cm/sec measured independently twice or TAMMV ≥220 cm/sec once at study screening to receive fixed low-dose or fixed moderate-dose hydroxyurea. The primary endpoint was a clinical stroke or a transient ischemic attack (TIA). Myelosuppression was assessed with monthly complete blood counts (CBCs). Adherence to hydroxyurea was primarily based on an increase in MCV from baseline and monthly pill count return as a percent of dispensed pills. Hemoglobin F levels were measured at baseline, annually and upon trial exit. To evaluate the safety of hydroxyurea in the trial, children attending the same SCA clinics with TCD (TAMMV) <200 cm/sec at study screening were prospectively followed with biweekly phone calls and annual research visits.Results: A total of 220 children (mean age: 7.5 years, 51.8% female) were randomly assigned to fixed low- (10 mg/kg/day) or moderate- (20 mg/kg/day) dose hydroxyurea, and were followed for a median of 2.4 years (IQR 2.0-2.8). NINDS Clinical Trials leaders stopped the trial early because of futility for the primary outcome. In the fixed low- and moderate-dose hydroxyurea groups, the incidence rates of strokes per 100 person-years were 1.19 and 1.92 respectively, with an incidence rate ratio of 1.60 (95% CI: 0.31-10.34), p = 0.768. The incidence rate ratio of mortality when comparing the children treated with low- and moderate- fixed-dose hydroxyurea to the non-elevated TCD group (no hydroxyurea therapy, n= 211) was 1.97 (95% CI: 0.64-6.02) and 0.47 (95% CI: 0.05-2.38), p = 0.265 and 0.545, respectively. Returned pills during the trial was 5.4% and 4.8% in the fixed low- and moderate-dose groups, respectively, p= 0.144. MCV from baseline to endpoint increased 1.5fl and 7.2 fl in the fixed low- and moderate-dose groups, respectively, p<0.001. Upon exit from the trial 29.4% and 66.7% of the fixed- low and moderate -dose groups, respectively, had either hemoglobin level ≥ 9.0 g/dl, or a fetal hemoglobin level ≥ 20%.Conclusions: For primary stroke prevention in children with SCA, fixed low-dose, when compared to fixed moderate-dose hydroxyurea therapy, demonstrated no difference in the incidence rate of strokes. Both fixed low- and moderate -dose hydroxyurea doses are superior to no treatment for primary stroke prevention with abnormal TCD values. In partnership with Katsina, Kano, and Kaduna health department's leaders in Nigeria, 9 distinct SCA and primary stroke prevention clinics have been established, with the provision of free fixed low-dose hydroxyurea therapy (Bond Chemical, Nigeria; $0.15 per 500 mg) for abnormal TCD values, and biannual CBCs as standard care ,for over 40,000 children with SCA

Primary prevention of stroke in children with sickle cell anemia in sub-Saharan Africa: rationale and design of phase III randomized clinical trial

Strokes in children with sickle cell anemia (SCA) are associated with significant morbidity and premature death. Primary stroke prevention in children with SCA involves screening for abnormal transcranial Doppler (TCD) velocity coupled with regular blood transfusion therapy for children with abnormal velocities, for at least one year. However, in Africa, where the majority of children with SCA live, regular blood transfusions are not feasible due to inadequate supply of safe blood, cost, and the reluctance of caregivers to accept transfusion therapy for their children. We describe the Primary Prevention of Stroke in Children with Sickle Cell Disease in Nigeria Trial [StrokePreventioninNigeria (SPRING) trial, NCT02560935], a three-center double-blinded randomized controlled Phase III clinical trial to 1) determine the efficacy of moderate fixed-dose (20 mg/kg/day) versus low fixed-dose (10 mg/kg/day) hydroxyurea therapy for primary stroke prevention; 2) determine the efficacy of moderate fixed-dose hydroxyurea for decreasing the incidence of all cause-hospitalization (pain, acute chest syndrome, infection, other) compared to low fixed-dose hydroxyurea. We will test the primary hypothesis that there will be a 66% relative risk reduction of strokes in children with SCA and abnormal TCD measurements, randomly allocated, for a minimum of three years to receive moderate fixed-dose versus low fixed-dose hydroxyurea (total n = 220). The results of this trial will advance the care of children with SCA in sub-Saharan Africa, while improving research capacity for future studies to prevent strokes in children with SCA.</p