Water and energy systems in sustainable city development: a case of Sub-saharan Africa

Current urban water and energy systems are expanding while increasing attention is paid to their social, economic and environmental impacts. As a research contribution that can support real-world decision making and transitions to sustainable cities and communities, we have built a model-based and data-driven platform combining comprehensive database, agent-based simulation and resource technology network optimization for system level water and energy planning. Several use cases are demonstrated based on the Greater Accra Metropolitan Area (GAMA) city-region in Ghana, as part of the Future Cities Africa (FCA) project. The outputs depict an overall resource landscape of the studied urban area, but also provide the energy, water, and other resource balance of supply and demand from both macro and micro perspectives, which is used to propose environmental friendly and cost effective sustainable city development strategies. This work is to become a core component of the resilience.io platform as an open-source integrated systematic tool gathering social, environmental and economic data to inform urban planning, investment and policy-making for city-regions globally

Comparative sustainability study of energy storage technologies using data envelopment analysis

The transition to energy systems with a high share of renewable energy depends on the availability of technologies that can connect the physical distances or bridge the time differences between the energy supply and demand points. This study focuses on energy storage technologies due to their expected role in liberating the energy sector from fossil fuels and facilitating the penetration of intermittent renewable sources. The performance of 27 energy storage alternatives is compared considering sustainability aspects by means of data envelopment analysis. To this end, storage alternatives are first classified into two clusters: fast-response and long-term. The levelized cost of energy, energy and water consumption, global warming potential, and employment are common indicators considered for both clusters, while energy density is used only for fast-response technologies, where it plays a key role in technology selection. Flywheel reveals the highest efficiency between all the fast-response technologies, while green ammonia powered with solar energy ranks first for long-term energy storage. An uncertainty analysis is incorporated to discuss the reliability of the results. Overall, results obtained, and guidelines provided can be helpful for both decision-making and research and development purposes. For the former, we identify the most appealing energy storage options to be promoted, while for the latter, we report quantitative improvement targets that would make inefficient technologies competitive if attained. This contribution paves the way for more comprehensive studies in the context of energy storage by presenting a powerful framework for comparing options according to multiple sustainability indicators

Framework for WASH sector data improvements in data-poor environments, applied to Accra, Ghana

Improvements in water, sanitation and hygiene (WASH) service provision are hampered by limited open data availability. This paper presents a data integration framework, collects the data and develops a material flow model, which aids data-based policy and infrastructure development for the WASH sector. This model provides a robust quantitative mapping of the complete anthropogenic WASH flow-cycle: from raw water intake to water use, wastewater and excreta generation, discharge and treatment. This approach integrates various available sources using a process-chain bottom-up engineering approach to improve the quality of WASH planning. The data integration framework and the modelling methodology are applied to the Greater Accra Metropolitan Area (GAMA), Ghana. The highest level of understanding of the GAMA WASH sector is achieved, promoting scenario testing for future WASH developments. The results show 96% of the population had access to improved safe water in 2010 if sachet and bottled water was included, but only 67% if excluded. Additionally, 66% of 338,000 m3 per day of generated wastewater is unsafely disposed locally, with 23% entering open drains, and 11% sewage pipes, indicating poor sanitation coverage. Total treated wastewater is <0.5% in 2014, with only 18% of 43,000 m3 per day treatment capacity operational. The combined data sets are made available to support research and sustainable development activities

Patients Enrolled in Large Randomized Clinical Trials of Antiplatelet Treatment for Prevention After Transient Ischemic Attack or Ischemic Stroke Are Not Representative of Patients in Clinical Practice: the Netherlands Stroke Survey

Background and Purpose—Many randomized clinical trials have evaluated the benefit of long-term use of antiplatelet drugs in reducing the risk of new vascular events in patients with a recent transient ischemic attack or ischemic stroke. Evidence from these trials forms the basis for national and international guidelines for the management of nearly all such patients in clinical practice. However, abundant and strict enrollment criteria may limit the validity and the applicability of results of randomized clinical trials to clinical practice. We estimated the eligibility for participation in landmark trials of antiplatelet drugs of an unselected group of patients with stroke or transient ischemic attack from a national stroke survey. Methods—Nine hundred seventy-two patients with transient ischemic at

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice