Sand dams for sustainable water management: challenges and future opportunities

Sand dams are impermeable water harvesting structures built to collect and store water within the volume of sediments transported by ephemeral rivers. The artificial sandy aquifer created by the sand dam reduces evaporation losses relative to surface water storage in traditional dams. Recent years have seen a renaissance of studies on sand dams as an effective water scarcity adaptation strategy for drylands. However, many aspects of their functioning and effectiveness are still unclear. Literature reviews have pointed to a range of research gaps that need further scientific attention, such as river corridors and network dynamics, watershed-scale impacts, and interaction with social dynamics. However, the scattered and partially incomplete information across the different reviews would benefit from an integrated framework for directing future research efforts. This paper is a collaborative effort of different research groups active on sand dams and stems from the need to channel future research efforts on this topic in a thorough and coherent way. We synthesize the pivotal research gaps of a) unclear definition of “functioning” sand dams, b) lack of methodologies for watershed-scale analysis, c) neglect of social aspects in sand dam research, and d) underreported impacts of sand dams. We then propose framing future research to better target the synthesized gaps, including using the social-ecological systems framework to better capture the interconnected social and biophysical research gaps on sand dams, fully utilizing the potential of remote sensing in large-scale studies and collecting sand dam cases across the world to create an extensive database to advance evidence-based research on sand dams

Hospital outcomes in non-surgical patients identified at risk for OSA

Background: In-hospital respiratory outcomes of non-surgical patients with undiagnosed obstructive sleep apnea (OSA), particularly those with significant comorbidities are not well defined. Undiagnosed and untreated OSA may be associated with increased cardiopulmonary morbidity. Study objectives: Evaluate respiratory failure outcomes in patients identified as at-risk for OSA by the Berlin Questionnaire (BQ). Methods: This was a retrospective study conducted using electronic health records at a large health system. The BQ was administered at admission to screen for OSA to medical-service patients under the age of 80 years old meeting the following health system criteria: (1) BMI greater than 30; (2) any of the following comorbid diagnoses: hypertension, heart failure, acute coronary syndrome, pulmonary hypertension, arrhythmia, cerebrovascular event/stroke, or diabetes. Patients with known OSA or undergoing surgery were excluded. Patients were classified as high-risk or low-risk for OSA based on the BQ score as follows: low-risk (0 or 1 category with a positive score on the BQ); high-risk (2 or more categories with a positive score on BQ). The primary outcome was respiratory failure during index hospital stay defined by any of the following: orders for conventional ventilation or intubation; at least two instances of oxygen saturation less than 88% by pulse oximetry; at least two instances of respiratory rate over 30 breaths per minute; and any orders placed for non-invasive mechanical ventilation without a previous diagnosis of sleep apnea. Propensity scores were used to control for patient characteristics. Results: Records of 15,253 patients were assessed. There were no significant differences in the composite outcome of respiratory failure by risk of OSA (high risk: 11%, low risk: 10%, p = 0.55). When respiratory failure was defined as need for ventilation, more patients in the low-risk group experienced invasive mechanical ventilation (high-risk: 1.8% vs. low-risk: 2.3%, p = 0.041). Mortality was decreased in patients at high-risk for OSA (0.86%) vs. low risk for OSA (1.53%, p < 0.001). Conclusions: Further prospective studies are needed to understand the contribution of undiagnosed OSA to in-hospital respiratory outcomes

Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study

Pathophysiology and treatment of rheumatic disease

90‐90‐90 by 2020? Estimation and projection of the adult HIV epidemic and ART programme in Zimbabwe – 2017 to 2020

INTRODUCTION: The 90-90-90 targets set by the United Nations aspire to 73% of people living with HIV (PLHIV) being virally suppressed by 2020. Using the HIV Synthesis Model, we aim to mimic the epidemic in Zimbabwe and make projections to assess whether Zimbabwe is on track to meet the 90-90-90 targets and assess whether recently proposed UNAIDS HIV transition metrics are likely to be met. METHODS: We used an approximate Bayesian computation approach to identify model parameter values which result in model outputs consistent with observed data, evaluated using a calibration score. These parameter values were then used to make projections to 2020 to compare with the 90-90-90 targets and other key indicators. We also calculated HIV transition metrics proposed by UNAIDS (percentage reduction in new HIV infections and AIDS-related mortality from 2010 to 2020, absolute rate of new infections and AIDS-related mortality, incidence-mortality ratio and incidence-prevalence ratios). RESULTS: After calibration, there was general agreement between modelled and observed data. The median predicted outcomes in 2020 were: proportion of PLHIV (aged 15 to 65) diagnosed 0.91 (90% uncertainty range 0.87, 0.94) (0.84 men, 0.95 women); of those diagnosed, proportion on treatment 0.92 (0.90, 0.93); of those receiving treatment, proportion with viral suppression 0.86 (0.81, 0.91). This results in 72% of PLHIV having viral suppression in 2020. We estimated a percentage reduction of 36.5% (13.7% increase to 67.4% reduction) in new infections from 2010 to 2020, and of 30.4% (9.7% increase to 56.6% reduction) in AIDS-related mortality (UNAIDS target 75%). The modelled absolute rates of HIV incidence and AIDS-related mortality in 2020 were 5.48 (2.26, 9.24) and 1.93 (1.31, 2.71) per 1000 person-years respectively. The modelled incidence-mortality ratio and incidence-prevalence ratios in 2020 were 1.05 (0.46, 1.66) and 0.009 (0.004, 0.013) respectively. CONCLUSIONS: Our model was able to produce outputs that are simultaneously consistent with an array of observed data and predicted that while the 90-90-90 targets are within reach in Zimbabwe, increased efforts are required in diagnosing men in particular. Calculation of the HIV transition metrics suggest increased efforts are needed to bring the HIV epidemic under control

Smallholder agriculture in African dryland agroecosystems has limited impact on trophic group composition, but affects arthropod provision of ecosystem services

DATA AVAILABILITY STATEMENT : Data will be made available on request.Agricultural intensification is a major driver of biodiversity loss, but the majority of studies highlighting these threats come from industrialised agriculture in temperate countries of the global North. However, more than 30% of global food production is produced by smallholder farmers, particularly in Africa. We know very little about the impact of these farming practices on arthropod communities and associated ecosystems in dryland agroecosystems. We investigated the trophic group composition of arthropod communities (detritivorous, her- bivorous, predatory & mixed feeders) and levels of associated ecosystem functions in replicated maize fields, paired adjacent natural bushveld habitats and the edge habitats between them in north-eastern Namibia and central-eastern Botswana during the dry and wet seasons. Predator activity densities differed significantly be- tween habitats depending on the season, with higher numbers in natural habitats in the wet season but lower numbers in the dry season compared to maize fields. In general, edge habitats had higher numbers of predators than the other habitats. Predator attack rates on artificial caterpillars in both seasons and dung removal in the wet season were higher in habitats with natural vegetation (natural and edge). However, dung removal in the dry season and herbivory in the wet season were highest in the maize fields, the latter due to high level of fall armyworm infestation. Wet season multifunctionality was higher in natural habitats in Botswana, and to a lesser extent in Namibia, than in maize fields. Smallholder agriculture is not detrimental to decomposers, herbivores and mixed feeders compared to adjacent natural habitats, but may be detrimental to the provision of some ecosystem services. These results highlight the challenge of sustainably managing dryland agricultural land that is marginal for crop production, while providing smallholders with an optimal environment to benefit from the ecosystem services associated with arthropod communities. New conservation agriculture practices need to support the production of higher and more stable yields over time, while maintaining the limited impact of smallholder agriculture on biotic communities.http://www.elsevier.com/locate/ageeZoology and EntomologySDG-02:Zero HungerSDG-15:Life on lan