China's coal-fired power plants impose pressure on water resources

Coal is the dominant fuel for electricity generation around the world. This type of electricity generation uses large amounts of water, increasing pressure on water resources. This calls for an in-depth investigation in the water-energy nexus of coal-fired electricity generation. In China, coal-fired power plants play an important role in the energy supply. Here we assessed water consumption of coal-fired power plants (CPPs) in China using four cooling technologies: closed-cycle cooling, once-through cooling, air cooling, and seawater cooling. The results show that water consumption of CPPs was 3.5 km3, accounting for 11% of total industrial water consumption in China. Eighty-four percent of this water consumption was from plants with closed-cycle cooling. China's average water intensity of CPPs was 1.15 l/kWh, while the intensity for closed-cycle cooling was 3-10 times higher than that for other cooling technologies. About 75% of water consumption of CPPs was from regions with absolute or chronic water scarcity. The results imply that the development of CPPs needs to explicitly consider their impacts on regional water resources

Mapping global hotspots and trends of water quality (1992–2010): a data driven approach

Clean water is key for sustainable development. However, large gaps in monitoring data limit our understanding of global hotspots of poor water quality and their evolution over time. We demonstrate the value added of a data-driven approach (here, random forest) to provide accurate high-frequency estimates of surface water quality worldwide over the period 1992-2010. We assess water quality for six indicators (temperature, dissolved oxygen, pH, salinity, nitrate-nitrite, phosphorus) relevant for the sustainable development goals. The performance of our modeling approach compares well to, or exceeds, the performance of recently published process-based models. The model’s outputs indicate that poor water quality is a global problem that impacts low-, middle- and high-income countries but with different pollutants. When countries become richer, water pollution does not disappear but evolves. Water quality exhibited a signif icant change between 1992 and 2010 with a higher percentage of grid cells where water quality shows a statistically significant deterioration (30%) compared to where water quality improved (22%)

Global water scarcity including surface water quality and expansions of clean water technologies

Water scarcity threatens people in various regions, and has predominantly been studied from a water quantity perspective only. Here we show that global water scarcity is driven by both water quantity and water quality issues, and quantify expansions in clean water technologies (i.e. desalination and treated wastewater reuse) to ‘reduce the number of people suffering from water scarcity’ as urgently required by UN’s Sustainable Development Goal 6. Including water quality (i.e. water temperature, salinity, organic pollution and nutrients) contributes to an increase in percentage of world’s population currently suffering from severe water scarcity from an annual average of 30% (22%–35% monthly range; water quantity only) to 40% (31%–46%; both water quantity and quality). Water quality impacts are in particular high in severe water scarcity regions, such as in eastern China and India. In these regions, excessive sectoral water withdrawals do not only contribute to water scarcity from a water quantity perspective, but polluted return flows degrade water quality, exacerbating water scarcity. We show that expanding desalination (from 2.9 to 13.6 billion m3 month−1) and treated wastewater uses (from 1.6 to 4.0 billion m3 month−1) can strongly reduce water scarcity levels and the number of people affected, especially in Asia, although the side effects (e.g. brine, energy demand, economic costs) must be considered. The presented results have potential for follow-up integrated analyses accounting for technical and economic constraints of expanding desalination and treated wastewater reuse across the world

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

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

A global salinity dataset of surface water and groundwater measurements from 1980-2019

This data contains a new global salinity database, compiled from electrical conductivity (EC) monitoring data of both surface water (rivers, lakes/reservoirs) and groundwater locations over the period 1980-2019. The database includes information from over 16.3 million samples, from 45,103 surface water locations and 208,550 groundwater locations around the world. The database consists of three categories; (1) River Data, (2) Lake/Reservoir Data and (3) Groundwater Data. Each category have two associated data files in csv-format, one containing the full salinity data, and one summary file, which provides basic EC statistics (median, mean, max, min, sd), sampling summary information (start and end period of measurements, number of measurements) and other station and data information (coordinates, country, continent, data source) for each data location (Station_ID)