A Systematic Review of Methodological Tools for Evaluating the Water, Energy, Food, and One Health Nexus in Transboundary Water Basins

Water plays a vital role in human socioeconomic development and overall well-being, making its effective management essential in achieving the Sustainable Development Goals. The close interlinkage between water, other environmental resources, and socioeconomic development have prompted the emergence and adoption of holistic and trans-sectoral concepts such as integrated water resources management and, more recently, the resource nexus. However, even such holistic approaches often exclude the one health approach, particularly at the transboundary water basins (TWBs), which not only dominate 40% of the earth but are vital in environmental and human sustainability. This review aimed to understand, evaluate, and compare assessment tools for water, energy, food, and one health (WEF + H) nexus management in TWBs. The review applied the systematic review guidelines for articles published in the Scopus database. The inclusion criteria encompassed English-language articles featuring case studies, meta-studies, or review articles with no less than three nexus resources. The review categorized the article based on criteria that focused on identifying tools capable of analyzing scenarios and policies for WEF + H in TWBs and their accessibility and easiness of implementation in case studies. Of the eighteen analyzed tools, 13 (72%) had limitations in their application at various geographical scales. Additionally, they could not integrate one health into the nexus or analyze policies through running scenarios. On the contrary, the Bayesian networks, system dynamics, agent-based models, life-cycle assessments, and input-output tools were highly accessible for efficiently conducting scenario-based WEF + H nexus assessments in TWBs.

Utilization of Plastic Wastes for Sustainable Environmental Management: A Review

The advancement and modernization of industries have provided numerous benefits to human life including diversification of manufacturing a wide range of products made from plastic materials, thereby leading to the generation of huge quantities of plastic waste. Owing to the increasing issues related with plastic waste, recycling methods have attracted much interest. Recycling not only protects the environment and resources for future generations but also reduces energy consumption and greenhouse gas emissions. A wide range of valuable products including char, oil, fuels, sorbent materials, and chemicals can be obtained through different techniques. This Review highlights various sustainable research avenues and potential routes to reduce the environmental impact of plastic waste based on both traditional and potential approaches for its utilization.

Simultaneous inactivation of multidrug-resistant Escherichia coli and enterococci by peracetic acid in urban wastewater: Exposure-based kinetics and comparison with chlorine

The presence of antibiotic resistance in wastewater sparked a great interest in investigating the inactivation of antibiotic-resistant bacteria by disinfecting agents. In this study, the inactivation kinetics of multidrug-resistant E. coli and enterococci by an emerging environmentally-friendly disinfectant, peracetic acid (PAA), in wastewater and phosphate buffer at pH 6.5 and pH 7.5, were characterized. It was demonstrated that the inactivation of the studied multidrug-resistant bacteria was governed by their exposure to PAA, i.e., integral of the PAA concentration over time (integral CT or ICT). Both regimes of the PAA inactivation of bacteria, i.e., initial resistance followed by a faster inactivation, were described well by an ICT-based Chick-Watson inactivation kinetic model. In wastewater at pH 7.5, the model-predicted ICT requirements showed that the multidrug-resistant enterococci were less susceptible to PAA than E. coli, e.g., to achieve a 3-log reduction, an ICT of 32.7 mg min/L and 23.4 mg min/L was needed, respectively. No regrowth of the studied bacteria was observed after 72 h from PAA disinfection at 25 ± 1 °C. Soluble constituents of wastewater decreased the PAA inactivation of both multidrug-resistant bacteria, i.e., higher inactivation was observed in phosphate buffer than wastewater at the same pH of 7.5. In phosphate buffer, a lower pH of 6.5 resulted in higher inactivation of multidrug-resistant E. coli compared with pH 7.5, but it did not affect the PAA inactivation of multidrug-resistant enterococci. A comparison with the most commonly used chemical disinfectant, chlorine, showed higher inactivation of both multidrug-resistant bacteria by chlorine and higher chlorine decay than PAA. The results of the present study may have implications in designing a PAA disinfection process, aiming at controlling antibiotic resistance, in terms of selecting a suitable fecal indicator and optimizing disinfectant dosing.

High genomic diversity of multi-drug resistant wastewater Escherichia coli

Wastewater treatment plants play an important role in the emergence of antibiotic resistance. They provide a hot spot for exchange of resistance within and between species. Here, we analyse and quantify the genomic diversity of the indicator Escherichia coli in a German wastewater treatment plant and we relate it to isolates’ antibiotic resistance. Our results show a surprisingly large pan-genome, which mirrors how rich an environment a treatment plant is. We link the genomic analysis to a phenotypic resistance screen and pinpoint genomic hot spots, which correlate with a resistance phenotype. Besides well-known resistance genes, this forward genomics approach generates many novel genes, which correlated with resistance and which are partly completely unknown. A surprising overall finding of our analyses is that we do not see any difference in resistance and pan genome size between isolates taken from the inflow of the treatment plant and from the outflow. This means that while treatment plants reduce the amount of bacteria released into the environment, they do not reduce the potential for antibiotic resistance of these bacteria.

Extended Spectrum Beta-Lactamase (ESBL)-producing bacteria isolated from hospital wastewaters, rivers and aquaculture sources in Nigeria

Untreated wastewater is a risk factor for the spread of antibiotic resistance in the environment. However, little is known about the contribution of untreated wastewater to the burden of antibiotic resistance in the Nigerian environment. In this study, a total of 143 ceftazidime-/cefpodoxime-resistant bacteria isolated from untreated wastewater and untreated wastewater-contaminated surface and groundwater in Nigeria were screened for extended-spectrum β-lactamase (ESBL) genes, integrons and integron gene cassettes by PCR. The genetic environment of bla _CTX-M-15 was mapped by PCR and potentially conjugative plasmids were detected among the isolates by degenerate primer MOB typing (DPMT). ESBL production was confirmed in 114 (79.7%) isolates and ESBL genes (bla _SHV, bla _CTX-M-15 and bla _TEM) were detected in 85 (74.6%) ESBL-producing isolates. bla _CTX-M-15 was associated with ISEcp1 and with orf477 in 12 isolates and with ISEcp1, IS26 and orf477 in six others. To the best of our knowledge, this is the first report of bla _CTX-M-15 in hand-dug wells and borehole serving as sources of drinking water and a first report of the genetic environment of bla _CTX-M-15 in environmental bacteria from Nigeria. The results of this study confirm untreated wastewater as an important medium for the spread of ESBL-producing bacteria within the Nigerian environment. Hence, the widespread practice of discharging untreated wastewater into the aquatic ecosystem in Nigeria is a serious risk to public health.

Seasonality of antibiotic prescriptions for outpatients and resistance genes in sewers and wastewater treatment plant outflow

To test the hypothesis of a seasonal relationship of antibiotic prescriptions for outpatients and the abundance of antibiotic resistance genes (ARGs) in the wastewater, we investigated the distribution of prescriptions and different ARGs in the Dresden sewer system and wastewater treatment plant during a two-year sampling campaign. Based on quantitative PCR (qPCR), our results show a clear seasonal pattern for relative ARGs abundances. The higher ARGs levels in autumn and winter coincide with the higher rates of overall antibiotic prescriptions. While no significant differences of relative abundances were observed before and after the wastewater treatment for most of the relative ARGs, the treatment clearly influenced the microbial community composition and abundance. This indicates that the ARGs are probably not part of the dominant bacterial taxa, which are mainly influenced by the wastewater treatment processes, or that plasmid carrying bacteria remain constant, while plasmid free bacteria decrease. An exception was vancomycin (vanA), showing higher relative abundance in treated wastewater. It is likely that a positive selection or community changes during wastewater treatment lead to an enrichment of vanA. Our results demonstrate that in a medium-term study the combination of qPCR and next generation sequencing corroborated by drug-related health data is a suitable approach to characterize seasonal changes of ARGs in wastewater and treated wastewater.

Increased levels of multiresistant bacteria and resistance genes after wastewater treatment and their dissemination into lake geneva, Switzerland

At present, very little is known about the fate and persistence of multiresistant bacteria (MRB) and their resistance genes in natural aquatic environments. Treated, but partly also untreated sewage of the city of Lausanne, Switzerland is discharged into Vidy Bay (Lake Geneva) resulting in high levels of contamination in this part of the lake. In the present work we have studied the prevalence of MRB and resistance genes in the wastewater stream of Lausanne. Samples from hospital and municipal raw sewage, treated effluent from Lausanne’s wastewater treatment plant (WTP) as well as lake water and sediment samples obtained close to the WTP outlet pipe and a remote site close to a drinking water pump were evaluated for the prevalence of MRB. Selected isolates were identified (16S rRNA gene fragment sequencing) and characterized with regards to further resistances, resistance genes, and plasmids. Mostly, studies investigating this issue have relied on cultivation-based approaches. However, the limitations of these tools are well known, in particular for environmental microbial communities, and cultivation-independent molecular tools should be applied in parallel in order to take non-culturable organisms into account. Here we directly quantified the sulfonamide resistance genes sul1 and sul2 from environmental DNA extracts using TaqMan real-time quantitative PCR. Hospital sewage contained the highest load of MRB and antibiotic resistance genes (ARGs). Wastewater treatment reduced the total bacterial load up to 78% but evidence for selection of extremely multiresistant strains and accumulation of resistance genes was observed. Our data clearly indicated pollution of sediments with ARGs in the vicinity of the WTP outlet. The potential of lakes as reservoirs of MRB and potential risks are discussed.

Retinal neovascularization in a case of macular branch retinal vein occlusion

BACKGROUND

Retinal neovascularization (RNV) has never been described in cases of macular branch retinal vein occlusion (MBRVO), due to the limited amount of ischemia in this form of retinal vein occlusion. Ischemic areas as wide as 5-10 disc diameters were required by previous studies to count as ischemic cases of central or major branch retinal vein occlusion.

CASE REPORT

A 56-year-old woman who had been suffering from MBRVO for 3 years presented at the posterior pole a zone of non-perfusion, extending over 7.5 disc areas, and three small tufts of RNV. RNV regressed after two subsequent laser treatments of the ischemia. Retrohyaloid hemorrhage was observed 2 months after the first treatment.

CONCLUSION

Since the average diameter of the non-perfused area was about 2.75 disc diameters, this case demonstrates that small RNVs can appear in less extensive areas of ischemia than is generally believed.

Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress

OBJECTIVE

The effects of a visual training technique on changes in myopia, visual acuity, and psychological distress were studied in a controlled prospective study.

METHOD

A group of 33 female students with myopia < or = 3.50 diopters (D) underwent visual training using an acoustic biofeedback technique. A group of 22 female students with myopia and a group of 27 students with emmetropia formed the two control groups, matched for school, age, sex, and refractive error. Manifest and cycloplegic refraction, visual acuity, personality profile (CPI), and psychological distress (SCL-90) were measured at the baseline (T0), at 10 weeks (T1), and after 12 months (T2).

RESULTS

At T2, myopia significantly progressed both in the treated and in the untreated students with myopia. Visual acuity improved only in the treated myopia group (despite refraction objectively being worse). No differences were found among the personality profiles in the three groups. All items indicative of psychological suffering improved in the group treated for myopia whose visual acuity was ameliorated.

CONCLUSIONS

The visual training technique led to no improvement in objective measures of visual acuity, but did lead to an improvement in one relatively subjective measure of visual acuity and a parallel improvement in psychological conditions. The students with myopia who were treated consequently had a greater sense of general well-being.

Changes in myopia, visual acuity, and psychological distress after biofeedback visual training

The effects of auditory biofeedback training on myopia, visual acuity (VA), and psychological distress were evaluated in a controlled prospective study involving 55 mildly myopic (< or = -3.5 D) high school students. These myopes were divided into 2 groups, matched for age and dioptric defect: 33 were treated with visual training and 22 were not; 27 emmetropic subjects formed a further control group. Subjects were evaluated at the baseline (T0), at 10 weeks after the end of the treatment (T1), and after an interval of 12 months (T2) from the baseline for: (1) manifest and cycloplegic refraction, and the difference between them (cycloplegic tonus); (2) VA measured with a conventional optotype in all subjects, and also with a computer-generated optotype in the treated group; and (3) psychometric values and personality profile. At T2, myopia had significantly worsened both in the treated and in the control myopes; VA in the treated myopes appeared significantly improved when measured by the conventional optotype, but unchanged when measured by computer. Psychometric scores improved significantly in the treated myopes and in the emmetropic controls. Objectively the autorefractometer showed that 38% of the myopes had voluntary control of positive accommodation, i.e., the ability to increase spherical defect; no voluntary control of negative accommodation was observed. An increase in VA was associated with a significant increase in the foveation time (i.e., the period of time when the target is imaged on the fovea and the eye is motionless), and was partly attributable to a learning effect. In conclusion, biofeedback visual training had a positive effect on psychological distress and subjective VA improvement, but failed to reduce the existing myopia or delay its evolution.