Investing in school systems: conceptualising returns on investment across the health, education and social protection sectors.

Public policies often aim to improve welfare, economic injustice and reduce inequality, particularly in the social protection, labour, health and education sectors. While these policies frequently operate in silos, the education sphere can operate as a cross-sectoral link. Schools represent a unique locus, with globally hundreds of millions of children attending class every day. A high-profile policy example is school feeding, with over 400 million students worldwide receiving meals in schools. The benefits of harmonising interventions across sectors with a common delivery platform include economies of scale. Moreover, economic evaluation frameworks commonly used to assess policies rarely account for impact across sectors besides their primary intent. For example, school meals are often evaluated for their impact on nutrition, but they also have educational benefits, including increasing attendance and learning and incorporating smallholder farmers into corporate value chains. To address these gaps, we propose the introduction of a comprehensive value-for-money framework for investments toward school systems that acknowledges the return to a common delivery platform-schools-and the multisectoral returns (eg, education, health and nutrition, labour, social protection) emerging from the rollout of school-based programmes. Directly building on benefit-cost analysis methods, this framework could help identify interventions that yield the highest gains in human capital per budget expenditure, with direct implications for finance ministries. Given the detrimental impact of COVID-19 on schoolchildren and human capital, it is urgent to build back stronger and more sustainable welfare systems.

Clinico-cytomorphological Spectrum of Calcinosis Cutis.

Introduction: The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically. Aim: To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears. Materials and Methods: A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details. Results: The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells. Conclusions: Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation.

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

Reduction of chemical oxygen demand through electrocoagulation: an exclusive study for hazardous waste landfill leachate.

Leachate produced from hazardous waste landfills has been observed to exhibit very complex characteristics including the presence of a high amount of refractory organics and toxic elements which make it unfit for conventional treatment. This study is focused on the characterization and treatability of "hazardous waste landfill leachate" through electrocoagulation for the reduction of chemical oxygen demand (COD). Effect of different operating parameters, such as electrode material, interelectrode distance (IED), current density (CD), and electrolysis time (ET), has also been studied. For galvanized iron (GI) electrodes, a significant reduction in phenolic compounds, cadmium, lead, and zinc concentration was observed and more than 80% reduction in COD and color was achieved on a bench-scale reactor for a CD value of 41.64 A/cm2 at IED of 1.5 cm and for ET equating to 240 min. Substantiated by experimental results and statistical analysis like ANOVA and post hoc analysis, it appears that electrocoagulation is a proficient technology for the treatment of hazardous waste landfill leachate which has a huge potential for further research.

Synergistic optimization of electrocoagulation process parameters using response surface methodology for treatment of hazardous waste landfill leachate.

Leachate treatment is an essential and integral part of solid waste management system, and its efficient treatment becomes more crucial when the leachate is produced from industrial or hazardous waste landfills (HWLs), as it is multi-fold more toxic than the leachate produced from municipal solid waste landfills (MSWLs). Electrocoagulation has appeared to be a promising technology for treating complex wastewater including MSWL leachate, but specific treatability studies dedicated to HWL leachate are rarely available, and thus pose a demand for fundamental and advance research in this area to bridge the existing gap. The current study delves into systematic design of experiments to check the treatability of HWL leachate through electrocoagulation, considering reduction (maximum) in chemical oxygen demand (COD) as a response variable. Response Surface Methodology (RSM) was used for design of experiments and process optimization and three-dimensional surface response was also created to understand the relationship among process parameters and response variables. After extensive experimental trials and data analysis, it was observed that electrocoagulation can be used as a potential treatment technology for leachate with Galvanized Iron (GI) as preferable electrode material and it resulted up to 90% reduction in COD under optimized condition. Significant reduction in other parameters was also observed with a removal efficiency of 58.1%, 63.6%, 42.4%, 52.5%, 54.7% and 84% for cadmium, zinc, phenolic compounds, lead, TOC, and colour, respectively. The results showed that Electrocoagulation can be used as a replacement of currently practised energy extensive treatment technologies like multiple effect evaporators, which are used by landfill operators for managing their HWL leachate. The methodology and results from this research may be utilized by the researchers and operators of HWL landfills to decide the treatment trail for HWL leachate.

Indirect impact of COVID-19 on environment: A brief study in Indian context.

Worldwide spread of COVID-19 in a quite short time has brought a dramatic decrease in industrial activities, road traffic and tourism. Restricted human interaction with nature during this crisis time has appeared as a blessing for nature and environment. Reports from all over the world are indicating that after the outbreak of COVID-19, environmental conditions including air quality and water quality in rivers are improving and wildlife is blooming. India has always been a hub of pollution with huge population, heavy traffics and polluting industries leading to high air quality index (AQI) values in all major cities. But after declaration of lockdown due to COVID-19, quality of air has started to improve and all other environmental parameters such as water quality in rivers have started giving a positive sign towards restoring. This paper provides evidence-based insight into improvement of air quality and environment during pre and post lockdown of this pandemic situation. An attempt has been made to visualize the improvement in the air quality using tools like satellite images of Indian atmosphere, results of onsite real-time monitoring at specific locations (Ghaziabad-highest polluting city of India) and Air quality index (AQI) calculated by central pollution control board of India.

Quality of Life in Patients with Spinal Cord Injury Attending Selected Rehabilitation Centers of Nepal.

BACKGROUND: Spinal cord injury is damage to the spinal cord resulting from trauma, diseases or degenerations. The aim of this study is to identify the quality of life among the patients with spinal cord injury in relation to the physical, psychological, social and environmental health. METHODS: This is a cross-sectional study performed within a period of one year in 103 spinal cord injury patients in two different rehabilitation centers of Nepal by using WHOQOL-BREF through face to face interview. The quality of life had been analyzed by descriptive and inferential statistics by using socio-demographic and disease related variables. RESULTS: The study finding revealed that the overall quality of life was impaired in spinal cord injury patients and it was more in psychological (48.17±14.99) and environmental health (38.70±13.79) as compared to physical (55.01±12.77) and social health (51.81±12.89). The mean difference of quality of life score in education (p=0.017), occupation (p= 0.003), and income status (p=0.001) was found statistically significant (p value <0.05) and the highest relationship was found between the psychological health and environmental health (r=0.668). CONCLUSIONS: More than 50%of the spinal cord injury patients had below the average quality of life. Physical health and social health scores are above the average but psychological and environmental health score are below the average. The overall quality of life of Spinal cord injury patients can be improved by modifying psychological health, environmental health, education, occupation, and income status.

Identification of novel candidate regulators of retinotectal map formation through transcriptional profiling of the chick optic tectum.

Information from the retina is carried along the visual pathway with accuracy and spatial conservation as a result of topographically mapped axonal connections. The optic tectum in the midbrain is the primary region to which retinal ganglion cells project their axons in the chick. The two primary axes of the retina project independently onto the tectum using different sets of guidance cues to give rise to the retinotectal map. Specificity of the map is determined by attractive or repulsive interactions between molecular tags that are distributed in gradients in the retina and the tectum. Despite several studies, knowledge of the retinotectal guidance molecules is far from being complete. We screened for all molecules that are expressed differentially along the anterior-posterior and medial-lateral axes of the chick tectum using microarray based transcriptional profiling and identified several novel candidate retinotectal guidance molecules. Two such genes, encoding Wnt5a and Raldh2, the synthesizing enzymes for retinoic acid, were further analyzed for their function as putative regulators of retinotectal map formation. Wnt5a and retinoic acid were found to exhibit differential effects on the growth of axons from retinal explants derived from different quadrants of the retina. This screen also yielded a large number of genes expressed in a lamina-specific manner in the tectum, which may have other roles in tectal development. J. Comp. Neurol. 525:459-477, 2017. © 2016 Wiley Periodicals, Inc.

Dose-dependent effects of ethanol on lead-induced oxidative stress in rats.

This study explored the dose-dependent effects of ethanol ingestion during co-exposure with lead in rats. Lead was administered orally, once daily at a dose of 10 mg/kg whereas ethanol was given in drinking water at 3 different doses: 1%, 2%, and 5% along with lead. The exposure continued for 3 months, after which the animals were decapitated and various biochemical assays were carried out. The results show increased oxidative stress in animals co-exposed to lead and ethanol compared with either lead or ethanol alone. A significant decrease in blood δ-aminolevulinic acid dehydratase activity, glutathione (GSH), GSH peroxidase, adenosine triphosphatase, and catalase but a significant increase in reactive oxygen species, oxidized GSH, thiobarbituric acid reactive substance, and intracellular calcium was noted in lead and ethanol co-exposed animals. The changes were found to be dose dependent in lead plus ethanol exposed animals. Decrease in glucose-6-phosphate dehydrogenase activity in blood was noted, with no significant changes in liver and kidney. Aldehyde dehdrogenase activity decreased significantly in animals exposed to either lead or ethanol but a pronounced depletion was seen in rats co-exposed to lead and ethanol (5%). The results suggest that the combined exposure to lead and ethanol leads to increased oxidative stress and possible initiation of apoptosis in rats.

Lead and ethanol co-exposure lead to blood oxidative stress and subsequent neuronal apoptosis in rats.

AIMS: The present study was aimed at investigating chronic exposure to lead and ethanol, individually and in combination with blood oxidative stress leading to possible brain apoptosis in rats. METHODS: Rats were exposed to lead (0.1% w/v in drinking water) or ethanol (1 and 10%) either individually or in combination for four months. Biochemical variables indicative of oxidative stress (blood and brain) and brain apoptosis were examined. Native polyacrylamide agarose gel electrophoresis was carried out in brain homogenates for glucose-6-phosphate dehydrogenase (G6PD) analysis, whereas western blot analysis was done for the determination of apoptotic markers like Bax, Bcl-2, caspase-3, cytochrome c and p53. RESULTS: The results suggest that most pronounced increase in oxidative stress in red blood cells and brain of animals co-exposed to lead and 10% ethanol compared all the other groups. Decrease in G6PD activity followed the same trend. Upregulation of Bax, cytochrome c, caspase-3, p53 and down-regulation of Bcl-2 suggested apoptosis in the rat brain co-exposed to lead and ethanol (10%) compared with their individual exposures. Significantly high lead accumulation in blood and brain during co-exposure further support synergistic toxicity. CONCLUSION: The present study thus suggests that higher consumption of ethanol during lead exposure may lead to brain apoptosis, which may be mediated through oxidative stress.

Oral supplementation of gossypin during lead exposure protects alteration in heme synthesis pathway and brain oxidative stress in rats.

OBJECTIVE: The objective was to study the efficacy of oral supplementation of gossypin, a flavonoid, during lead exposure in preventive alterations in the heme synthesis pathway, brain oxidation, and tissue lead uptake in rats. METHODS: Male rats were used for the experiment and were exposed to lead (0.5% in drinking water) or lead plus oral supplementation of gossypin (25 or 100mg/kg) for 3 wk to determine the preventive effect of gossypin against lead toxicity. Animals were sacrificed after 3 wk for various biochemical variables suggestive of oxidative stress and heme synthesis pathway in addition to the concentration of lead in the blood and brain. RESULTS: Exposure to lead produced significant inhibition in the activity of blood delta-aminolevulinic acid dehydratase accompanied by an increase in urinary delta-aminolevulinic acid and the levels of reactive oxygen species. There were significant alterations in the levels of glutathione, thiobarbituric acid-reactive substances, reactive oxygen species, and superoxide dismutase activity on lead exposure. Most of these alterations were significantly prevented by oral coadministration of gossypin, particularly at the dose of 100mg/kg. CONCLUSION: The antioxidant and moderate chelating properties of oral gossypin suggest a promising role in use either as a nutritional supplement during lead exposure or as a complementary chelating agent during chelation therapy.

Essential metal status, prooxidant/antioxidant effects of MiADMSA in male rats: age-related effects.

Thiols are known to act as protectants in the biological system for their involvement in a number of metabolic regulations. In this study, we investigated the effect of a new and potent thiol-chelating agent, monoisoamyl 2,3-dimercaptosuccinic acid (MiADMSA), an analog of meso 2,3-dimercaptosuccinic acid, to find out if it could act as a prooxidant (because of its lipophilic character) or antioxidant (because of thiol moiety) that could supplement its chelating properties in different age groups of male rats (young, adult, and old rats) and produce effective clinical recoveries in the treatment of metal intoxication. Animals were treated with 25, 50, and 100 mg/kg of MiADMSA, i.p, once daily for 1 week to assess the effect on the antioxidant system in major organs based on sensitive biochemical variables indicative of oxidative stress. Results suggested that MiADMSA administration increased the activity of d-aminolevulinic acid dehydratase in all the age groups and increased blood glutathione (GSH) levels in young rats. MiADMSA also potentiated the synthesis of metallothioneine in liver and kidneys and GSH levels in liver and brain. Apart from this it also significantly reduced the glutathione disulfide levels in tissues. However, administration of MiADMSA caused some concern over the copper loss. MiADMSA was found to be safe in rats of all ages.

Response of lead-induced oxidative stress and alterations in biogenic amines in different rat brain regions to combined administration of DMSA and MiADMSA.

The present study was planned to investigate if combined administration of meso-2,3-dimercaptosuccinic acid (DMSA) and monoisoamyl DMSA (MiADMSA) could achieve better recovery in the altered biochemical parameters suggestive of brain oxidative stress and depletion of lead from blood and brain following acute lead exposure. Male Wistar rats were exposed to lead nitrate (50 mg/kg, i.p., once daily for 5 days) followed by treatment with the above chelating agents using two different doses of 25 or 50 mg/kg (orally) either alone and in combination once daily for five consecutive days. Lead exposure resulted in the significant inhibition of delta-aminolevulinic acid dehydratase activity and depletion of glutathione (GSH) in blood. These changes were accompanied by significant reduction in blood hemoglobin, RBC levels and superoxide dismutase and catalase activities. Significant increase in blood reactive oxygen species (ROS) and thiobarbituric acid reactive substances (TBARS) levels were noted. We observed marked increase in brain ROS level while GSH/oxidized glutathione ratio showed significant decrease accompanied by a significant increase in blood and brain lead concentration. The levels of norepinephrine, dopamine and serotonin in different brain regions were also altered on lead exposure. Co-administration of DMSA and MiADMSA particularly at the lower dose was most effective in the recovery of lead-induced changes in the hematological variables and oxidative stress and resulted in more pronounced depletion of lead from blood and brain compared to monotherapy with these chelators. On the other hand, combined administration of MiADMSA (50 mg/kg) in combination with DMSA (25 mg/kg each) had additional beneficial effect over the individual effect of chelating agent in the recovery of altered levels of brain biogenic amines. The study suggests that administration of MiADMSA is generally a better lead chelator than DMSA while combined administration of DMSA and MiADMSA might be a better treatment option compared to monotherapy at least in the removal of lead from the target tissues.