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BACKGROUND: Cognitive functions are altered in patients with CKD. However, it is suggested that cognitive functions improve after kidney transplantation, at least partially. A possible cause for this improvement could be the reduction of uremic retention solutes after transplantation. This study assessed the association between the changes in uremic toxin concentration with the changes in cognitive function in patients after kidney transplantation. METHODS: Ten recipients of kidney transplants were compared with 18 controls (nine patients on hemodialysis, and nine patients with CKD stage 4 or 5 [eGFR

Antes de considerar particularmente el tratamiento del carcinoma del cuello, es necesario referirnos brevemente a los métodos de diagnóstico y la clasificación del proceso en varias etapas. Nuestra interpretación del diagnóstico, así como su clasificación tiene una influencia muy importante en nuestra elección del tratamiento en cada caso individual. Cn el uso tan desarrollado de la citología y la biopsia, muchos casos tempranos pueden ser descubiertos, los cuales no hubieran sido reconocidos diez o más años atrás. Algunos de estos están en la etapa preinvasiva cuando la enfermedad es todavía curable en un 100%.

This paper demonstrates a framework for producing probabilistic flood risk estimates, focusing on two sections of the Rhine River. We used an ensemble of six (bias-corrected) regional climate model (RCM) future simulations to create a 3000-year time-series through resampling. This was complemented with 12 global climate model (GCM)-based future time-series, constructed by resampling observed time-series of daily precipitation and temperature and modifying these to represent future climate conditions using an advanced delta change approach. We used the resampled time-series as input in the hydrological model Hydrologiska Byrans Vattenbalansavdelning (HBV)-96 to simulate daily discharge and extreme discharge quantiles for return periods up to 3000 years. To convert extreme discharges to estimates of flood damage and risk, we coupled a simple inundation model with a damage model. We then fitted probability density functions (PDFs) for the RCM, GCM, and combined ensembles. The framework allows for the assessment of the probability distribution of flood risk under future climate scenario conditions. Because this paper represents a demonstration of a methodological framework, the absolute figures should not be used in decision making at this time.

Climate change increases flood probabilities in the Rhine river basin, which complicates long-term flood management planning. This paper explores a method to evaluate the effectiveness of flood management measures for the river Rhine assuming a relatively extreme climate change scenario for the year 2050. Considered are planned measures described in the Rhine Action Plan on Floods (APF) and several additional measures, which include the restoration of abandoned meanders, a bypass around Cologne, the implementation of additional retention polders and land-use change to forest. The method includes resampling of meteorological data and a hydrological model to simulate long discharge series (10000 years), and can be considered as a process-based approach to estimate peak discharges of low-probability flood events. It is found that upstream flooding in Germany has a profound decreasing effect on the simulated peak water levels and discharges along the main Rhine branch and downstream in the Netherlands. Currently implemented and proposed measures in the APF, as well as most additional measures, seem inadequate to cope with the increased flood probabilities that are expected in the future climate change scenario. © The Authors. Journal of Flood Risk Management © 2010 The Chartered Institution of Water and Environmental Management.

In de Green Deal Grondstoffen heeft STOWA met het Rijk afgesproken dat zij in 2015 een Onderzoeksprogramma Grondstoffen opstelt dat inzicht biedt in, en een overzicht geeft van het geheel van onderzoek en ontwikkeling op het gebied van grondstoffenwinning in de waterketen. Deze rapportage geeft ter voorbereiding op zo'n onderzoeksprogramma een beknopt overzicht van de binnen de Energie- en Grondstoffenfabriek onderscheiden onderzoeksvelden en van de daarbinnen lopende projecten, projecten in voorbereiding en nieuwe ideeën.

Nuclear genome size, as measured by flow cytometry with propidium iodide, was used to investigate the relationships within the genus Gagea (Liliaceae), mainly from the Netherlands. The basic chromosome number for Gagea is x = 12. The inferred ploidy in the Dutch and German accessions varies from diploid to decaploid. Consequently there is a large range of genome sizes (DNA 2C-values) from 14.9 to 75.1 pg. Genome sizes are evaluated here in combination with the results of morphological observations. Five species and the hybrid G. × megapolitana are reported. Apart from 14 diploid G. villosa, six plants of G. villosa with an inferred tetraploidy were found. For the 186 Dutch accessions investigated 85 turned out to be the largely sterile G. pratensis (inferred to be pentaploid). Inferred tetraploid and hexaploid G. pratensis were found in 30 and 20 localities, respectively. In one locality an inferred decaploid (10×) plant was found that could represent a doubled pentaploid G. pratensis. An inferred decaploid G. pratensis was never reported before. The genome size of Gagea × megapolitana from Germany fitted with its origin as a cross between the two hexaploids G. pratensis and G. lutea. Gagea spathacea from the Netherlands was inferred to be nonaploid as was recorded from plants across Europe. The aim of the study was to use flow cytometry as a tool to elucidate the taxonomic position of the Dutch Gagea.

Severe dry periods (droughts) receive less attention than floods and storms in natural hazard risk assessments. This is remarkable as droughts (heat waves) cause the most casualties of all natural hazards in Europe. The combination of socio-economic developments and climate change poses a challenge to water managers to not only mitigate flood and drought probabilities but also consider measures that a priori alleviate the damage of extreme floods and droughts. This chapter describes how climate scenarios and socio-economic scenarios can be combined to assess future flood risks. Furthermore, several ways are explained of dealing with uncertainty in an approach that may inform river basin managers on flood and drought risks. Finally, an example of drought risk assessment is provided for the Netherlands. The chapter concludes that cooperation with social and economic sciences is a prerequisite for a strategy that best informs river basin management on flood and drought risks. By applying such a strategy, river basin management could involve information on flood and drought risks to assess urgency and priority of a priori risk reduction measures.

Planbureau voor de Leefomgeving (PBL), Centraal Planbureau (CPB), KNMI en Wageningen UR, LEI publiceren onder leiding van Deltares de ‘Deltascenario’s voor 2050 en 2100 – nadere uitwerking 2012-2013’. Deze scenario’s bouwen voort op de in 2011 gepubliceerde Deltascenario’s. Ze zijn gebaseerd op meer óf minder economische groei in combinatie met matige óf grote klimaatverandering. De vier scenario’s hebben de namen: RUST (resultaat van matige klimaatverandering en lage groei van economie en bevolking); DRUK (matige klimaatverandering, sterke groei); WARM (snelle klimaatverandering, lage groei); STOOM (snelle klimaatverandering, sterke groei). Aan de hand van elk van de uitgewerkte scenario’s toont het consortium voor welke uitdagingen Nederland in de toekomst kan komen te staan als het gaat om zoetwatervoorziening, de ruimtelijke inrichting van stad en land en bescherming tegen overstromingen.

The low lying delta country The Netherlands has a long history of coping with fluctuating and changing natural and socioeconomic conditions in the river delta. Projected changes in relevant climatic conditions are being explored using a range of scenario approaches, both concerning climate and socio economic developments. This manuscript describes the convolution of this scenario approach with the necessary assessments of the various vulnerabilities in the area, guided by a number of examples where these approaches are tightly coupled.

Het algemene doel van het ACER project is om de gevolgen van klimaatverandering en adaptatie strategieën te onderzoeken voor het Rijnstroomgebied, zowel grensoverschrijdend in Duitsland en Frankrijk als voor het regionale waterbeheer in Nederland. ACER gebruikt een scenario analyse om effecten en oplossing te analyseren en vergelijken, onder de veronderstelling van verschillende klimaatverandering en sociaal-economische scenario’s voor 2050. Aan de basis van deze scenario aanpak staat een internationale groep van belanghebbenden en waterbeheerders uit verschillende bestuurslagen in het Rijnstroomgebied. Het is de vraag of de maatregelen die momenteel stroomopwaarts in Duitsland worden uitgevoerd positieve of negatieve effecten op de piekavoeren benedenstrooms hebben

This report describes floods in a European context with the purpose of highlighting factors that contribute to the occurrence and adverse consequences of floods, and possibilities to reduce flood risks from inland waters and rainfall. It includes a discussion on changes in flood patterns and illustrates how different scenarios for climate change may affect vulnerability to floods and flood risks. The report provides illustrative examples of flood risk management from the local to European level.

The Netherlands are carrying out the Delta programme to adapt their water management system to climate change and sea level rise. Adaptation needs a number of decisions regarding the way the Netherlands will organize -- in the long -term -- their flood protection system, their water supply and the distribution of this water over the different sectors and regions. To support these decisions quantative information is needed on the occurrence of different water levels with respect to floods, on the water supply and the occurrence of dry spells, on the water available and its quality needed for flushing polders, sectors as agriculture, drinking water, recreation etc etc. The only way to provide such information is by simulation, using combinations of hydrological and hydraulic models that are linked to sectoral models. Where all models are forced by climatic and sea level boundary conditions. The water management system in the Netherlands, situated within the Rhine Meuse Delta, depends on the fluctuations and rise in sea level, variations and trends in river flow, rainfall and evaporation. The delta has a highly complicated system of water distribution and the design levels for flood protection are among the highest in the world. Adaptation measures are implemented on relatively small scales. Therefore the questions asked to the results of the simulation models are increasingly detailed. This all puts substantial pressure on the level of functional and technical design of these models. It is therefore essential that these models are used in a consistent way. Even more so, many of these models cannot be run independently but should be linked to other models to solve the interactions between the different parts of the simulated (natural) system. For the deltaprogramme, a model is currenly assembled from the numerous modelling systems that occur in the Netherlands (the Detamodel). To support the building of this Deltamodel, in this Knowledge for Climate project we explore methods for linking different existing models within the spatial domain in and around The Netherlands. We investigated the chain of hydrological and hydrodynamic models needed in the Rhine/Meuse basin and the North Sea and the groundwater, water demand and distribution model (NHI) for The Netherlands. In addition, the necessary interaction between the hydrological models and land-use and nature models was investigated and a suitable structure for linking these has been proposed that is based on existing modelling systems that are developed and maintained at different research institutes in the Netherlands. In parallel the coupled running of a climate and air quality model has been worked on, resulting in detailed simulations of air quality in a changing climate. The focus is particularly on the technology, as we prepared a prototype of such a linked modelling system. It will be used later to facilitate the preparation of scenarios in the investigated areas (water, air quality, nature, land use). It will also support further research that can support the Netherlands adaptation planning. The first case studies that have been run using 30 years of ESSENCE data driving the entire modeling chain show that such diverse results as future habitat development in Lake IJssel and the coincidence of high flow in the Rhine and storm Surge in the North Sea can be obtained. We are convinced that by formalizing the model linkages in a data and modeling platform, we increase the consistency of the different scenarios .

[1] Climate change will increase winter precipitation, and in combination with earlier snowmelt it will cause a shift in peak discharge in the Rhine basin from spring to winter. This will probably lead to an increase in the frequency and magnitude of extreme floods. In this paper we aim to enhance the simulation of future low-probability flood peak events in the Rhine basin using different climate change scenarios, and downscaling methods. We use the output of a regional climate model (RCM) and a weather generator to create long, resampled time series (1000 years) of climate change scenarios as input for hydrological (daily) and hydrodynamic (hourly) modeling. We applied this approach to three parallel modeling chains, where the transformation method from different resampled RCM outputs to the hydrological model varied (delta change approach, direct output, and bias-corrected output). On the basis of numerous 1000 year model simulations, the results indicate a basin-wide increase in peak discharge in 2050 of 8%–17% for probabilities between 1/10 and 1/1250 years. Furthermore, the results show that increasing the length of the climate data series using a weather generator reduced the statistical uncertainty when estimating low-probability flood peak events from 13% to 3%. We further conclude that bias-corrected direct RCM output is to be preferred over the delta change approach because it provides insight into geographical differences in discharge projections under climate change. Also, bias-corrected RCM output can simulate changes in the variance of temperature and rainfall and in the number of precipitation days, as changes in temporal structure are expected under climate change. These added values are of major importance when identifying future problem areas due to climate change and when planning potential adaptation measures.

Climate change will increase winter precipitation, and in combination with earlier snowmelt it will cause a shift in peak discharge in the Rhine basin from spring to winter. This will probably lead to an increase in the frequency and magnitude of extreme floods. In this paper we aim to enhance the simulation of future low-probability flood peak events in the Rhine basin using different climate change scenarios, and downscaling methods. We use the output of a regional climate model (RCM) and a weather generator to create long, resampled time series (1000 years) of climate change scenarios as input for hydrological (daily) and hydrodynamic (hourly) modeling. We applied this approach to three parallel modeling chains, where the transformation method from different resampled RCM outputs to the hydrological model varied (delta change approach, direct output, and bias-corrected output). On the basis of numerous 1000 year model simulations, the results indicate a basin-wide increase in peak discharge in 2050 of 8%-17% for probabilities between 1/10 and 1/1250 years. Furthermore, the results show that increasing the length of the climate data series using a weather generator reduced the statistical uncertainty when estimating low-probability flood peak events from 13% to 3%. We further conclude that bias-corrected direct RCM output is to be preferred over the delta change approach because it provides insight into geographical differences in discharge projections under climate change. Also, bias-corrected RCM output can simulate changes in the variance of temperature and rainfall and in the number of precipitation days, as changes in temporal structure are expected under climate change. These added values are of major importance when identifying future problem areas due to climate change and when planning potential adaptation measures. Copyright 2010 by the American Geophysical Union.

Due to the growing wish and necessity to simulate the possible effects of climate change on the discharge regime on large rivers such as the Rhine in Europe, there is a need for well performing hydrological models that can be applied in climate change scenario studies. There exists large variety in available models and there is an ongoing debate in research on rainfall-runoff modelling on whether or not physically based distributed models better represent observed discharges than conceptual lumped model approaches do. In addition, it is argued that Land Surface Models (LSMs) carry the potential to accurately estimate hydrological partitioning, because they solve the coupled water and energy balance. In this paper, the hydrological models HBV and VIC were compared for the Rhine basin by testing their performance in simulating discharge. Overall, the semi-distributed conceptual HBV model performed much better than the distributed land surface model VIC (E=0.62, r2=0.65 vs. E=0.31, r2=0.54 at Lobith). It is argued here that even for a well-documented river basin such as the Rhine, more complex modelling does not automatically lead to better results. Moreover, it is concluded that meteorological forcing data has a considerable influence on model performance, irrespectively to the type of model structure and the need for ground-based meteorological measurements is emphasized.