Search

This paper investigates the influence of multi-decadal climatic variability on the temporal evolution of root zone storage capacities (Sr,max) and its implications for streamflow predictions in the Meuse basin. Through a comprehensive analysis of 286 catchments across Europe and the US that are hydro-climatically comparable to the Meuse basin, we construct inter-decadal distributions of past deviations in evaporative ratios (IE) from expected values based on catchment aridity (IA). These distributions of ΔIE were then used to estimate inter-decadal changes in Sr,max and to quantify the associated consequences for streamflow predictions in the Meuse basin. Our findings reveal that, while catchments do not strictly adhere to their specific parametric Budyko curves over time, the deviations in IE are generally very minor, with an average ΔIE=0.01 and an interquartile range (IQR) of −0.01 to 0.03. Consequently, these minor deviations lead to limited inter-decadal changes in Sr,max, mostly ranging between −10 and +21 mm (−5 % to +10 %). When these changes (ΔSr,max) are accounted for in hydrological models, the impact on streamflow predictions in the Meuse basin is found to be marginal, with the most significant shifts in monthly evaporation and streamflow not exceeding 4 % and 12 %, respectively. Our study underscores the utility of parametric Budyko-style equations for first-order estimates of future Sr,max in hydrological models, even in the face of climate change and variability. This research contributes to a more nuanced understanding of hydrological responses to changing climatic conditions and offers valuable insights for future climate impact studies in hydrology.

The wflow_sbm hydrological model, recently released by Deltares, as part of the Wflow.jl (v0.7.3) modelling framework, is being used to better understand and potentially address multiple operational and water resource planning challenges from a catchment scale to national scale to continental and global scale. Wflow.jl is a free and open-source distributed hydrological modelling framework written in the Julia programming language. The development of wflow_sbm, the model structure, equations and functionalities are described in detail, including example applications of wflow_sbm. The wflow_sbm model aims to strike a balance between low-resolution, low-complexity and high-resolution, high-complexity hydrological models. Most wflow_sbm parameters are based on physical characteristics or processes, and at the same time wflow_sbm has a runtime performance well suited for large-scale high-resolution model applications. Wflow_sbm models can be set a priori for any catchment with the Python tool HydroMT-Wflow based on globally available datasets and through the use of point-scale (pedo)transfer functions and suitable upscaling rules and generally result in a satisfactory (0.4 ≥ Kling–Gupta efficiency (KGE) < 0.7) to good (KGE ≥ 0.7) performance for discharge a priori (without further tuning). Wflow_sbm includes relevant hydrological processes such as glacier and snow processes, evapotranspiration processes, unsaturated zone dynamics, (shallow) groundwater, and surface flow routing including lakes and reservoirs. Further planned developments include improvements on the computational efficiency and flexibility of the routing scheme, implementation of a water demand and allocation module for water resource modelling, the addition of a deep groundwater concept, and computational efficiency improvements through for example distributed computing and graphics processing unit (GPU) acceleration.

Intercatchment groundwater flows (IGFs), defined as groundwater flows across topographic divides, can occur as regional groundwater flows that bypass headwater streams and only drain into the channel further downstream or directly to the sea. However, groundwater flows can also be diverted to adjacent river basins due to geological features (e.g., faults, dipping beds and highly permeable conduits). Even though intercatchment groundwater flows can be a significant part of the water balance, they are often not considered in hydrological studies. Yet, assuming this process to be negligible may introduce misrepresentation of the natural system in hydrological models, for example in regions with complex geological features. The presence of limestone formations in France and Belgium potentially further exacerbates the importance of intercatchment groundwater flows, and thus brings into question the validity of neglecting intercatchment groundwater flows in the Meuse basin. To isolate and quantify the potential relevance of net intercatchment groundwater flows in this study, we propose a three-step approach that relies on the comparison and analysis of (1) observed water balance data within the Budyko framework, (2) results from a suite of different conceptual hydrological models and (3) remote-sensing-based estimates of actual evaporation. The data of 58 catchments in the Meuse basin provide evidence of the likely presence of significant net intercatchment groundwater flows occurring mainly in small headwater catchments underlain by fractured aquifers. The data suggest that the relative importance of net intercatchment groundwater flows is reduced at the scale of the Meuse basin, as regional groundwater flows are mostly expected to be self-contained in large basins. The analysis further suggests that net intercatchment groundwater flow processes vary over the year and that at the scale of the headwaters, net intercatchment groundwater flows can make up a relatively large proportion of the water balance (on average 10 % of mean annual precipitation) and should be accounted for to prevent overestimating actual evaporation rates.

International collaboration between research institutes and universities is a promising way to reach consensus on hydrological model development. Although model comparison studies are very valuable for international cooperation, they do often not lead to very clear new insights regarding the relevance of the modelled processes. We hypothesise that this is partly caused by model complexity and the comparison methods used, which focus too much on a good overall performance instead of focusing on a variety of specific events. In this study, we use an approach that focuses on the evaluation of specific events and characteristics. Eight international research groups calibrated their hourly model on the Ourthe catchment in Belgium and carried out a validation in time for the Ourthe catchment and a validation in space for nested and neighbouring catchments. The same protocol was followed for each model and an ensemble of best-performing parameter sets was selected. Although the models showed similar performances based on general metrics (i.e. the Nash–Sutcliffe efficiency), clear differences could be observed for specific events. We analysed the hydrographs of these specific events and conducted three types of statistical analyses on the entire time series: cumulative discharges, empirical extreme value distribution of the peak flows and flow duration curves for low flows. The results illustrate the relevance of including a very quick flow reservoir preceding the root zone storage to model peaks during low flows and including a slow reservoir in parallel with the fast reservoir to model the recession for the studied catchments. This intercomparison enhanced the understanding of the hydrological functioning of the catchment, in particular for low flows, and enabled to identify present knowledge gaps for other parts of the hydrograph. Above all, it helped to evaluate each model against a set of alternative models.

Objective: Breast cancer screening decision aids (DAs) are designed to help women decide whether or not to participate in mammography-based programmes. We aimed to explore women's and healthcare professionals' expectations of a breast cancer screening DA, as part of the French DEDICACES study., Methods: This French qualitative study was based on semistructured, individual interviews with women from the general population, general practitioners (GPs), midwives, gynaecologists, radiologists and screening centre managers. Sampling was purposive and used diversification criteria. The inductive analysis was based on grounded theory., Results: Between April 2018 and May 2019, we interviewed 40 people: 13 women, 14 GPs, 4 gynaecologists, 3 midwives, 3 radiologists and 3 screening centre managers. The women and the healthcare professionals considered that a DA could help to improve levels of knowledge, harmonise medical practice and provide reliable, comprehensive information. Overall, the interviewees wanted an easy-to-use, intuitive, graphic-rich, interactive, computer-based, patient-centred DA. Use of the DA might be limited by a lack of familiarity with shared decision-making (SDM), the risk of misuse and a preference for asymmetric positive information., Conclusion: The present results are likely to facilitate the development of the first validated tool for SDM support in French breast cancer screening programmes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Activated protein C resistance (APCR) is a significant risk factor for venous thromboembolism (VTE), with the factor V (FV) G1691A (Leiden) mutation accounting for the majority of inherited APCR cases. An additional FV polymorphism, A4074G (FV-HR2), reportedly increased VTE risk by some, but not all groups. We determined the prevalence of FV-Leiden and FV-HR2 SNPs in 126 patients with deep venous thrombosis (DVT), and 197 control subjects. Frequencies of FV-Leiden A and HR2 G alleles, together with FV-Leiden G/A and A/A (but not HR2 A/G) genotypes were significantly higher among patients. While no significant linkage disequilibrium was noted between FV 1691A and 4070G or A alleles, significantly higher prevalence of single-mutant 1691G/4070G and 1691A/4070A haplotypes were seen in patients. FV Leiden and FV HR2 haplotype are independent risk factors for DVT, and their coinheritance does not seem to increase significantly DVT risk imparted by either.

Factor V G1691A (FV-Leiden) and prothrombin (PRT) G20210A single nucleotide polymorphisms (SNPs) were associated with venous thrombosis among Caucasians. We assessed the contribution of both SNPs to the genetic susceptibility of deep venous thrombosis (DVT) among Lebanese and Tunisian patients. Subjects comprised 198 DVT patients and 540 healthy controls from Lebanon and 126 Tunisian DVT patients and 197 control subjects; FV-Leiden (MnlI) and PRT G20210A (HindIII) genotyping was done by PCR-RFLP. While the prevalence of FV-Leiden mutant A allele and the G/A and A/A genotypes were significantly higher among DVT patients from Lebanon and Tunisia, the association of PRT G20210A with DVT was pronounced among Lebanese but not Tunisian patients. The prevalence of PRT G20210A mutant A allele (P < 0.001 vs. P = 181) and G/A genotype (P < 0.001 vs. P = 0.994) was significantly higher among Lebanese but not Tunisians, respectively. While FV-Leiden was a common genetic risk factor for DVT in both communities, the contribution of PRT G20210A to the genetic susceptibility of DVT differed among Lebanese and Tunisians, which underscores the need to determine prothrombotic gene polymorphisms associated with DVT among Arab and Mediterranean basin communities.

Background: The thrombin-generation assay has a variety of clinical uses, including diagnosis of thromboembolism-related disease, and particular profiles are associated with thrombophilic risk factors. The aim of this study was to evaluate the use of this assay in screening and identifying patients who require specific thrombophilic testing., Methods: We used a 2-step approach to perform specific thrombophilic testing and thrombin-generation assays on 169 consecutive patients. The first step was to identify particular profiles of thrombin generation corresponding to each type of thrombophilic risk factor and to determine the pertinent variables related to thrombin generation. We then performed ROC curve analysis for each predefined variable to determine the relevant cutoffs for identification of patients in need of further testing (negative predictive value, 100%)., Results: Suggestive profiles were seen in factor V Leiden (n = 49) and prothrombin (n = 12) mutations and in protein S deficiency (n = 12). ROC curves showed that factor V Leiden may be excluded when the difference between lag times obtained in the absence and presence of activated protein C (APC) is >1.5 min and that prothrombin G20210A may also be excluded when the peak thrombin concentration is 63%., Conclusion: The thrombin-generation assay represents a promising tool for screening thrombophilic risk factors, particularly in patients who are carriers of factor V Leiden or prothrombin G20210A mutations and patients with protein S deficiency.