Eco-hydrological process simulations within an integrated surface water-groundwater model

There are several key modelling challenges in addressing the complementary requirements of the Water Framework Directive and the Groundwater Directive. The first is to consider groundwater, surface water, water quality and ecosystems as an integrated system and develop modelling tools capable of representing these interactions. For example, the restoration of wetlands often requires an understanding of the interaction of surface water and groundwater quantity and quality. Secondly while static indicator-based or statistical approaches are widely used for overall management, the actual ecosystem is highly dynamic and both the actual response to different threats and impact of measures will also be dynamic. To address these challenges a new integrated eco-hydrological modelling tool has been developed that allows hydrologists and ecologists to represent the complex and dynamic interactions occurring including surface water groundwater interactions within a catchment. This is achieved by integrating a general ecological modelling tool into an integrated catchment hydrological modelling framework, MIKE SHE. The capabilities of this new tool are evaluated using analytical solutions and laboratory experiments. Finally we demonstrate the practical application of this tool to two case studies where the interaction of surface water and ground water are important for the ecosystem. The importance of the surface water groundwater dynamics for a riparian wetland on the Odense stream in Denmark is examined and simulations compared to field observations in the wetland. The Silver Creek ecosystem is controlled large-scale interactions of surface water and groundwater systems in the Lower Wood River Valley, USA. We examine ecological impacts related to the flows and temperatures in the Silver Creek ecosystem which are important for the fish population. We show that different water management scenarios can have significant impacts on the ecosystem

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)