A Multi-Scale Assessment of Land-Use Impacts on Hydrologic Ecosystem Services in the Vouga Basin, North-Central Portugal

Sustainable water resource management requires understanding how hydrologic processes are impacted by environmental management and land-use decisions across multiple spatial and temporal scales. A key concept in this respect is hydrologic ecosystem services (HES), which are the water related ‘goods’ produced by the environment which are valuable to humans. This dissertation assesses a range of topics concerning HES in the Vouga basin (north-central Portugal), and their connection with land-cover and land-use practices. Specifically, the relationship between changes in forest and agricultural land-cover and management practices, and associated changes in HES were examined using a range of statistical and modeling approaches. To quantify the effects of different agricultural scenarios on both HES and potential stakeholders, the ‘Soil and Water Assessment Tool’ (SWAT) was utilized, in conjunction with economic assessment methods. The first research section (Section 6) of the dissertation assesses the trends in streamflow quantity and yield in the Águeda watershed (a sub-basin of the Vouga) over a 75-yr period which coincided with large-scale afforestation of Pinus pinaster and (later) Eucalyptus globulus. Counter to the findings from meta-analysis studies of the effect of forest change on water availability, this study did not detect statistically significant trends in streamflow. By contrast, these findings support the view that there are prerequisite climatic, pedological, and eco-physiological watershed conditions that are necessary to observe hydrologic impacts at the watershed scale (which are not present in the Águeda watershed). By contrast, the significant changes which were detected are related to baseflow, which correspond with different periods of afforestation, and may be attributable to the promotion of soil water repellency under the mature pine and eucalypt stands. In the second research section (Section 7), an assessment is carried out on the hydrologic and nitrate dynamics at the whole basin scale, using the SWAT model. This assessment indicated that there is a high degree of variability in nitrate export from the different parts of the basin, with the highest rates coming from the lower (agriculturally dominated portion) of the basin. The main flow pathways for nitrate export were found to be leaching from agricultural land-cover types, which consistently had the highest export for all land-use and pathways. These findings indicate that the water bodies at the highest risk of nitrate pollution in the Vouga basin are the groundwater aquifers. The final research section (Section 8) utilizes the SWAT model to examine how reduced rates of fertilizer inputs would affect nitrate leaching, crop yields, and agricultural profitability in the lower Vouga basin. This research found that reduced rates of fertilization would reduce the amount of leached nitrate substantially, but that this would also lead to a large decrease in crop yield and profitability. A large difference in the inefficiency (i.e. crop production vs. nitrate export) between different HRUs was found, which could provide a focus for potential management action. This research strongly indicates that such actions may be needed to reduce the negative impacts of this pollution on the value of the groundwater aquifers, and to avoid associated costs which are otherwise passed on to local water users (e.g. through higher water treatment costs). The overall findings of the dissertation highlight the importance of the upper (forested) basin as a drinking water supply area, given the prevalence of nitrate pollution in the lower basin. However, the historic afforestation in the Vouga basin has resulted in a reduction in baseflow, which is negative from a drinking water supply perspective. Therefore, while the forested uplands are beneficial from water quality standpoint (compared to intensive agriculture), they also have altered flow patterns in a manner which will reduce available supply. The findings from the upper basin contrast sharply with the lower basin, where there are potentially large negative HES impacts due to current agricultural practices. These practices will primarily impact groundwater aquifers, and therefore the water quality within the lower basin receive little benefit from the relatively high-quality water from the upper basin. This highlights the importance of considering the interconnectivity of HES across spatial scales, which will depend on the specific site characteristics of the river basin

Oral Abstracts 7: RA ClinicalO37. Long-Term Outcomes of Early RA Patients Initiated with Adalimumab Plus Methotrexate Compared with Methotrexate Alone Following a Targeted Treatment Approach

Background: This analysis assessed, on a group level, whether there is a long-term advantage for early RA patients treated with adalimumab (ADA) + MTX vs those initially treated with placebo (PBO) + MTX who either responded to therapy or added ADA following inadequate response (IR). Methods: OPTIMA was a 78- week, randomized, controlled trial of ADA + MTX vs PBO + MTX in MTX-naïve early (<1 year) RA patients. Therapy was adjusted at week 26: ADA + MTX-responders (R) who achieved DAS28 (CRP) <3.2 at weeks 22 and 26 (Period 1, P1) were re-randomized to withdraw or continue ADA and PBO + MTX-R continued randomized therapy for 52 weeks (P2); IR-patients received open-label (OL) ADA + MTX during P2. This post hoc analysis evaluated the proportion of patients at week 78 with DAS28 (CRP) <3.2, HAQ-DI <0.5, and/or ΔmTSS ≤0.5 by initial treatment. To account for patients who withdrew ADA during P2, an equivalent proportion of R was imputed from ADA + MTX-R patients. Results: At week 26, significantly more patients had low disease activity, normal function, and/or no radiographic progression with ADA + MTX vs PBO + MTX (Table 1). Differences in clinical and functional outcomes disappeared following additional treatment, when PBO + MTX-IR (n = 348/460) switched to OL ADA + MTX. Addition of OL ADA slowed radiographic progression, but more patients who received ADA + MTX from baseline had no radiographic progression at week 78 than patients who received initial PBO + MTX. Conclusions: Early RA patients treated with PBO + MTX achieved comparable long-term clinical and functional outcomes on a group level as those who began ADA + MTX, but only when therapy was optimized by the addition of ADA in PBO + MTX-IR. Still, ADA + MTX therapy conferred a radiographic benefit although the difference did not appear to translate to an additional functional benefit. Disclosures: P.E., AbbVie, Merck, Pfizer, UCB, Roche, BMS—Provided Expert Advice, Undertaken Trials, AbbVie—AbbVie sponsored the study, contributed to its design, and participated in the collection, analysis, and interpretation of the data, and in the writing, reviewing, and approval of the final version. R.F., AbbVie, Pfizer, Merck, Roche, UCB, Celgene, Amgen, AstraZeneca, BMS, Janssen, Lilly, Novartis—Research Grants, Consultation Fees. S.F., AbbVie—Employee, Stocks. A.K., AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, UCB—Research Grants, Consultation Fees. H.K., AbbVie—Employee, Stocks. S.R., AbbVie—Employee, Stocks. J.S., AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, GlaxoSmithKline, Lilly, Pfizer (Wyeth), MSD (Schering-Plough), Novo-Nordisk, Roche, Sandoz, UCB—Research Grants, Consultation Fees. R.V., AbbVie, BMS, GlaxoSmithKline, Human Genome Sciences, Merck, Pfizer, Roche, UCB Pharma—Consultation Fees, Research Support. Table 1.Week 78 clinical, functional, and radiographic outcomes in patients who received continued ADA + MTX vs those who continued PBO + MTX or added open-label ADA following an inadequate response ADA + MTX, n/N (%)a PBO + MTX, n/N (%)b Outcome Week 26 Week 52 Week 78 Week 26 Week 52 Week 78 DAS28 (CRP) <3.2 246/466 (53) 304/465 (65) 303/465 (65) 139/460 (30)*** 284/460 (62) 300/460 (65) HAQ-DI <0.5 211/466 (45) 220/466 (47) 224/466 (48) 150/460 (33)*** 203/460 (44) 208/460 (45) ΔmTSS ≤0.5 402/462 (87) 379/445 (86) 382/443 (86) 330/459 (72)*** 318/440 (72)*** 318/440 (72)*** DAS28 (CRP) <3.2 + ΔmTSS ≤0.5 216/462 (47) 260/443 (59) 266/443 (60) 112/459 (24)*** 196/440 (45) 211/440 (48)*** DAS28 (CRP) <3.2 + HAQ-DI <0.5 + ΔmTSS ≤0.5 146/462 (32) 168/443 (38) 174/443 (39) 82/459 (18)*** 120/440 (27)*** 135/440 (31)** aIncludes patients from the ADA Continuation (n = 105) and OL ADA Carry On (n = 259) arms, as well as the proportional equivalent number of responders from the ADA Withdrawal arm (n = 102). bIncludes patients from the MTX Continuation (n = 112) and Rescue ADA (n = 348) arms. Last observation carried forward: DAS28 (CRP) and HAQ-DI; Multiple imputations: ΔmTSS. ***P < 0.001 and **iP < 0.01, respectively, for differences between initial treatments from chi-squar

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

A Multi-Scale Assessment of Land-Use Impacts on Hydrologic Ecosystem Services in the Vouga Basin, North-Central Portugal

Sustainable water resource management requires understanding how hydrologic processes are impacted by environmental management and land-use decisions across multiple spatial and temporal scales. A key concept in this respect is hydrologic ecosystem services (HES), which are the water related ‘goods’ produced by the environment which are valuable to humans. This dissertation assesses a range of topics concerning HES in the Vouga basin (north-central Portugal), and their connection with land-cover and land-use practices. Specifically, the relationship between changes in forest and agricultural land-cover and management practices, and associated changes in HES were examined using a range of statistical and modeling approaches. To quantify the effects of different agricultural scenarios on both HES and potential stakeholders, the ‘Soil and Water Assessment Tool’ (SWAT) was utilized, in conjunction with economic assessment methods. The first research section (Section 6) of the dissertation assesses the trends in streamflow quantity and yield in the Águeda watershed (a sub-basin of the Vouga) over a 75-yr period which coincided with large-scale afforestation of Pinus pinaster and (later) Eucalyptus globulus. Counter to the findings from meta-analysis studies of the effect of forest change on water availability, this study did not detect statistically significant trends in streamflow. By contrast, these findings support the view that there are prerequisite climatic, pedological, and eco-physiological watershed conditions that are necessary to observe hydrologic impacts at the watershed scale (which are not present in the Águeda watershed). By contrast, the significant changes which were detected are related to baseflow, which correspond with different periods of afforestation, and may be attributable to the promotion of soil water repellency under the mature pine and eucalypt stands. In the second research section (Section 7), an assessment is carried out on the hydrologic and nitrate dynamics at the whole basin scale, using the SWAT model. This assessment indicated that there is a high degree of variability in nitrate export from the different parts of the basin, with the highest rates coming from the lower (agriculturally dominated portion) of the basin. The main flow pathways for nitrate export were found to be leaching from agricultural land-cover types, which consistently had the highest export for all land-use and pathways. These findings indicate that the water bodies at the highest risk of nitrate pollution in the Vouga basin are the groundwater aquifers. The final research section (Section 8) utilizes the SWAT model to examine how reduced rates of fertilizer inputs would affect nitrate leaching, crop yields, and agricultural profitability in the lower Vouga basin. This research found that reduced rates of fertilization would reduce the amount of leached nitrate substantially, but that this would also lead to a large decrease in crop yield and profitability. A large difference in the inefficiency (i.e. crop production vs. nitrate export) between different HRUs was found, which could provide a focus for potential management action. This research strongly indicates that such actions may be needed to reduce the negative impacts of this pollution on the value of the groundwater aquifers, and to avoid associated costs which are otherwise passed on to local water users (e.g. through higher water treatment costs). The overall findings of the dissertation highlight the importance of the upper (forested) basin as a drinking water supply area, given the prevalence of nitrate pollution in the lower basin. However, the historic afforestation in the Vouga basin has resulted in a reduction in baseflow, which is negative from a drinking water supply perspective. Therefore, while the forested uplands are beneficial from water quality standpoint (compared to intensive agriculture), they also have altered flow patterns in a manner which will reduce available supply. The findings from the upper basin contrast sharply with the lower basin, where there are potentially large negative HES impacts due to current agricultural practices. These practices will primarily impact groundwater aquifers, and therefore the water quality within the lower basin receive little benefit from the relatively high-quality water from the upper basin. This highlights the importance of considering the interconnectivity of HES across spatial scales, which will depend on the specific site characteristics of the river basin

A Multi-Scale Assessment of Land-Use Impacts on Hydrologic Ecosystem Services in the Vouga Basin, North-Central Portugal

Sustainable water resource management requires understanding how hydrologic processes are impacted by environmental management and land-use decisions across multiple spatial and temporal scales. A key concept in this respect is hydrologic ecosystem services (HES), which are the water related ‘goods’ produced by the environment which are valuable to humans. This dissertation assesses a range of topics concerning HES in the Vouga basin (north-central Portugal), and their connection with land-cover and land-use practices. Specifically, the relationship between changes in forest and agricultural land-cover and management practices, and associated changes in HES were examined using a range of statistical and modeling approaches. To quantify the effects of different agricultural scenarios on both HES and potential stakeholders, the ‘Soil and Water Assessment Tool’ (SWAT) was utilized, in conjunction with economic assessment methods. The first research section (Section 6) of the dissertation assesses the trends in streamflow quantity and yield in the Águeda watershed (a sub-basin of the Vouga) over a 75-yr period which coincided with large-scale afforestation of Pinus pinaster and (later) Eucalyptus globulus. Counter to the findings from meta-analysis studies of the effect of forest change on water availability, this study did not detect statistically significant trends in streamflow. By contrast, these findings support the view that there are prerequisite climatic, pedological, and eco-physiological watershed conditions that are necessary to observe hydrologic impacts at the watershed scale (which are not present in the Águeda watershed). By contrast, the significant changes which were detected are related to baseflow, which correspond with different periods of afforestation, and may be attributable to the promotion of soil water repellency under the mature pine and eucalypt stands. In the second research section (Section 7), an assessment is carried out on the hydrologic and nitrate dynamics at the whole basin scale, using the SWAT model. This assessment indicated that there is a high degree of variability in nitrate export from the different parts of the basin, with the highest rates coming from the lower (agriculturally dominated portion) of the basin. The main flow pathways for nitrate export were found to be leaching from agricultural land-cover types, which consistently had the highest export for all land-use and pathways. These findings indicate that the water bodies at the highest risk of nitrate pollution in the Vouga basin are the groundwater aquifers. The final research section (Section 8) utilizes the SWAT model to examine how reduced rates of fertilizer inputs would affect nitrate leaching, crop yields, and agricultural profitability in the lower Vouga basin. This research found that reduced rates of fertilization would reduce the amount of leached nitrate substantially, but that this would also lead to a large decrease in crop yield and profitability. A large difference in the inefficiency (i.e. crop production vs. nitrate export) between different HRUs was found, which could provide a focus for potential management action. This research strongly indicates that such actions may be needed to reduce the negative impacts of this pollution on the value of the groundwater aquifers, and to avoid associated costs which are otherwise passed on to local water users (e.g. through higher water treatment costs). The overall findings of the dissertation highlight the importance of the upper (forested) basin as a drinking water supply area, given the prevalence of nitrate pollution in the lower basin. However, the historic afforestation in the Vouga basin has resulted in a reduction in baseflow, which is negative from a drinking water supply perspective. Therefore, while the forested uplands are beneficial from water quality standpoint (compared to intensive agriculture), they also have altered flow patterns in a manner which will reduce available supply. The findings from the upper basin contrast sharply with the lower basin, where there are potentially large negative HES impacts due to current agricultural practices. These practices will primarily impact groundwater aquifers, and therefore the water quality within the lower basin receive little benefit from the relatively high-quality water from the upper basin. This highlights the importance of considering the interconnectivity of HES across spatial scales, which will depend on the specific site characteristics of the river basin