Integrated Hydrological Modeling for Water Resources Management of Heeia Coastal Wetland in Hawaii.

Ph.D. Thesis. University of Hawaiʻi at Mānoa 2017

The Impacts of Climate Change and Wetland Restoration on the Water Balance Components of the Coastal Wetland

The coastal wetlands represent the critical interface between the terrestrial and ocean zones, which have gained vital importance in terms of economic and environmental aspects. Land cover change (LU) and climate change (CC) are considered the determinant factors for the changes in nutrient fluxes, thermal energy, and water balance components (WBCs). These factors are also expected to affect each other through interaction process effects. An essential tool that may be used to evaluate the sustainability and availability of water resources for food security and the ecological health of coastal zones is a hydrological modeling technique. The Heeia coastal wetlands in Hawaii, USA, are used as a case study in this study to evaluate the effects of LU and CC on WBCs

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Assessment of climate change impacts on water balance components of Heeia watershed in Hawaii

Study region: Heeia watershed, Oahu, Hawaii, USA. Study focus: Hydrological models are useful tools for assessing the impact of climate change in watersheds. We evaluated the applicability of the Soil and Water Assessment Tool (SWAT) model in a case study of Heeia, Pacific-island watershed that has highly permeable volcanic soils and suffers from hydrological data scarcity. Applicability of the model was enhanced with several modifications to reflect unique watershed characteristics. The calibrated model was then used to assess the impact of rainfall, temperature, and CO2 concentration changes on the water balance of the watershed. New hydrological insights for the study region: Compared to continental watersheds, the Heeia watershed showed high rainfall initial abstraction due to high initial infiltration capacity of the soils. The simulated and observed streamflows generally showed a good agreement and satisfactory model performance demonstrating the applicability of SWAT for small island watersheds with large topographic, precipitation, and land-use gradients. The study also demonstrates methods to resolve data scarcity issues. Predicted climate change scenarios showed that the decrease in rainfall during wet season and marginal increase in dry season are the main factors for the overall decrease in water balance components. Specifically, the groundwater flow component may consistently decrease by as much as 15% due to predicted rainfall and temperature changes by 2100, which may have serious implications on groundwater availability in the watershed

Assessment of SWAT Model Performance in Simulating Daily Streamflow under Rainfall Data Scarcity in Pacific Island Watersheds

Evaluating the performance of watershed models is essential for a reliable assessment of water resources, particularly in Pacific island watersheds, where modeling efforts are challenging due to their unique features. Such watersheds are characterized by low water residence time, highly permeable volcanic rock outcrops, high topographic and rainfall spatial variability, and lack of hydrological data. The Soil and Water Assessment Tool (SWAT) model was used for hydrological modeling of the Nuuanu area watershed (NAW) and Heeia watershed on the Island of Oahu (Hawaii). The NAW, which had well-distributed rainfall gauging stations within the watershed, was used for comparison with the Heeia watershed that lacked recoded rainfall data within the watershed. For the latter watershed, daily rain gauge data from the neighboring watersheds and spatially interpolated 250 m resolution rainfall data were used. The objectives were to critically evaluate the performance of SWAT under rain gauge data scarce conditions for small-scale watersheds that experience high rainfall spatial variability over short distances and to determine if spatially interpolated gridded rainfall data can be used as a remedy in such conditions. The model performance was evaluated by using the Nash⁻Sutcliffe efficiency (NSE), the percent bias (PBIAS), and the coefficient of determination (R2), including model prediction uncertainty at 95% confidence interval (95PCI). Overall, the daily observed streamflow hydrographs were well-represented by SWAT when well-distributed rain gauge data were used for NAW, yielding NSE and R2 values of > 0.5 and bracketing > 70% of observed streamflows at 95PCI. However, the model showed an overall low performance (NSE and R2 ≤ 0.5) for the Heeia watershed compared to the NAW’s results. Although the model showed low performance for Heeia, the gridded rainfall data generally outperformed the rain gauge data that were used from outside of the watershed. Thus, it was concluded that finer resolution gridded rainfall data can be used as a surrogate for watersheds that lack recorded rainfall data in small-scale Pacific island watersheds

Assessment of Wetland Restoration and Climate Change Impacts on Water Balance Components of the Heeia Coastal Wetland in Hawaii

Hydrological modeling is an important tool that can be used to assess water resources’ availability and sustainability that are necessary for food security and ecological health of coastal regions. In this study, we assessed the impacts of land use and climate changes on water balance components (WBCs) of the Heeia coastal wetland. We developed a Soil and Water Assessment Tool (SWAT) model to capture the unique characteristics of the Hawaiian Islands, including its volcanic soil’s nature and high initial infiltration rates. We used the sequential uncertainty fitting algorithm to assess the sensitivity and uncertainty of WBCs under different climate change scenarios. Results of the statistical analysis of daily streamflow simulations showed that the model performance was within the generally acceptable criteria. Under future climate scenarios, rainfall change was the determinant factor most negatively impacting WBCs. Recharge and baseflow components had the highest sensitivity to the combined effects of land use and climate changes, especially during dry season. The uncertainty analysis indicated that the streamflow is projected to slightly increase by the middle of 21st century, but expected to decline by 40% during the late 21st century of Representative Concentration Pathways (RCP) 8.5

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care