Comparison of environmental tracers including organic micropollutants as groundwater exfiltration indicators into a small river of a karstic catchment

Understanding groundwater–surface water (GW–SW) interactions is vital for water management in karstic catchments due to its impact on water quality. The objective of this study was to evaluate and compare the applicability of seven environmental tracers to quantify and localize groundwater exfiltration into a small, human‐impacted karstic river system. Tracers were selected based on their emission source to the surface water either as (a) dissolved, predominantly geogenic compounds (radon‐222, sulphate and electrical conductivity) or (b) anthropogenic compounds (predominantly) originating from wastewater treatment plant (WWTP) effluents (carbamazepine, tramadol, sodium, chloride). Two contrasting sampling approaches were compared (a) assuming steady‐state flow conditions and (b) considering the travel time of the water parcels (Lagrangian sampling) through the catchment to account for diurnal changes in inflow from the WWTP. Spatial variability of the concentrations of all tracers indicated sections of preferential groundwater inflow. Lagrangian sampling techniques seem highly relevant for capturing dynamic concentration patterns of WWTP‐derived compounds. Quantification of GW inflow with the finite element model FINIFLUX, based on observed in‐stream Rn activities led to plausible fluxes along the investigated river reaches (0.265 m3 s−1), while observations of other natural or anthropogenic environmental tracers produced less plausible water fluxes. Important point sources of groundwater exfiltration can be ascribed to locations where the river crosses geological fault lines. This indicates that commonly applied concepts describing groundwater–surface water interactions assuming diffuse flow in porous media are difficult to transfer to karstic river systems whereas concepts from fractured aquifers may be more applicable. In general, this study helps selecting the best suited hydrological tracer for GW exfiltration and leads to a better understanding of processes controlling groundwater inflow into karstic river systems.Karst aquifers represent an increased complexity when aiming to measure the interaction between groundwater and river water. Combining field‐based measurements on catchment scale and modelling, the applicability of ‘classical’ environmental groundwater tracers was compared to selected organic (micro)pollutants often considered as conservative and originally arising from a wastewater treatment plant. This study demonstrates that the choice of an appropriate tracer is crucial when either aiming to quantify groundwater exfiltration into karstic river systems, or indicating hydrological processes, applying (globally) omnipresent pollutants.German Research Foundation (DFG) http://dx.doi.org/10.13039/50110000165

Personalized Research on Diet in Ulcerative Colitis and Crohn\u27s Disease: A Series of N-of-1 Diet Trials

INTRODUCTION: Evidence about specific carbohydrate diet (SCD) for inflammatory bowel disease (IBD) is limited. We conducted 54 single-subject, double-crossover N-of-1 trials comparing SCD with a modified SCD (MSCD) and comparing each with the participant\u27s baseline, usual diet (UD). METHODS: Across 19 sites, we recruited patients aged 7–18 years with IBD and active inflammation. Following a 2-week baseline (UD), patients were randomized to 1 of 2 sequences of 4 alternating 8-week SCD and MSCD periods. Outcomes included fecal calprotectin and patient-reported symptoms. We report posterior probabilities from Bayesian models comparing diets. RESULTS: Twenty-one (39%) participants completed the trial, 9 (17%) completed a single crossover, and 24 (44%) withdrew. Withdrawal or early completion occurred commonly (lack of response [n = 11], adverse events [n = 11], and not desiring to continue [n = 6]). SCD and MSCD performed similarly for most individuals. On average, there was \u3c1% probability of a clinically meaningful difference in IBD symptoms between SCD and MSCD. The average treatment difference was −0.3 (95% credible interval −1.2, 0.75). There was no significant difference in the ratio of fecal calprotectin geometric means comparing SCD and MSCD (0.77, 95% credible interval 0.51, 1.10). Some individuals had improvement in symptoms and fecal calprotectin compared with their UD, whereas others did not. DISCUSSION: SCD and MSCD did not consistently improve symptoms or inflammation, although some individuals may have benefited. However, there are inherent difficulties in examining dietary changes that complicate study design and ultimately conclusions regarding effectiveness

Personalized Research on Diet in Ulcerative Colitis and Crohn\u27s Disease: A Series of N-of-1 Diet Trials

INTRODUCTION: Evidence about specific carbohydrate diet (SCD) for inflammatory bowel disease (IBD) is limited. We conducted 54 single-subject, double-crossover N-of-1 trials comparing SCD with a modified SCD (MSCD) and comparing each with the participant\u27s baseline, usual diet (UD). METHODS: Across 19 sites, we recruited patients aged 7–18 years with IBD and active inflammation. Following a 2-week baseline (UD), patients were randomized to 1 of 2 sequences of 4 alternating 8-week SCD and MSCD periods. Outcomes included fecal calprotectin and patient-reported symptoms. We report posterior probabilities from Bayesian models comparing diets. RESULTS: Twenty-one (39%) participants completed the trial, 9 (17%) completed a single crossover, and 24 (44%) withdrew. Withdrawal or early completion occurred commonly (lack of response [n = 11], adverse events [n = 11], and not desiring to continue [n = 6]). SCD and MSCD performed similarly for most individuals. On average, there was \u3c1% probability of a clinically meaningful difference in IBD symptoms between SCD and MSCD. The average treatment difference was −0.3 (95% credible interval −1.2, 0.75). There was no significant difference in the ratio of fecal calprotectin geometric means comparing SCD and MSCD (0.77, 95% credible interval 0.51, 1.10). Some individuals had improvement in symptoms and fecal calprotectin compared with their UD, whereas others did not. DISCUSSION: SCD and MSCD did not consistently improve symptoms or inflammation, although some individuals may have benefited. However, there are inherent difficulties in examining dietary changes that complicate study design and ultimately conclusions regarding effectiveness