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The city of Morelia (western Mexico) has a population of 800,000 inhabitants and constant urban growth, requiring large volumes of water and facing problems with the supply, causing a deficit and affecting water availability.The study evaluates the quality conditions in which the main sources of supply are found, through physicochemical and isotopic characterization, used as tools to relate the intense use of water with the natural water cycle and its renewability. By studying the relative abundance of stable isotopes and differences in physicochemical parameters of rainwater, surface water, groundwater, and spring sources, natural recharge and discharge processes can be analyzed, as well as the effect of groundwater overexploitation.Two samplings were carried out, one in 2018 for rainwater (with more than 70 samples), and another in February 2021, from the drinking water supply system (operated by a local water agency), collecting 76 samples from wells, springs, and surface streams. Climatological precipitation and temperature data were collected and processed with hydrogeological and isotope data.The isotopic data were compared with the Water Isotopes database of sites near the study area, and a provisional Local Meteoric Line (LML) was determined. The isotopic and physicochemical results of the water from supply sources (wells, springs, rivers), their analysis through bivariate graphs, hydrogeochemical classification, and spatial distribution in the study area give an idea of the groundwater flow dynamics and its relationship with its exploitation, observing a similar behavior between some of the parameters measured in the field for the different water sources., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare primary liver cancer. Our aims were to analyze the demographic, clinical, and pathological characteristics of cHCC-CC at a population level and to investigate the effects of these features as well as different management strategies on the prognosis. The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for 1988-2009. Data analyses were performed with chi-square tests, analyses of variance, Kaplan-Meier curves, and Cox proportional hazards regression. Four hundred sixty-five patients with cHCC-CC, 52,825 patients with hepatocellular carcinoma (HCC), and 7181 patients with cholangiocarcinoma (CC) were identified. cHCC-CC was more common in patients who were white, male, and older than 65 years. Treatment was more frequently nonsurgical/interventional. Patients with cHCC-CC, HCC, and CC had 5-year overall survival (OS) and disease-specific survival rates of 10.5%, 11.7%, and 5.7% (P < 0.001) and 17.8%, 21.0%, and 11.9% (P < 0.001), respectively. For cHCC-CC patients, an increasing invasiveness of the therapeutic approach was significantly associated with prolonged survival (P < 0.001). In a multivariate model, black race, a distant SEER stage, and a tumor size of 5.0 to 10.0 cm were independently associated with lower survival for cHCC-CC patients; a year of diagnosis after 1995 and surgical treatment with minor hepatectomy, major hepatectomy (MJH), or liver transplantation (LT) were independently associated with better survival for cHCC-CC patients. Patients diagnosed with cHCC-CC, HCC, and CC and treated with LT had 5-year OS rates of 41.1%, 67.0%, and 29.0%, respectively (P < 0.001). In conclusion, cHCC-CC patients appear to have intermediate demographic, clinical, and survival characteristics in comparison with HCC and CC patients. cHCC-CC patients undergoing LT showed inferior survival in comparison with HCC patients, and the role and indications for LT in cHCC-CC have yet to be defined. At this time, MJH may be considered the best therapeutic approach for such patients. © 2014 American Association for the Study of Liver Diseases.