Global Withdrawal Research Articles

How will climate change affect the sources of global irrigation water withdrawal?

How will climate change affect the sources of global irrigation water withdrawal?

Comparing withdrawal- and anxiety-like behaviors following oral and subcutaneous oxycodone administration in C57BL/6 mice.

Excessive prescribing and misuse of prescription opioids, such as oxycodone, significantly contributed to the current opioid crisis. Although oxycodone is typically consumed orally by humans, parenteral routes of administration have primarily been used in preclinical models of oxycodone dependence. To address this issue, more recent studies have used oral self-administration procedures to study oxycodone seeking and withdrawal in rodents. Behavioral differences, however, following oral oxycodone intake versus parenteral oxycodone administration remain unclear. Thus, the goal of the current studies was to compare anxiety- and withdrawal-like behaviors using established opioid dependence models of either home cage oral intake of oxycodone (0.5 mg/ml) or repeated subcutaneous (s.c.) injections of oxycodone (10 mg/kg) in male and female mice. Here, mice received 10 days of oral or s.c. oxycodone administration, and following 72 h of forced abstinence, anxiety- and withdrawal-like behaviors were measured using elevated zero maze, open field, and naloxone-induced precipitated withdrawal procedures. Global withdrawal scores were increased to a similar degree following oral and s.c. oxycodone use, while both routes of oxycodone administration had minimal effects on anxiety-like behaviors. When examining individual withdrawal-like behaviors, mice receiving s.c. oxycodone exhibited more paw tremors and jumps during naloxone-induced precipitated withdrawal compared with oral oxycodone mice. These results indicate that both models of oxycodone administration are sufficient to elevate global withdrawal scores, but, when compared with oral consumption, s.c. oxycodone injections yielded more pronounced effects on some withdrawal-like behaviors.

Persistent Transmission of Circulating Vaccine-Derived Poliovirus - Somalia, January 2017-March 2024.

Since the launch of the Global Polio Eradication Initiative in 1988, substantial progress has been made in the interruption of wild poliovirus (WPV) transmission worldwide: global eradication of WPV types 2 and 3 were certified in 2015 and 2019, respectively, and endemic transmission of WPV type 1 continues only in Afghanistan and Pakistan. After the synchronized global withdrawal of all serotype 2 oral poliovirus vaccines (OPVs) in 2016, widespread outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) have occurred, which are linked to areas with low population immunity to poliovirus. Officials in Somalia have detected ongoing cVDPV2 transmission since 2017. Polio vaccination coverage and surveillance data for Somalia were reviewed to assess this persistent transmission. During January 2017-March 2024, officials in Somalia detected 39 cVDPV2 cases in 14 of 20 regions, and transmission has spread to neighboring Ethiopia and Kenya. Since January 2021, 28 supplementary immunization activities (SIAs) targeting cVDPV2 were conducted in Somalia. Some parts of the country are security-compromised and inaccessible for vaccination campaigns. Among 1,921 children with nonpolio acute flaccid paralysis, 231 (12%) had not received OPV doses through routine immunization or SIAs, 95% of whom were from the South-Central region, and 60% of whom lived in inaccessible districts. Enhancing humanitarian negotiation measures in Somalia to enable vaccination of children in security-compromised areas and strengthening campaign quality in accessible areas will help interrupt cVDPV2 transmission.

Irrigation scheduling needs to consider both plant‐available water and soil aeration requirements

AbstractGlobal food production relying on irrigated agriculture accounts for >70% of the global freshwater withdrawal. A thorough understanding of soil–water characteristics (SWCs) and critical soil–water values in the soil and subsoil is important for effective management of irrigated water. A critical soil–water “window” for plants is generally taken as the plant‐available water window without considering diffusion‐dominated soil aeration as a co‐requisite. This study examined SWC curves in vadose soil profiles (up to 1.5‐m depth) in eight pasture soils. The soil moisture measurements were made over matric potentials ranging from −1 to −1500 kPa using tension table and pressure plate apparatus. The van Genuchten model was used to parameterize the measured SWC curve, while the Millington‐Quirk model was used to derive soil–gas diffusivity from measured soil physical properties. We defined critical soil–water windows considering the threshold values for both plant‐available water and soil–gas diffusivity to ensure water and aeration corequisites for plant growth. The results clearly distinguished depth‐dependent regimes of gravitational, plant‐available, and unavailable water in selected profiles and their responses to soil structural changes across the depth. In some of the observed soil profiles, only 30%–60% of the plant‐available water window was able to be utilized by plants because the remainder existed under soil conditions where soil aeration was inadequate for plant growth, emphasizing the importance of considering both the plant's water and aeration requirements during irrigation scheduling. Further, the infiltration profiles in two selected soils under simulated irrigation highlighted the importance of a priori knowledge of the soil structure in deeper soil layers for scheduling irrigation.

Somatic and anxiety-like behaviors in male and female rats during withdrawal from the non-selective cannabinoid agonist WIN 55,212–2

Synthetic cannabinoids are associated with higher risk of dependence and more intense withdrawal symptoms than plant-derived Δ9-tetrahydrocannabinol (THC). Avoidance of withdrawal symptoms, including anxiogenic effects, can contribute to continued cannabinoid use. Adult male and female Long-Evans rats were given escalating doses of WIN 55,212–2 (WIN) via twice daily intrajugular infusions. Precipitated withdrawal was elicited with SR 141716 (rimonabant) 4 h after the final infusion. Global withdrawal scores (GWS) were compiled by summing z-scores of observed somatic behaviors over a 30-min period with locomotor activity simultaneously collected via beam breaks. Rimonabant precipitated withdrawal in female and male rats at 3 or 10 mg/kg, respectively, but the individual behaviors contributing to GWS were not identical. 3 mg/kg rimonabant did not impact locomotor behavior in females, but 10 mg/kg decreased locomotion in male controls. Spontaneous withdrawal observed between 6 and 96 h after the final infusion was quantifiable up to 24 h following WIN administration. Individual behaviors contributing to GWS varied by sex and time point. Males undergoing spontaneous withdrawal engaged in more locomotion than females undergoing withdrawal. Separate groups of rats were subjected to a battery of anxiety-like behavioral tests (elevated plus maze, open field test, and marble burying test) one or two weeks after WIN or vehicle infusions. At one week abstinence, sex-related effects were noted in marble burying and the open field test but were unrelated to drug treatment. At two weeks abstinence, females undergoing withdrawal spent more time grooming during marble burying and performed more marble manipulations than their male counterparts. WIN infusions did not impact estrous cycling, and GWS scores were not correlated with estrous at withdrawal. Collectively, these results show qualitative sex differences in behaviors contributing to the behavioral experience of cannabinoid withdrawal supporting clinical findings from THC.

Groundwater for People and the Environment: A Globally Threatened Resource.

The intensity of global groundwater use rose from 124 m3 per capita in 1950 to 152 m3 in 2021, for a 22.6% rise in the annual per capita use. This rise in global per capita water use reflects rising consumption patterns. The global use of groundwater, which provides between 21% and 30% of the total freshwater annual consumption, will continue to expand due to the sustained population growth projected through most of the 21st century and the important role that groundwater plays in the water-food-energy nexus. The rise in groundwater use, on the other hand, has inflicted adverse impacts in many aquifers, such as land subsidence, sea water intrusion, stream depletion, and deterioration of groundwater-dependent ecosystems, groundwater-quality degradation, and aridification. This paper projects global groundwater use between 2025 and 2050. The projected global annual groundwater withdrawal in 2050 is 1535 km3 (1 km3 = 109 m3 = 810,713 acre-feet). The projected global groundwater depletion, that is, the excess of withdrawal over recharge, in 2050 equals 887 km3, which is about 61% larger than in 2021. This projection signals probable exacerbation of adverse groundwater-withdrawal impacts, which are worsened by climatic trends and the environmental requirement of groundwater flow unless concerted national and international efforts achieve groundwater sustainability.

The effects of (2R,6R)-hydroxynorketamine on oxycodone withdrawal and reinstatement

Despite the thousands of lives lost during the ongoing opioid crisis, a scarcity of new and effective clinical treatments for opioid use disorder (OUD) remains. To address this unmet need, some researchers have turned to dissociative and psychedelic drugs to treat multiple psychiatric conditions. In particular, low doses of ketamine have been shown to attenuate opioid withdrawal and drug use in clinical and preclinical studies. However, ketamine has misuse liability and dissociative side effects that may limit its widespread application as a treatment for OUD. More recently, (2R,6R)-hydroxynorketamine (HNK), a ketamine metabolite that lacks misuse potential, has gained attention for its effectiveness in depression and stress models. To uncover its role in OUD, we tested the time-dependent effects of (2R,6R)-HNK on oxycodone withdrawal and reinstatement of oxycodone conditioned place preference (CPP). In male and female oxycodone-dependent mice, we found that 24h pretreatment with (2R,6R)-HNK (10 or 30mg/kg, s.c.) reduced the frequency of withdrawal-like behaviors and global withdrawal scores during naloxone-precipitated withdrawal, whereas 1h pretreatment with (2R,6R)-HNK only reduced paw tremors and the sum of global withdrawal scores but not GWS Z-scores. In other experiments, both 1h and 24h pretreatment with (2R,6R)-HNK (30mg/kg, s.c.) blocked drug-induced reinstatement of oxycodone CPP. Finally, we found (2R,6R)-HNK (30mg/kg, sc) had no effect on locomotor activity and thigmotaxis. Together, these results indicate that acute (2R,6R)-HNK has efficacy in some preclinical models of OUD without producing locomotor or anxiety-like side effects.

The Diplomacy of Military Assistance: The Royal Navy Training Team and the Nigerian Civil War

ABSTRACT This article studies the Anglo-Nigerian negotiations for a Royal Navy training team during the Nigerian Civil War against the background of Africa’s ‘phoney’ Cold War and Britain’s global strategic withdrawal. This allows it to show Britain’s diplomatic manoeuvres to simultaneously prevent provoking debilitating opposition against its tightrope policy of supporting Federal Nigeria against Biafra and safeguard its significant, predominantly economic – particularly oil – interests in Nigeria. Initially inconvenienced by the Nigerian request for a naval training team, British policymakers gradually agreed to send one after the war, then promised to do so already before, and, after the foreign policy establishment had overcome the Ministry of Defence’s resistance, finally sent out Royal Navy officers to Nigeria before the end of hostilities. In this process, the Nigerians had allies in the British High Commission in Lagos and the Foreign (and Commonwealth) Office, as well as substantial leverage as a result of Indian and Soviet competition in the Nigerian market for military assistance. Yet this leverage was mitigated by the Federals’ preference for British over Indian military assistance, and fear of becoming too reliant on Moscow. Not only in the British, but also in the Nigerian case, diplomatic concerns thus outweighed the military rationale for the naval training team, and this ‘diplomacy of military assistance’ contrasts with the basic tenor of the theoretical literature on military assistance in civil wars.

Global monthly sectoral water use for 2010–2100 at 0.5° resolution across alternative futures

Water usage is closely linked with societal goals that are both local and global in scale, such as sustainable development and economic growth. It is therefore of value, particularly for long-term planning, to understand how future sectoral water usage could evolve on a global scale at fine resolution. Additionally, future water usage could be strongly shaped by global forces, such as socioeconomic and climate change, and the multi-sector dynamic interactions those forces create. We generate a novel global gridded monthly sectoral water withdrawal and consumption dataset at 0.5° resolution for 2010–2100 for a diverse range of 75 scenarios. The scenarios are harmonized with the five Shared Socioeconomic Pathways (SSPs) and four Representative Concentration Pathways (RCPs) scenarios to support its usage in studies evaluating the implications of uncertain human and earth system change for future global and regional dynamics. To generate the data, we couple the Global Change Analysis Model (GCAM) with a land use spatial downscaling model (Demeter), a global hydrologic framework (Xanthos), and a water withdrawal downscaling model (Tethys).

Analysis of population immunity to poliovirus following cessation of trivalent oral polio vaccine.

The global withdrawal of trivalent oral poliovirus vaccine (OPV) (tOPV, containing Sabin poliovirus strains serotypes 1, 2 and 3) from routine immunization, and the introduction of bivalent OPV (bOPV, containing Sabin poliovirus strains serotypes 1 and 3) and trivalent inactivated poliovirus vaccine (IPV) into routine immunization was expected to improve population serologic and mucosal immunity to types 1 and 3 poliovirus, while population mucosal immunity to type 2 poliovirus would decline. However, over the period since tOPV withdrawal, the implementation of preventive bOPV supplementary immunization activities (SIAs) has decreased, while outbreaks of type 2 circulating vaccine derived poliovirus (cVDPV2) have required targeted use of monovalent type 2 OPV (mOPV2). We develop a dynamic model of OPV-induced immunity to estimate serotype-specific, district-level immunity for countries in priority regions and characterize changes in immunity since 2016. We account for the changes in routine immunization schedules and varying implementation of preventive and outbreak response SIAs, assuming homogenous coverages of 50% and 80% for SIAs. In areas with strong routine immunization, the switch from tOPV to bOPV has likely resulted in gains in population immunity to types 1 and 3 poliovirus. However, we estimate that improved immunogenicity of new schedules has not compensated for declines in preventive SIAs in areas with weak routine immunization. For type 2 poliovirus, without tOPV in routine immunization or SIAs, mucosal immunity has declined nearly everywhere, while use of mOPV2 has created highly heterogeneous population immunity for which it is important to take into account when responding to cVDPV2 outbreaks. The withdrawal of tOPV and declining allocations of resources for preventive bOPV SIAs have resulted in reduced immunity in vulnerable areas to types 1 and 3 poliovirus and generally reduced immunity to type 2 poliovirus in the regions studied, assuming homogeneous coverages of 50% and 80% for SIAs. The very low mucosal immunity to type 2 poliovirus generates substantially greater risk for further spread of cVDPV2 outbreaks. Emerging gaps in immunity to all serotypes will require judicious targeting of limited resources to the most vulnerable populations by the Global Polio Eradication Initiative (GPEI).

The Origins and Risk Factors for Serotype-2 Vaccine-Derived Poliovirus Emergences in Africa During 2016-2019.

Serotype 2 oral poliovirus vaccine (OPV2) can revert to regain wild-type neurovirulence and spread to cause emergences of vaccine-derived poliovirus (VDPV2). After its global withdrawal from routine immunization in 2016, outbreak response use has created a cycle of VDPV2 emergences that threaten eradication. We implemented a hierarchical model based on VP1 region genetic divergence, time, and location to attribute emergences to campaigns and identify risk factors. We found that a 10 percentage point increase in population immunity in children younger than 5 years at the campaign time and location corresponds to a 18.0% decrease (95% credible interval [CrI], 6.3%-28%) in per-campaign relative risk, and that campaign size is associated with emergence risk (relative risk scaling with population size to a power of 0.80; 95% CrI, .50-1.10). Our results imply how Sabin OPV2 can be used alongside the genetically stable but supply-limited novel OPV2 (listed for emergency use in November 2020) to minimize emergence risk.

Analysis of a Sabin-Strain Inactivated Poliovirus Vaccine Response to a Circulating Type 2 Vaccine-Derived Poliovirus Event in Sichuan Province, China 2019-2021

The Sabin-strain inactivated poliovirus vaccine (IPV) may be a tool for polio outbreak response in certain situations. To investigate the response to a type 2 vaccine-derived poliovirus (VDPV2) outbreak. This case series was conducted in China after a VDPV2 was detected in stool specimens from a child with acute flaccid paralysis (AFP) in Sichuan Province in 2019, 3 years after the global withdrawal of live, attenuated type 2 oral poliovirus vaccine (OPV). Investigation followed National Health Commission and World Health Organization guidance and included searching hospitals for unreported AFP cases; testing stool specimens from the child, his contacts, and local children; enhanced environmental surveillance for VDPV2s in wastewater; and measuring vaccination coverage. Sabin-strain IPV campaigns were conducted in a wide geographic area. Any VDPV2 detection after completion of the supplementary immunization activities. A 28-nucleotide-change VDPV2 was isolated from a young boy. Three VDPV2s were detected in healthy children; 2 were contacts of the original child, and none had paralysis. A search of 31 million hospital records found 10 unreported AFP cases; none were polio. No type 2 polioviruses were found in wastewater. Prior to the event, polio vaccine coverage was 65% among children younger than 5 years. Sabin-strain IPV campaigns reached more than 97% of targeted children, administering 1.4 million doses. No transmission source was identified. More than 1 year of enhanced poliovirus environmental and AFP surveillance detected no additional VDPVs. These findings suggest that the circulating VPDV2 outbreak in 2019 was associated with low vaccine coverage. An investigation discovered 3 infected but otherwise healthy children and no evidence of the virus in wastewater. Following Sabin-strain IPV-only campaigns expanding from county to prefecture, the poliovirus was not detected, and the outbreak response was considered by an expert panel and the World Health Organization to have been successful. This success suggests that the Sabin-strain IPV may be a useful tool for responding to circulating VDPV2 outbreaks when high-quality supplementary immunization activities can be conducted and carefully monitored in settings with good sanitation.

A global gridded municipal water withdrawal estimation method using aggregated data and artificial neural network.

Municipal water withdrawal (MWW) information is of great significance for water supply planning, including water supply pipeline networks planning, optimization and management. Currently most MWW data are reported as spatially aggregated over large-area survey regions or even lack of data, which is unable to meet the growing demand for spatially detailed data in many applications. In this paper, six different models are constructed and evaluated in estimatingglobal MWW using aggregated MWW data and gridded raster covariates. Among the models, the artificial neural network-based indirect model (NNM) shows the best accuracy with higher R2and lower NMAE and NRMSE in different spatial scales. The estimates achieved from the NNMmodel are consistent with census and survey data, and outperforms the existing global gridded MWW dataset. At last, the NNMmodel is applied to mapping global gridded MWW for the year 2015 at 0.1 × 0.1° resolution.The proposed method can be applied to a wider aggregated output learning problemand the high-resolution global gridded MWW data can be used in hydrological models and water resources management.

A data set of distributed global population and water withdrawal from 1960 to 2020

Population and water withdrawal data sets are currently faced with difficulties in collecting, processing and verifying multi-source time series, and the spatial distribution characteristics of long series are also relatively lacking. Time series is the basic guarantee for the accuracy of data sets, and the production of long series spatial distribution is a realistic requirement to expand the application scope of data sets. Through the time-consuming and laborious basic processing work, this research focuses on the population and water intake time series, and interpolates and extends them to specific land uses to ensure the accuracy of the time series and the demand of spatially distributed data sets. This research provides a set of population density and water intensity products from 1960 to 2020 distributed to the administrative units or the corresponding regions. The data set fills the gaps in the multi-year data set for the accuracy of population density and the intensity of water withdrawal.

The delusive accuracy of global irrigation water withdrawal estimates.

The delusive accuracy of global irrigation water withdrawal estimates.

Multiscale model for forecasting Sabin 2 vaccine virus household and community transmission.

Since the global withdrawal of Sabin 2 oral poliovirus vaccine (OPV) from routine immunization, the Global Polio Eradication Initiative (GPEI) has reported multiple circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. Here, we generated an agent-based, mechanistic model designed to assess OPV-related vaccine virus transmission risk in populations with heterogeneous immunity, demography, and social mixing patterns. To showcase the utility of our model, we present a simulation of mOPV2-related Sabin 2 transmission in rural Matlab, Bangladesh based on stool samples collected from infants and their household contacts during an mOPV2 clinical trial. Sabin 2 transmission following the mOPV2 clinical trial was replicated by specifying multiple, heterogeneous contact rates based on household and community membership. Once calibrated, the model generated Matlab-specific insights regarding poliovirus transmission following an accidental point importation or mass vaccination event. We also show that assuming homogeneous contact rates (mass action), as is common of poliovirus forecast models, does not accurately represent the clinical trial and risks overestimating forecasted poliovirus outbreak probability. Our study identifies household and community structure as an important source of transmission heterogeneity when assessing OPV-related transmission risk and provides a calibratable framework for expanding these analyses to other populations.Trial Registration: ClinicalTrials.gov This trial is registered with clinicaltrials.gov, NCT02477046.

Interconnections among rural practices and Food-Water-Energy Security Nexus in the Atlantic Forest biome

Global agricultural production is expected to double by 2050 due to both global population increase and changes in diets as a consequence of growing incomes. This also means more pressure on water resources, as agriculture accounts for 70 % of global water withdrawal and for energy production as the entire food supply chain accounts for about 30 % of total global energy consumption. Although there are ongoing discussions related to the sustainability of food, water, and energy sectors, integrating [...]

The first fine-resolution mapping of contour-levee irrigation using deep Bi-Stream convolutional neural networks

Agricultural irrigation accounts for nearly 70% of global freshwater withdrawal. Among irrigation practices, contour-levee cascade irrigation is of particular interest as it is water-intensive and widely used in many rice production regions. Despite its significant environmental implications, no study has quantified the distribution of contour-levee irrigation. One major challenge of remote sensing-based contour-levee field detection is how to accurately identify the thin and curved levee lines whose appearance varies dramatically in different fields. This paper presents a new deep network-based method that jointly optimizes semantically meaningful features to quantify the contour-levee fields. This new method uses a bi-stream encoder-decoder architecture to capture spectral information and gradient features. To maintain image gradient sharpness, a skip connection approach is employed to facilitate gradient propagation across long-range connections. Moreover, the new method uses deep supervision to generate more informative features from the earlier hidden layers and superpixel segmentation to reduce classification noise as a post-processing step. By testing against 41 images across 10 Arkansas counties, the average accuracy was 86.23% and the method achieved 15%-17% improvement over benchmark methods. The results show that IrrNet-Bi-Seg maintains good transferability and is thus promising for larger-scale applications.

Risk factors for the spread of vaccine-derived type 2 polioviruses after global withdrawal of trivalent oral poliovirus vaccine and the effects of outbreak responses with monovalent vaccine: a retrospective analysis of surveillance data for 51 countries in Africa

SummaryBackgroundExpanding outbreaks of circulating vaccine-derived type 2 poliovirus (cVDPV2) across Africa after the global withdrawal of trivalent oral poliovirus vaccine (OPV) in 2016 are delaying global polio eradication. We aimed to assess the effect of outbreak response campaigns with monovalent type 2 OPV (mOPV2) and the addition of inactivated poliovirus vaccine (IPV) to routine immunisation.MethodsWe used vaccination history data from children under 5 years old with non-polio acute flaccid paralysis from a routine surveillance database (the Polio Information System) and setting-specific OPV immunogenicity data from the literature to estimate OPV-induced and IPV-induced population immunity against type 2 poliomyelitis between Jan 1, 2015, and June 30, 2020, for 51 countries in Africa. We investigated risk factors for reported cVDPV2 poliomyelitis including population immunity, outbreak response activities, and correlates of poliovirus transmission using logistic regression. We used the model to estimate cVDPV2 risk for each 6-month period between Jan 1, 2016, and June 30, 2020, with different numbers of mOPV2 campaigns and compared the timing and location of actual mOPV2 campaigns and the number of mOPV2 campaigns required to reduce cVDPV2 risk to low levels.FindingsType 2 OPV immunity among children under 5 years declined from a median of 87% (IQR 81–93) in January–June, 2016 to 14% (9–37) in January–June, 2020. Type 2 immunity from IPV among children under 5 years increased from 3% (<1–6%) in January–June, 2016 to 35% (24–47) in January–June, 2020. The probability of cVDPV2 poliomyelitis among children under 5 years was negatively correlated with OPV-induced and IPV-induced immunity and mOPV2 campaigns (adjusted odds ratio: OPV 0·68 [95% CrI 0·60−0·76], IPV 0·82 [0·68−0·99] per 10% absolute increase in estimated population immunity, mOPV2 0·30 [0·20−0·44] per campaign). Vaccination campaigns in response to cVDPV2 outbreaks have been smaller and slower than our model shows would be necessary to reduce risk to low levels, covering only 11% of children under 5 years who are predicted to be at risk within 6 months and only 56% within 12 months.InterpretationOur findings suggest that as mucosal immunity declines, larger or faster responses with vaccination campaigns using type 2-containing OPV will be required to stop cVDPV2 transmission. IPV-induced immunity also has an important role in reducing the burden of cVDPV2 poliomyelitis in Africa.FundingBill & Melinda Gates Foundation, Medical Research Council Centre for Global Infectious Disease Analysis, and WHO.TranslationFor the French translation of the abstract see Supplementary Materials section.

Environmental flow requirements largely reshape global surface water scarcity assessment

The inclusion of environmental flow requirements (EFRs) in global water scarcity assessments is essential to obtain a reasonable representation of the water scarcity status. However, at a global scale, the quantification of EFRs is subject to large uncertainties resulting from various methods. So far, it is unclear to what extent the uncertainties in EFRs affect global water scarcity assessments. In this study, we examined the differences between EFR estimation methods and quantified their effects on spatially explicit water scarcity assessments, based on reconstructed global water withdrawal data and naturalized streamflow simulations. The global mean EFRs estimated by different methods ranged from 129 m3 s−1 to 572 m3 s−1. Consequently, with the fulfillment of the EFRs, the area under water scarcity ranged between 8% and 52% of the total global land area, and the affected population ranged between 28% and 60% of the total population. In India and Northern China, 44%–66% and 22%–58% of the country’s land area, respectively, is affected by water scarcity; this percentage is higher than that found in other countries. The effects of different EFRs on water scarcity assessment are large in many regions, but relatively small in regions that experience intensive water use due to anthropological activities (such as Northern China and India). Through this study, we have put forth the need for the reconciliation of the estimates of EFRs to produce more reasonable and consistent water scarcity assessments.