Household-specific barriers to citizen-led flood risk adaptation.

Adaptation is essential to mitigate the effects of climate change, such as increasing flood risk. In response to widespread maladaptation, citizen-led approaches are increasingly championed, whereby people on the frontline of climate change determine their own objectives and strategies of adaptation. Enabling equitable and effective citizen-led adaptation requires an understanding of the barriers for different groups of people but this is currently lacking, especially in low- and middle-income countries.

To mix or not to mix? A holistic approach to stratification-preserving and destratification aeration of drinking-water supply reservoirs.

Aeration is used globally as a remediation method for lakes and reservoirs with methods generally falling into two categories, those which preserve natural stratification (hypolimnetic aeration; HA) and those which destratify reservoirs through mixing of the water column (destratification aeration; DA). The United Kingdom and Australia largely focus on DA methods to manage harmful algal blooms and decrease trace metal concentrations, whereas the United States and Europe frequently focus on HA techniques to increase dissolved oxygen (DO) concentrations and decrease benthic nutrient and metal release from the sediment. A more holistic understanding of how the different techniques influence water quality in regard to raw water supply and ecosystem health should lead to more efficient treatment, reducing wasted energy and other costs during both reservoir management and the drinking-water treatment process.

National Evaluation of HIV Service Resource Allocation in Tanzania.

Using time-driven activity-based costing (TDABC), we examined resource allocation and costs for HIV services throughout Tanzania at patient and facility levels. This national, cross-sectional analysis of 22 health facilities quantified costs and resources associated with 886 patients receiving care for five HIV services: antiretroviral therapy, prevention of mother-to-child transmission, HIV testing and counseling, voluntary medical male circumcision, and pre-exposure prophylaxis. We also documented total provider-patient interaction time, the cost of services with and without inclusion of consumables, and conducted fixed-effects multivariable regression analyses to examine patient- and facility-level correlates of costs and provider-patient time.

Superficial temporal artery perforator flaps for reconstruction of intraoral defects.

Background: Intraoral defects after tumor resection are often reconstructed with free tissue transfer. However, in patients who are not good candidates for free tissue transfer, regional flaps based on the superficial temporal artery can be utilized. The authors present our technique to reconstruct intraoral defects with the superficial temporal artery perforator (STAP) flap and early outcomes.

HIV treatment support services in Tanzania: a cost and efficiency analysis at facility and community levels.

Differentiated service delivery models provide an opportunity to reduce the cost of HIV treatment while increasing the focus on advanced patients. Also, stable patients who need less attention can visit facilities less frequently, saving time and money and reducing overcrowding. Tanzania needs treatment support services that can improve the quality of life, ensure adherence and result in viral suppression.

Smart cascades: using cost analysis to improve HIV care and treatment interventions to achieve global 95-95-95 goals.

HIV programmes are achieving significant scale, even as external financing plateaus. Maximising achievement from identification to viral suppression is key to epidemic control and reaching global 95-95-95 goals. Cost and technical efficiency analyses can help programs understand why losses occur along the cascade, which tactics prevent losses, and additional investments required for cost-efficient solutions.

Estimating the microbiological risks associated with inland flood events: Bridging theory and models of pathogen transport.

Flooding is known to facilitate infectious disease transmission, yet quantitative research on microbiological risks associated with floods has been limited. Pathogen fate and transport models provide a framework to examine interactions between landscape characteristics, hydrology, and waterborne disease risks, but have not been widely developed for flood conditions. We critically examine capabilities of current hydrological models to represent unusual flow paths, non-uniform flow depths, and unsteady flow velocities that accompany flooding.

Caring behaviours of student nurses: Effects of pre-registration nursing education.

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice.

Hypolimnetic oxygen depletion in eutrophic lakes.

The oxygen-consuming processes in the hypolimnia of freshwater lakes leading to deep-water anoxia are still not well understood, thereby constraining suitable management concepts. This study presents data obtained from 11 eutrophic lakes and suggests a model describing the consumption of dissolved oxygen (O(2)) in the hypolimnia of eutrophic lakes as a result of only two fundamental processes: O(2) is consumed (i) by settled organic material at the sediment surface and (ii) by reduced substances diffusing from the sediment. Apart from a lake's productivity, its benthic O(2) consumption depends on the O(2) concentration in the water overlying the sediment and the molecular O(2) diffusion to the sediment.

Long-term transformation and fate of manufactured ag nanoparticles in a simulated large scale freshwater emergent wetland.

Transformations and long-term fate of engineered nanomaterials must be measured in realistic complex natural systems to accurately assess the risks that they may pose. Here, we determine the long-term behavior of poly(vinylpyrrolidone)-coated silver nanoparticles (AgNPs) in freshwater mesocosms simulating an emergent wetland environment. AgNPs were either applied to the water column or to the terrestrial soils.

Response of sediment microbial community structure in a freshwater reservoir to manipulations in oxygen availability.

Hypolimnetic oxygenation systems (HOx) are being increasingly used in freshwater reservoirs to elevate dissolved oxygen levels in the hypolimnion and suppress sediment-water fluxes of soluble metals (e.g. Fe and Mn) which are often microbially mediated.

Solving the problem at the source: Controlling Mn release at the sediment-water interface via hypolimnetic oxygenation.

One of the primary goals of hypolimnetic oxygenation systems (HOx) from a drinking water perspective is to suppress sediment-water fluxes of reduced chemical species (e.g., manganese and iron) by replenishing dissolved oxygen (O(2)) in the hypolimnion.

Increased sediment oxygen uptake caused by oxygenation-induced hypolimnetic mixing.

Hypolimnetic oxygenation systems (HOx) are increasingly used in lakes and reservoirs to elevate dissolved oxygen (O(2)) while preserving stratification, thereby decreasing concentrations of reduced chemical species in the hypolimnion. By maintaining an oxic zone in the upper sediment, HOx suppress fluxes of reduced soluble species from the sediment into the overlying water. However, diminished HOx performance has been observed due to HOx-induced increases in sediment O(2) uptake.

Effect of hypolimnetic oxygenation on oxygen depletion rates in two water-supply reservoirs.

Oxygenation systems, such as bubble-plume diffusers, are used to improve water quality by replenishing dissolved oxygen (DO) in the hypolimnia of water-supply reservoirs. The diffusers induce circulation and mixing, which helps distribute DO throughout the hypolimnion. Mixing, however, has also been observed to increase hypolimnetic oxygen demand (HOD) during system operation, thus accelerating oxygen depletion.

Controlling soluble iron and manganese in a water-supply reservoir using hypolimnetic oxygenation.

Soluble metals such as iron (Fe) and manganese (Mn) often reach problematic levels in water-supply reservoirs during summer stratification following the onset of hypolimnetic hypoxia. The behavior of soluble and particulate Fe and Mn was studied following the installation of a hypolimnetic oxygenation system in Carvins Cove Reservoir, a water-supply impoundment managed by the Western Virginia Water Authority. During oxygenation, manganese concentrations were very low in the bulk hypolimnion (<0.

KLF6 allelic loss is associated with tumor recurrence and markedly decreased survival in head and neck squamous cell carcinoma.

The Krüppel-like transcription factor (KLF6) gene is a tumor suppressor gene (TSG) reported to be dysregulated and inactivated through loss of heterozygosity (LOH) and/or somatic mutation in a number of major human cancers. The aim of the present study was to examine KLF6 gene status and expression in head and neck squamous cell carcinomas (HNSCC). A collection of 81 well-characterized oral and oropharyngeal HNSCC samples were analyzed for evidence of KLF6 LOH and mutation and differences in expression patterns between normal and cancerous tissues and these findings were correlated with clinicopathological variables.

Internal mammary artery and vein: recipient vessels for free tissue transfer to the head and neck in the vessel-depleted neck.

Background: Microvascular free tissue transfer is a standard reconstructive option for postablative defects of the head and neck. However, the success of this surgery requires suitable recipient vessels in the cervical region. This form of reconstruction can be particularly challenging in the vessel-depleted neck.

Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment.

Chronic cough is often attributed to reflux, postnasal drip, or asthma. We present 28 patients who had chronic cough or throat-clearing as a manifestation of sensory neuropathy involving the superior or recurrent laryngeal nerve. They had been identified as having sudden-onset cough, laryngospasm, or throat-clearing after viral illness, surgery, or an unknown trigger.

Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival.

To analyze the impact of resection margin status and histologic prognosticators on local recurrence (LR) and overall survival (OS) for patients with oral squamous cell carcinoma (OSCC). This study was both retrospective and prospective in design. Cohort 1 refers to the entire group of 292 patients with OSCC.

Use of injectable hydroxyapatite in the secondary setting to restore glottic competence after partial laryngectomy with arytenoidectomy.

Hydroxyapatite cement is a calcium phosphate putty, approved by the US Food and Drug Administration, that solidifies in 20 minutes and gains bone-like stability after 4 to 6 hours. It has been used for craniofacial reconstruction, spinal stabilization, and ossicular reconstruction. This is the first report of use of injectable hydroxyapatite to rebuild soft and hard tissue defects of the larynx after partial laryngeal surgery.