Household Flood Severity and Migration Extent in Central Java: Analysis of the Indonesian Family Life Survey.

Central Java, Indonesia, is prone to river and coastal flooding due to climate changes and geological factors. Migration is one possible adaptation to flooding, but research is limited due to lack of longitudinal spatially granular datasets on migration and metrics to identify flood-affected households. The available literature indicates social and economic barriers may limit mobility from flood prone areas. The Indonesian Family Life Survey (IFLS) provides self-reported data on household experiences with natural disasters among 1501 Central Java households followed over two waves (2007 and 2014). We examined how the severity of flooding, defined by household-level impacts captured by the IFLS (death, injury, financial loss, or relocation of a household member), influenced the extent of household movement in Central Java using a generalized ordered logit/partial proportional odds model. Households severely impacted by floods had 75% lower odds of moving farther away compared to those that did not experience floods. The most severely impacted households may be staying within flood-affected areas in Central Java. Public health, nutrition, and economic surveys should include modules focused on household experiences, impacts, and adaptations to facilitate the study of how climate changes are impacting these outcomes.

Potential for surprising heat and drought events in wheat-producing regions of USA and China.

Previous analyses of the possibility of global breadbasket failures have extrapolated risks based on historical relationships between climate and yields. However, climate change is causing unprecedented events globally, which could exceed critical thresholds and reduce yields, even if there is no historical precedent. This means that we are likely underestimating climate risks to our food system. In the case of wheat, parts of the USA and China show little historical relationship between yields and temperature, but extreme temperatures are now possible that exceed critical physiological thresholds in wheat plants. UNprecedented Simulated Extreme ENsemble (UNSEEN) approaches use large ensembles to generate plausible unprecedented events, which can inform our assessment of the risk to crops. We use the UNSEEN approach with a large ensemble of archived seasonal forecasts to generate thousands of plausible events over the last 40 years and compare the results with historically observed extreme temperature and precipitation. In the US midwest, extreme temperatures that would have happened approximately 1-in-100-years in 1981 now have a return period of 1-in-6 years, while in China, the current return period is on the order of 1-in-16 years. This means that in the US midwest, extreme temperatures that used to have a 1% chance to occur in 1981 now have a 17% chance to occur in any given year, while in China, the chance increased from 1% to 6%. Record-breaking years exceeding critical thresholds for enzymes in the wheat plant are now more likely than in the past, and these record-breaking hot years are associated with extremely dry conditions in both locations. Using geopotential height and wind anomalies from the UNSEEN ensemble, we demonstrate that strong winds over land pull dry air towards the regions these during extremely hot and dry unseen events. We characterize plausible extremes from the UNSEEN ensemble that can be used to help imagine otherwise unforeseen events, including a compound event in which high impacts co-occur in both regions, informing adaptation planning in these regions. Recent temperature extremes, especially in the US midwest, are unlikely to be a good proxy for what to expect in the next few years of today's climate, and local stakeholders might perceive their risk to be lower than it really is. We find that there is a high potential for surprise in these regions if people base risk analyses solely on historical datasets.

The effectiveness of forecast-based humanitarian assistance in anticipation of extreme winters: a case study of vulnerable herders in Mongolia.

This paper presents evidence relating to a forecast-based cash and non-food item distribution among vulnerable herder households during the 2017-18 dzud (extreme winter) season in Mongolia, and analyses the results of a quasi-experimental study evaluating its impacts. An innovative approach in disaster risk reduction, forecast-based financing (FbF) can have short- and long-term benefits to vulnerable households but remains understudied. The paper contributes information on a multimodal FbF programme offering one-off cash grants and in-kind veterinary kits. The data found significant effects of reduced mortality and increased offspring survival in some types of livestock, and that the timing of FbF assistance is crucial, as reported early assistance correlated to positive outcomes in terms of reduced animal mortality. These findings can be used to design more effective FbF interventions, to understand better the appropriateness of FbF designs, and to use early warnings and early actions to help people prepare and withstand disasters such as dzuds.

The role of international organizations in equitable and just planned relocation.

Since 2010, States party to the United Nations Framework Convention on Climate Change have recognized planned relocation as a viable adaptation to climate change. Planned relocation has been attempted in many communities globally and has raised serious issues of equity in some cases. Implementation driven by principles of equity is crucial in ensuring successful planned relocations that decrease loss and damage. In this Policy Analysis, we put forth a framework for equitable planned relocation rooted in theories of justice as a basis for implementation. The framework centers around three principles: comprehensive recognition of affected stakeholders in decision-making, consideration of socio-cultural risk factors relevant to relocation, and evaluation of multiple measures of well-being. There are many actors involved in planned relocation. Unique features and abilities of international organizations lend themselves to promoting equitable planned relocation in partnership with other stakeholders. Through the exploration of case studies, we identify best practices that international organizations have available to influence the design, implementation, and evaluation of planned relocation processes. These practices are relevant when striving for equity for all affected individuals and communities. Points of intervention include agenda-setting and advocacy, funding and implementation standards, and facilitation of international cooperation. International organizations also face barriers to supporting equitable planned relocation. Limitations include lack of enforcement mechanisms, limited resources, and fundamental dependence on existing governance structures and global collaboration. As the necessity of planned relocations grows, the need for leadership from international organizations in implementation is magnified, underscoring the importance of developing and evaluating approaches to just implementation.

Quantifying tinnitus suppression in cochlear implantation using tinnitus interval-limited tracking.

OBJECTIVES: Quantify the effects of cochlear implants (CI) on tinnitus suppression in patients with previous cochlear implantation using a novel audiologic sequence: Tinnitus Interval Limited Tracking (TILT). STUDY DESIGN: Prospective cohort study. METHODS: Consecutive patients with tinnitus and previous cochlear implantation for profound hearing loss underwent an audiologic testing sequence called TILT. Patients rated tinnitus severity using the validated Tinnitus Handicap Inventory (THI) as well as a visual analog scale at baseline and in a variety of audiologic scenarios. Changes in tinnitus severity between scenarios allow for the isolation of the effects of masking and electrical stimulation on the reduction of tinnitus. RESULTS: Twenty patients were enrolled, 10 of whom have tinnitus with average THI 30.2 (standard deviation 22.6). Patients had an acute decrease in tinnitus severity when their CIs were turned on, even in the absence of noise in a soundproof booth. This effect reversed once the CIs were turned off. This effect was greater in magnitude than with masking that occurred with the presentation of soft speech. Acute tinnitus severity trended toward improvement with increased level of presented speech. Degree of improvement was not correlated with THI. CONCLUSION: Acute tinnitus suppression in patients using CIs is multifactorial. Masking plays a role; however, it cannot sufficiently account for the totality of symptom improvement experienced by CI patients. Quantifiable tinnitus suppression observed when a CI is turned on, even in the absence of audiologic stimulation, suggests that electrical stimulation is involved in the mechanism of symptom improvement in these patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 130: 2047-2052, 2020.

Comparative Anatomy of the Mammalian Corneal Subbasal Nerve Plexus.

Purpose: The subbasal nerve plexus (SNP) is the densest and most recognizable component of the mammalian corneal innervation; however, the anatomical configuration of the SNP in most animal models remains incompletely described. The purpose of the current study is to describe in detail the SNP architecture in eight different mammals, including several popular animal models used in cornea research. Methods: Corneal nerves in mouse, rat, guinea pig, rabbit, dog, macaque, domestic pig, and cow eyes were stained immunohistochemically with antiserum directed against neurotubulin. SNP architecture was documented by digital photomicrography and large-scale reconstructions, that is, corneal nerve maps, using a drawing tube attached to a light microscope. Results: Subbasal nerve fibers (SNFs) in mice, rats, guinea pigs, dogs, and macaques radiated centrally from the corneoscleral limbus toward the corneal apex in a whorl-like or spiraling pattern. SNFs in rabbit and bovine corneas swept horizontally across the ocular surface in a temporal-to-nasal direction and converged on the inferonasal limbus without forming a spiral. SNFs in the pig cornea radiated centrifugally in all directions, like a starburst, from a focal point located equidistant between the corneal apex and the superior pole. Conclusions: The results of the present study have demonstrated for the first time substantial interspecies differences in the architectural organization of the mammalian SNP. The physiological significance of these different patterns and the mechanisms that regulate SNP pattern formation in the mammalian cornea remain incompletely understood and warrant additional investigation.

Declining vulnerability to river floods and the global benefits of adaptation.

The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whereas the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is still lacking. Due to this knowledge gap, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. We show for the first time (to our knowledge) that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We find that rising per-capita income coincided with a global decline in vulnerability between 1980 and 2010, which is reflected in decreasing mortality and losses as a share of the people and gross domestic product exposed to inundation. The results also demonstrate that vulnerability levels in low- and high-income countries have been converging, due to a relatively strong trend of vulnerability reduction in developing countries. Finally, we present projections of flood losses and fatalities under 100 individual scenario and model combinations, and three possible global vulnerability scenarios. The projections emphasize that materialized flood risk largely results from human behavior and that future risk increases can be largely contained using effective disaster risk reduction strategies.