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City to city learning and knowledge exchange for climate resilience in southern Africa
Authors: Mzime R. Ndebele-Murisa aff001; Chipo P. Mubaya aff002; Lulu Pretorius aff003; Rudo Mamombe aff001; Kornelia Iipinge aff004; Wilma Nchito aff005; John K. Mfune aff004; Gilbert Siame aff005; Brenda Mwalukanga aff005
Authors place of work: Department of Freshwater and Fishery Science, Chinhoyi University of Technology, Chinhoyi, Zimbabwe aff001; International Collaborations Office, Chinhoyi University of Technology, Chinhoyi, Zimbabwe aff002; School of Life Sciences, University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa aff003; Department of Biological Sciences, University of Namibia, Windhoek, Namibia aff004; Department of Geography and Environmental Studies, University of Zambia, Lusaka, Zambia aff005
Published in the journal: PLoS ONE 15(1)
Category: Research Article
doi: https://doi.org/10.1371/journal.pone.0227915Summary
Southern African cities face several challenges including management of rapid urbanization, rising populations, expanding informal settlements; adequate water and other service provision, and a host of governance challenges. Climate change and variability add a compounding effect to this complex, multi stressor context. Addressing the complexity requires an understanding of urban ecosystems functioning and interactions amongst the built and natural environment (climate) and human systems. In this paper we argue that learning is essential for cities to be resilient to current and future challenges. We profile the Future Resilience for African CiTies And Lands (FRACTAL) project which contributed towards climate resilient development by providing relevant climate information for decision-making at the city regional scale in southern Africa. Following FRACTAL’s city-to-city learning approach of sharing good practices, knowledge and experiences framed around transdisciplinary research, the study cities of Harare, Lusaka, Windhoek and Durban conducted city learning exchange visits between 2017 and 2018. We used a mixed methods approach to collect and analyze historical climate and hydrological data and current socio-economic and development data among the cities. A qualitative, in-depth, case study comparative analysis was used to identify similarities and differences as well as lessons drawn from the learning process during the city exchanges and these were complimented by desktop studies. Results showed water scarcity, large informal settlements, reliance on external water and energy sources, inadequate protection of ecologically sensitive resources and service provision as some of the common complications in the cities. Several lessons and transferable practices learnt from the cities included effective water conservation and waste management and the use of public-private partnerships in Windhoek, community engagements in Durban and Lusaka while lessons on decisive leadership in dealing with informal settlements emanated from Harare’s limited informal settlements. Lastly, Durban’s Adaptation Charter and integrated climate planning provided lessons for biodiversity protection and mainstreaming climate change at city governance level. While we recognize that cities are context-specific we consider these good practices as being broadly transferable to other southern African cities. We conclude that social, experiential and structured learning can be an innovative way of multi-stakeholder engagement and a useful approach to increase city resilience planning across southern Africa and cities that face similar developmental challenges.
Keywords:
Learning – Human learning – Water resources – Flooding – Urban ecosystems – Climate change – Surface water – Fractals
Introduction
Southern African cities, being densely populated, urban environments with expanding populations as compared to the rest of the countryside, are vulnerable to harsh weather, climate variability, extreme climate events and associated risks among other factors [1]; [2]; [3]; [4]; [5]; [6]; [7]. For instance, droughts often experienced in cities like Cape Town and Windhoek and currently across the southern African region because of low rainfall levels this past rainy season of 2018/2019 have become more frequent, intense and widespread [8]; [9]) while variations in inter annual rainfall have increased in the past half century [10]. These extreme events are projected to likely increase in the future [11]; [12]. Cities play a tripartite role when it comes to climate change as they are contributors to climate change through greenhouse gas emissions; bear the brunt of climate change; and can simultaneously be places of climate change (transformational) adaptation through innovation and solutions that can build resilience [13]; [14]. Cities in southern Africa face a multiple stressor context with several development challenges including inadequate water provision, mismanagement, governance and infrastructure challenges and lack of financial resources. At the same time, these and other cities function as ecosystems which are connected through processes that function at multi-scalar and high levels of complexity [15]; [16]. The city-space, is therefore characterized by complexity, and multiple, interconnected subsystems or ecosystems [17] in which city planning and implementation should be considered using a climate-resilience development lens. Notably, the interaction of physical ecosystems with the built environment, social and financial systems, environment and climate is indeed complex, even more so in rapidly urbanizing African city regions where intricately, interconnected infrastructure, institutions and information form the urban ecosystem. Understandably, there is growing concern about the resilience of these urban areas, particularly in vulnerable and underdeveloped regions such as southern Africa, given the connectedness and fragility of the urban ecosystems and the need for transformative over an incremental adaptation and mitigation agenda even under 1.5°C average global warming trends [16].
The multi-stressor context, which is compounded by climate change and variability, means that these cities need to respond swiftly, flexibly and creatively to develop systematic, systemic, sustainable and resilient solutions to the climate crisis. The multi-stressor context requires numerous responses, which may consist of responses in physical planning such as ‘hardening up of infrastructure systems, including storm-drainage systems, water supply and treatment plants with protective physical improvements; protection or relocation of solid waste management facilities, energy generation and distribution systems; and consolidation of hydro-geologically fragile areas’ [18], and/or ecosystem - and community-based adaptation [19] coupled with the transformative adaptation agenda given that resilient development now requires nothing less than transformational change [20]; [21]. At the same time, processes that foster adaptation, mitigation and resilience building such as learning from and adopting best practices are essential. Learning is essential for cities to adapt to current and future challenges. One approach to fostering resilience includes city to city learning in order to obtain ‘good practices’ through sharing knowledge and experiences [22]. Although Moodley [23] questions whether an international network of learning is effective where contexts and challenges are different among regions (such as southern African cities and those in the global North), he demonstrates how a structured learning process amongst cities that face similar developmental challenges can help improve the quality of urban strategic planning. It is assumed that cities that are at an advanced stage in terms of adaptation planning can act as focal points for learning to cities that are engaging in adaptation planning [24]. However, Moodley [23] demonstrated the importance of partnerships rather than mentorship as shown in a USLG program that the southern African municipalities of eThekwini (Durban) in South Africa, Otijiwarongo in Namibia, Mzuzu in Malawi were involved in. Therefore, mutual learning and equal partnerships through city networks can offer valuable lessons among cities in the continent and for promoting change using ‘early adopters’ such as the cities of Lagos and Durban [25]; [26], which have been identified as having made remarkable progress in terms of climate change adaptation [27].
In this paper we argue from the perspective that cities are connected, complex as well as vulnerable entities, which can be regarded as urban ecosystems. We aim to contribute to the argument on, and advocacy for, city to city learning. We center our discussion around the question of how useful city exchanges are in facilitating learning from experience and good practices in urban ecosystems and contributing towards building resilience in southern Africa. We draw attention to how such learning can contribute towards developing the capacity of cities in order to build climate resilience. We anticipate that lessons and good practices are relevant for a broader set of urban ecosystems that are dealing with similar environmental, climatic, demographic, institutional and developmental challenges, particularly in sub-Saharan Africa. We frame our argument by: i) outlining an overview of the various urban ecosystem issues for four southern African cities, and ii) examining the learning from each city and how it can potentially be taken on board for resilience building by the cities concerned.
Evolution of climate research
Climate research has traditionally been conducted in siloed approaches with little to no linkages between the science, policy and society; a characteristic which has repressed the application of science for addressing societal problems [28]; [29]; [30]. The discipline-specific focus and specialization—though important—cannot address the multi-faceted challenges in society or complexities involving multiple stakeholders and interconnected urban ecosystems. Traditional approaches in climate sciences and the resilience discourse has seen climate information inappropriately regarded as a superior knowledge type [31] being developed, packaged and communicated by ‘experts’ in mostly linear trajectories that involve climate ‘producers’ and ‘end users’ [32]. This approach fails to deal with the multiple stressor context and interconnected, complex urban ecosystems. In addition, a host of information is ‘lost’ that helps to contextualize the environment of the end-user [33]. There is a need to move beyond linear approaches to communicating climate information to ensure closer alignment with end-user needs, based on a growing demand for more usable climate information as societies deal with its real and devastating cross-cutting impacts.
There is a growing awareness that new ways of knowledge production and decision-making must move beyond disciplinary silos, and that approaches such as transdisciplinary research, and knowledge co-production may provide the means to do so [34]; [35]; [36]. Disciplinary silos compartmentalize knowledge and emphasize introverted specialization while transdisciplinary research incorporates different actors, disciplines and knowledge bases from science and practice [37], and has the potential to close the gap between knowledge and action - making science relevant for addressing climate change adaptation and building resilience [38]; [39]. In the transdisciplinary research approach, where stakeholder engagement and inclusivity is encouraged, reflexivity around concept framing, inclusion of perspectives, knowledge, and experiences, a better understanding of how communication affects interpretation and trust, and mechanisms of knowledge exchange and communication of climate information can be used more effectively toward producing climate solutions and responses [40]; [41]. The inclusive and participatory approach in transdisciplinarity works well as it seeks to address challenges associated with complex urban ecosystems [42].
Social and experiential learning
The concept of learning is based on the premise that change occurs across spatial and temporal scales and we argue that the interconnectedness of socio-ecological systems presents the need to increase our global cognitive, behavioural and moral intelligence through learning [43]. This brings to the fore, the concept of social learning (learning from each other) which transcends the local scale by crossing boundaries such as cities and countries [44]; [45]; [46]. Wenger [47]) puts emphasis on how learning can be used to make better decisions in the future. In that regard, Tschakert and Dietrich [48] emphasize anticipatory learning for climate change adaptation which is learning that is forward-looking. All these concepts point to building and developing resilience as well as partnerships [49]; [50]; [51]. Approaches to learning are embedded in the social learning theory which explains why people behave the way they do based on intrinsic and extrinsic, and especially social influence [52]. This places social learning within a cognitive decision-making framework [53] as well as the knowledge sharing mantra to promote application of knowledge. Our approach to social learning follows Bandura’s first proponent, which is learning from others through observation in the hope that this may lead to the rest of the social learning components of application, i.e. imitation and modeling. Weissberg and Cascarino [54] define social (and emotional) learning as comprising five sequential elements which are self-awareness, self-management, social awareness, relational skills and responsible decision-making. Social learning provides knowledge that is essential for institutional capacity building and sustainable development [55]. Decision-making is a major component in the steering of sustainable development and resilience and provides a platform where both lessons can be drawn from, and where implementation of lessons for tailor-made development based on the understanding of the context and decision-making processes, can be derived. Transformative decision-making processes which promote integrated planning are necessarily for resilience building and these processes are fostered by processes of learning and imbued under concepts such as leadership and strategies (see ARUP’s city resilience framework).
The importance of knowledge sharing, and cross city learning is evidenced by the emergence of city networks such as the C40 Cities Climate Leadership Group, ICLEI - Local Governments for Sustainability and the international United Cities and Local Governments (UCLG) network [44]; [45]; [46]; [23]; [24]. New approaches to research in the last couple of decades have fostered the concept of learning in a bid to encourage the addressing of complex global challenges such as climate change and variability in urban and other ecosystems. The importance of learning in dealing with complex challenges can be drawn from Wenger ([47] pp 3) who posits that, what if we assumed that learning is as much a part of our human nature as eating and sleeping, that is both life-sustaining and inevitable? The co-development of new knowledge generated through collaborative, transdisciplinary research efforts, fosters diverse ways of learning, including the concept of experiential ‘learning as you go’ which implies iterative, reflective and feedback mechanisms. The use of these learning concepts have been on the rise, given funders’ recent (in the past decade) inclination towards larger-scale, impactful research that solves complex problems; versus the traditional and mere generation of new knowledge and the need for socially robust knowledge in adapting to climate change and building resilience [49]; [50]; [51]. Knowledge generation and sharing, as well as learning for implementation, have been emphasized as some of the important components of successful research, while underscoring the importance of learning from past experiences and scaling-up of successful models of adaptation and resilience approaches which encompass components of experiential learning [52]; [33].
Contextualizing city learning within a multi-country research project; the case of FRACTAL
The Future Climate for African Cities And Lands (FRACTAL) research project employed and emphasized the use of city learning and contextualizing of issues, by understanding decision-making processes in cities as social learning concepts and in a bid to help build resilience through informed decision-making in the project’s study cities. This research project, which ran for a four-year period from 2015 to 2019; operated in nine cities in southern Africa, gave the participating cities impetus to learn together using a city-to-city or cross-city learning approach, and thus provided the basis for this paper. The specific goal of FRACTAL was to advance scientific knowledge of the southern African regional climate responses to human drivers of climate change and enhance the integration of scientific climate knowledge into city regional decision-making for building resilience [42]. This was done by providing city-scale, co-produced, relevant and useful climate information for study cities in the region to help develop resilience through transdisciplinary research, which learns from and informs decision-making. The focus is on university officials partnering with city practitioners in the process of formulating research questions framed around resilience, co-exploring solutions, and disseminating and presenting the findings within a transdisciplinary space, which allows time and space to disagree, debate, test alternatives and learn from mistakes; which in essence is experiential learning. The transdisciplinary research approach in FRACTAL has been operationalized through a number of processes, such as a series of multi-city ‘learning labs’; the use of embedded researchers (ERs) as bridges between academia and city municipality administrations; as well as learning exchanges between multiple cities. It is this last approach which is the focus of our paper, and which outlines the processes and outcomes of this innovative way of research in multi-stakeholder engagement as an approach to increase learning, city resilience and improved urban planning.
The FRACTAL project is hinged on four interconnected concepts and practices (transdisciplinary co-production (of knowledge), distillation (of climate information), receptivity and capacity development), which guide the learning and knowledge production as well as sharing processes. The aim of these concepts is to expand and (semi) formalize spaces of connection and co-production to be more inclusive, diverse and consequential; develop capacity to engage and know more, differently; develop receptivity to exercise agency in co-producing knowledge and decisions; and distill information through bringing it to bear on decisions [56]. Although the city exchange visits were conducted mainly to encourage and facilitate the transdisciplinary knowledge co-production concept [57]; the purposes of the other three concepts were also served well. During the city exchange visits, researchers, decision makers and practitioners from two or more cities shared experiences and learnt from each other about responding and adapting to (distilled) climate information, decision-making, city contexts and key issues as well as solutions. In the process, receptivity was created to new, innovative, climate change action-related ideas and approaches in other cities, with the aim of advancing capacity to respond likewise in their own contexts.
FRACTAL city learning approach
The FRACTAL city learning process was founded on the understanding that cities function as complex ecosystems and that the learning component is an important facet for engaging city decision makers and practitioners, among other facets, such as the development of climate services information. In the learning process, city labs were used as an important platform for promoting dialogue and learning, through which the exploration of solutions, drawing on both research and practice and the expertise of participants was done. The labs provided a space where academia, civil society, city and government officials interacted, co-identified and prioritized projects, mapped out problems and co - produced potential solutions to prioritized projects within the cities. The learning-by-doing and engagement approaches were emphasized in the labs [32]. In this approach, participants recognized that learning is not limited to individual city stakeholders, but rather, that the learning fora should be extended to other FRACTAL cities that exhibit similar issues or have innovations that another city could benefit and learn from.
Following this approach, the FRACTAL city learning visits were co-designed to ensure that cross-learning from experiences, lessons, best practices and failures which were drawn by a wide range of participants from the visiting and visited city were demonstrated. The goal of the exchange visits was to encourage inter-city learning and to strengthen relationships and foster partnerships, as well as contribute towards capacity development given that challenges faced by southern African cities can be similar. Another aim of the exchange visits was to provide a visual of the risks faced and processes being undertaken in the respective cities, and to share lessons from good practices (and failures) through specific site visits. The idea was that visitors would then take the learning and experiences back to their cities and institutions for further knowledge sharing as well as championing the implementation of some of the aspects learnt.
In addition, the city learning exchanges further provided the opportunity to co-identify similar problems across the FRACTAL cities participating in the exchange visits, co-develop solutions and cross pollinate on viable decisions that could be made to build resilience to the effects of climate change in cities. Co-production of outputs was also promoted and facilitated as the learnings were disseminated through various media such as blogs and reports that were co-authored by the city officials, early career and embedded researchers and local university academics from the cities involved in the learning exchanges. In all the city exchanges, emphasis was placed on a systems approach in understanding context, values, and city-specific issues while social and experiential learning and building relationships and equal partnerships stood out as major themes. This is important in the context of the (southern) African region, where mostly top-down concepts have been imposed without understanding and considering the local context in intervention program designs.
Materials and methods
Between August 2017 and February 2018, the cities of Harare, Windhoek, Lusaka and Durban conducted learning exchanges through START International’s Global Environmental Change (GEC) Research in Africa and Small Opportunity Grants (SOGs) under the FRACTAL project. The visits brought together key city actors and academic researchers to share knowledge and experiences related to the on-going water (energy) and climate change work in the cities of Harare (Zimbabwe), Windhoek (Namibia), Lusaka (Zambia) and Durban (South Africa) (see Fig 1 for exchange visit routes).
Fig. 1. An illustration of city exchanges across southern Africa; Blue- Lusaka in Zambia, Purple- Harare in Zimbabwe, Orange- Windhoek in Namibia and Green- Durban in South Africa. The arrows indicate direction of exchange. A mixed methods approach was used to collect data from the study cities and to determine both climate and non - climate risks and vulnerabilities, as well as city infrastructure and governance systems. Both quantitative and qualitative research methods were employed. For the quantitative analysis, 30 to 50 years of historical climate and hydrological data from the cities’ water sources - the river catchments were collected (Table 1). This data was used to determine historical climate and hydrological trends using time series analysis. For the qualitative data collection, household surveys, key informant interviews (KIIs) and focus group discussions (FDGs) were used. A total of 1483 of both open and closed household questionnaires were administered across the cities mostly in informal settlements with the exception of Durban where no questionnaires were distributed and Harare where a cross sectional representative sample across high, medium and low density suburbs were interviewed (Table 1 and S1–S10 Files). Questionnaires and KIIs gathered socio-economic and demographic data as well as perceptions on climate and resilience which were recorded by enumerators. Additionally, facilitators and embedded researchers recorded responses on climate perceptions using FDGs, during workshops and city learning labs. Key informants and FGD interviews and workshops as well as city labs discussions were framed around key issues following the FRACTAL engagement approach which incorporated interactive methods such as games to foster engagement from a pool of diverse city stakeholders and participants. The city learning labs and dialogues were facilitated as either initial consultative and/or project validation workshops (Table 1). These engagement processes in the cities collated information, which was documented as interview transcriptions, reports and in the case of the city of Lusaka, flood maps.
Tab. 1. Sources of information in the cities. After the field and data collection was done in each city, city exchange visits were organized in such a way that researchers from visiting cities could learn about the host cities’ sources of information, sampling techniques, relevant sites, policies and practices using field and site visits. Visiting and hosting city teams held joint community and council meetings in the host cities and discussed commonalities in thematic problems as well as potential solutions using guided agenda (see S8–S10 Files). Simultaneous to the field sampling and exchange visits, desktop studies were used to complement the learning labs and engagements that we convened in the cities and collectively helped to identify key issues for the study cities and urban ecosystems, and to assess the cities’ advancement and gaps that need to be addressed in resilience planning. Altogether, the mixed methods approach of collecting data where we used multiple (> three - 3) approaches, sources and types of information including during the city exchange visits allowed triangulation and verification of trends, perceptions and assessments in order to reduce bias that emanates from single informants, methods, observers or single theory studies [58]. Prior to official engagement, participants were informed of the FRACTAL and follow-on projects through preliminary meetings and during data collection cover letters and introductory statements were used to inform participants about the study. No identifiable information was collected from the participants in the surveys so that data was collected anonymously. We therefore adhered to principles and practices of ethical research which included among others, voluntary participation, informed consent, respect for people and communities, confidentiality and anonymity. Simultaneously, desktop studies (literature review, document and policy analyses) were conducted to review policies and city developmental plans (Table 1).
The collated data on the cities is unpacked in the results section of this paper. In response to the question on the usefulness of city learning in contributing to building resilience that we pose in the introduction; we conducted a comparative case study analysis. Given the disparity in the type of data collected across the cities which was due to the limited scope of the study in undertaking an experimental design across the cities, a comparative, in-depth case study analysis was relevant for evaluating and comparing the condition(s) of the cities. In the comparative analysis, we focused on the cities’ advancements in their responses and adaptation to climate change, particularly for water conservation, energy, solid waste management and biodiversity protection mobilized against risks and vulnerabilities as a result of climate-induced and non-climatic factors (see Table 2 for specific purpose of visits). The case study approach is appropriate for analysing and synthesizing ‘similarities, differences and patterns across two or more cases… and understanding how the context influences the success of an intervention’ ([59] pp 1). Thus, this approach provided the opportunity for us to single out best - and worst-case scenarios and in this way draw out lessons, good practices, failures and to evaluate the process of learning in the context of climate resilience across the cities. This effectively helped to answer the research questions on outlining issues in the study cities including good practices and examining the usefulness of city learning across the region for building resilience.
Tab. 2. Summary of key issues, city exchange visits and visit purpose. Results
Key issues in the urban ecosystems
A suite of risks that are impeding sound service delivery in the four cities were identified in the workshops and city learning labs during the identification of city key issues (see Table 2). Chief among these were water security as a key risk of climate change. We also identified dynamics of water and solid waste; informal settlements; energy; water governance; and climate change planning and policy integration as presenting both problems and solutions across the cities. We present brief descriptions of the cities and summaries of key issues identified through desktop studies and during the city exchanges in order to provide city-specific contexts and as obtained from the sources of data shown in Table 1.
Harare
The Zimbabwean capital is situated in the north-eastern part of the country. Inadequate supply of potable water was a key issue for the city. Zimbabwe is divided into seven river catchments as a way of decentralizing water provision. Harare falls under the Upper Manyame Catchment with Lake Chivero, an artificial reservoir that was built in the 1950s situated downstream of the city, being the city’s main raw water source. The Zimbabwe National Water Authority (ZINWA) is responsible for maintenance of all surface water bodies such as dams as well as underground water resources across the country, whilst city councils such as Harare City Council (HCC) are responsible for provision of potable water to all residents as stipulated by the Urban Councils Acts. HCC purchases raw water from ZINWA and then treats and distributes it to residents and industries. It is noteworthy that the two entities (ZINWA and HCC) are housed under different ministries and this presents challenges in the governance of and provision of water for the city. ZINWA is housed under the Ministry of Lands, Agriculture, Water, Climate and Rural settlement whereas HCC is housed under the Ministry of Local Government and National Housing.
With a population of 1.6 (2.8 in the metropolitan area) million, Harare is the industrial hub of the country. During the co-design processes of the FRACTAL project, stakeholders identified potable water supply as the major key issue followed by wetlands degradation and water governance (see Table 2) showing that there are grave concerns around issues to do with water in the city. Urban agriculture, which draws a substantial amount of water for production through irrigation particularly in the form of horticulture is practiced to a large extent in and around the city. The city has aged water and sanitation infrastructure which is expensive to maintain. Because the city is located upstream of its catchment, partially treated wastewater, together with pollutants from industries and agriculture ends up being washed into the main water source for the city, Lake Chivero [60]. Climate-induced impacts such as reduced availability of rainwater during drought and dry spells or in the opposing and extreme case, flooding exacerbate challenges of access to safe water, sanitation and hygiene and further lessen the city’s capacity to provide potable water, given its already limited capacity.
Contested development in an almost unregulated manner is leading to the degradation of wetlands in the city. This is a real challenge as it threatens the city’s water catchment processes. Another challenge in Harare and the nation is of energy supply which, like raw water is generated from external sources far from the city and is also distributed at national and not at city level. There is a nexus between climate (rainfall), water and energy which is mostly wood biomass, followed by hydropower, thermal and coal-based forms which all use water in their production. Despite a relatively high electrification rate (45%) in comparison to other SADC countries, current power supplies are inadequate for meeting energy demand across the country and of late the city and country have been subject to significant power load shedding which negatively affects productivity. In the past decade, both fuel and electricity shortages have hit the country partly as a result of recurrent droughts negatively affecting hydropower production and also as a result of forex and budget constraints for purchasing fuel and electricity from neighbouring countries with excess power such as Mozambique and South Africa.
Windhoek
Namibia, like many countries in semi-arid areas, is characterized by high climatic variability in the form of persistent droughts, unpredictable and variable rainfall patterns leading to scarcity of water [61]. Coupled with rapid urbanization, the threats of persistent water scarcity are real. A growing concern is the city of Windhoek, with a population of approximately 268,000 and an urbanization rate of 3.1% per annum. This surge in the population has created many problems for urban planning and vulnerabilities such as water shortage, energy problems, poor sanitation and waste management and related health problems. The city of Windhoek is charged with the responsibility for urban planning but is constrained or challenged by the high influx of people from rural areas. Among others, the persistent droughts and unpredictable and variable rainfall patterns, due in part to climate change, adversely affects the availability and supply of acceptable quantities and quality of water to the city of Windhoek (Table 2). This is exacerbated by the high rate of urbanization. Hence, there is a strain on service delivery, including water supply, land and infrastructural development.
These issues are compounded by low quantity water available for domestic use for the city residents, and energy supply challenges. The situation is made worse by informal settlements, which tend to be fueled by rural-urban migrations that have led to increased populations in the city. Most informal structures in Windhoek are made of corrugated sheets, which the local authorities tolerate as these are temporary structures that can easily be removed while the residents in the informal settlements rely mostly on wood for energy and lack access to proper sanitation facilities.
Lusaka
The City of Lusaka’s 1.7 million inhabitants face significant climate related challenges such as urban flooding on a yearly basis (see Table 2). Geological factors largely contribute to flooding in the city but flood risk in Lusaka appears to be exacerbated by poor municipal solid waste management systems [62]. Large parts of the city are underlain by limestone, which is porous, creating underground aquifers which easily become saturated. This in turn creates a high water-table and results in flooding when the city experiences high rainfall. The water table fluctuations do not exceed 5 metres and during the rainy season borehole water tables reach ground surface [63].
Informal settlements in the city tend to compound the multi-stressor context for Lusaka. This is because the major aerial extent (70%) of the city has developed informally and lacks proper structures to drain excess water [64]. Another major issue is the management of solid waste—garbage that is left uncollected which ends up blocking the drainage systems. Urban planners and city decision-makers do not understand how municipal solid waste interacts with climate change, infrastructure, and urban planning to affect urban flooding and flood risk (Table 2).
Durban
Major flooding risks as a result of increased variability in rainfall and extreme storm events under climate change is one of the challenges facing the city of Durban (see Table 2). Durban is a middle-income African city of 3.5 million people residing under highly unequal social, economic and environmental conditions—a legacy inherited from the Apartheid regime. However, what is notable for this city is significant strides that have been made towards the integration of climate change into planning at city level and evidence on the ground of projects and efforts to deal with the potential challenges that were identified. The anticipation that climate change could undermine development efforts and exacerbate the plight of the city’s most vulnerable residents in informal settlements gave the eThekwini Municipality the impetus for innovative adaptation efforts. More recently, the city has been hit by a series of floods which has exposed its infrastructure and more so the informal settlements.
City learning points
The multiple stressor context and interconnectedness of the urban ecosystem across the four study cities of Harare, Windhoek, Lusaka and Durban was demonstrated well by presenting similarities and differences (see Tables 3 and 4). We present the learning points in five emerging thematic areas, namely water and waste, energy, informal settlements, water governance and city climate integration and planning.
Tab. 3. Similarities across the study cities. Tab. 4. Differences across the study cities. Water and waste issues
As a learning point, the City of Windhoek (CoW) is implementing efficient water conservation measures, which are linked to several factors and actions that form part of the city’s water ecosystem. These factors include climate (droughts), raw water availability, water scarcity and/or availability of water from remote catchment areas. The city deals with water scarcity through several initiatives such as wastewater reclamation and desalinization (although this is not a specific CoW initiative), artificial recharge of aquifers, water rationing and awareness campaigns to change water use behavior e.g. changing gardens by replacing water intensive plants with indigenous alternatives that are drought tolerant and allowing only public green spaces to be watered and this through wastewater irrigation [65]. More raw water is available from Harare city’s river catchment, where the Greater Harare area receives an average of more than 700mm of rainfall per rainy season as compared to Windhoek’s paltry 365mm and where very high mean evaporation rates (3,400mm) per year exist.
Another issue is the reliance of these cities like Lusaka and CoW, on external and far water sources namely Kafue, Omatako, Swakoppoort and Von Bach dams located some 60 km to 200 km away from the cities; and Kafue River where several projects have and continue to take place to increase abstraction for Lusaka. Climate-induced flash floods and intense rainfall coupled with inadequate stormwater infrastructure result in health implications that are associated with unhealthy, sanitary conditions and affect vulnerable communities such as in Kanyama and Kalikiliki informal settlements of Lusaka. While Harare and Lusaka are also challenged with solid waste management, CoW in contrast has a reliable solid waste management plan and it implements ward contractor systems in informal settlements where waste is picked up weekly at households and business with daily clean-up of open spaces. This is a good practice that many African cities which also have high informal settlements can learn from as the cities struggle with solid waste disposal management of which the city of Harare, once called the ‘sunshine city’ because of its historic efficacious waste management systems from decades ago, is no exception. Harare and Lusaka municipalities, which can learn from CoW, appear to have failed to effectively deal with solid waste as well as waste water treatment as over the years, increased mushrooming of informal dumping sites and decomposed piles of garbage now characterize the cities; broken sewer pipes discharge raw waste into clean water sources and the provision of clean water is still way below the expected standards.
Lessons were also learnt on waste management from Durban, which has numerous fully engineered landfill sites; one of which is the award-winning site at Buffelsdraai. The land reclamation in the buffer zone of the Buffelsdraai landfill through planting of indigenous trees, is an example of climate adaptation and mitigation being practiced by the local authorities; through green job creation, carbon sequestration, and land restoration. The tree planting project in Durban which uses ‘treepreneurs’ in a Community Reforestation Project presented a viable option to planting trees around the city of Lusaka to increase the green spaces in the city. The Sihlanzimvelo Programme, which uses local community businesses to deal with the issue of waste and alien plants causing flooding of streams and rivers by blocking the waterways during flood events, was another learning opportunity from Durban for Lusaka.
The city of Durban also illustrated the importance of biodiversity and ecological ‘green’ infrastructure as part of the urban ecosystem; and how the incorporation of this bioresource into city planning is important for building resilience and as part of the climate action response. This lesson is important for other southern African/African cities where bioresource conservation is often not a priority because city planners and decision-makers may not view the city as an ecosystem. In contrast to Durban, the city of Harare appears to be failing in the area of biodiversity conservation by allowing development in and around its wetlands [66]. Developments on wetlands in the past two decades are leading to less groundwater and throughflow recharge to the city’s rivers and eventually the reservoirs as wetlands are a major source of water for the city [67]. Despite the importance of these wetlands and their function as part of the city’s river recharge system and therefore the need for conservation measures [68], there has been unprecedented encroachment and degradation of wetlands across the city of Harare. This has posed a threat to the delicate wetland ecosystems and subsequent services and in this case the availability of raw and clean water for the city’s use.
Informal settlements
The exchange visits to Lusaka and Windhoek; and illustrated to a lesser extent in Durban; showed high proportions of informal settlements in the cities with the exception of Harare which has a low percentage coverage of informal settlements (Table 4). A notable difference in the informal settlements in the various cities is the permanency of the housing structures and its contribution to exacerbated climate impacts such as flooding. An example is Windhoek’s informal settlements, which are made up of temporary structures, whilst the structures in Lusaka are permanent. In Lusaka, the issue of flooding and solid waste disposal is a huge problem in informal settlements such as in Kanyama (one of the city exchanges sites); where only a tenth of the over 300,000 residents have access to potable water. Lusaka stands out, as it has a long history of permanent, unplanned and illegal settlements. In Lusaka, the proliferation of permanent illegal structures makes upgrading through redevelopment and provision of services costly and difficult to attain. Services such as waste management cannot be provided to these areas using conventional methods, therefore community-based options have been resorted to. Unfortunately, these Community Based Enterprises (CBEs) lack capacity and know-how, causing waste to pile up and subsequently contribute to flooding in some of these settlements. The lesson learnt from Katutura in Windhoek was the proactive actions taken by CoW in curtailing the expansion of the unplanned settlement by putting up fencing and allowing only temporary structures.
In comparison, Williams et al. [69] demonstrated how the Palmiet Rehabilitation Project in Durban, a multi sector partnership helped develop a deeper understanding of the current governance system, and embedded social values enacted in the case of the Quarry Road West informal settlement. This was helpful for integrative and transdisciplinary management of flood risk, at the climate change and water governance interface as climate change adaptation remains a challenge for decision-makers and policy-planners in the city. The need for engagement and more effective integration of informal settlements into local governance for water management was demonstrated lately, when informal settlements, including Quarry Road in Durban were hard-hit by the recent flooding (April 2019) that caused damage to infrastructure. Reports projected cost of repairs for damaged stormwater pipes, washed away walls and culvert and subsequent repairs related to human settlements to be over hundreds of thousands of dollars including repairs to reconstruction and development program (RDP) houses, transit camp units, informal settlements, retaining walls and hostel blocks as well as costs related with electricity repairs to eleven substations.
Only one out of Harare’s 33 wards is an informal settlement and plans to formalize this area are advanced. Here, very strict infrastructure and by-laws and standards by the city are applied and enforced. This has seen the city destroying informal structures through an initiative dubbed ‘Operation Murambatsvina ("Drive Out Trash"), which started in 2005 and has been used by HCC in a bid to curb criminality and disease. Over the years, approaches to deal with informal settlements have also included formalization of informal settlements such as the famous Epworth and Churu Farm in Harare, coupled with building initiatives such as Operation Garikayi/Hlalani Kuhle (Operation "Better Living"), which consists of building concrete housing. These efforts have led to limited informal settlements in Harare and the urban areas of Zimbabwe. A positive development was noted in that there are deliberate efforts to formalize informal settlements in the city of Windhoek.
Energy issues
Currently, the Electricity Centre Board (ECB), regulates electricity distributors in Windhoek and other regions and there is some co-dependence in terms of energy supply to the city (Table 3). The major power plant is in the North of the country as well as the conflicts with Botswana over the use of the Okavango for water and energy supply. CoW buys energy from NamPower and supplies electricity to the residents directly whilst this is done at national level by South Africa (Eskom), Zambia (ZESCO) and in Zimbabwe through ZEDC, a subsidiary company of the Zimbabwe Electricity Supply Association (ZESA). ZEDC is solely responsible for energy supply and regulation of rates in Harare and Zimbabwe from the main grid.
South Africa is ranked 114th out of 115 nations in its readiness for an energy transition away from fossil fuels [70], and yet addressing climate issues and associated problems in the region is closely related to tackling southern Africa’s dependence on coal. Climate change poses a looming power threat to hydropower, with changing rainfall, temperature and evaporation in watersheds such as the Zambezi (where countries such as Zimbabwe, Zambia and other southern African countries and subsequent cities draw hydropower from) have potential impacts on hydropower production. Power rationing programs have been implemented across the region, including in South African and Zimbabwean cities. Lusaka and Harare have a common energy production and supply resource having a 45 : 55% power sharing between Zambia and Zimbabwe respectively from Kariba hydropower stations that are along the Zambezi River, but Zambia also draws hydropower along the Kafue River.
Water governance
The CoW provides an admirable example of how partnerships—in this case, a public-private-partnership (PPP) has worked in favour of the city. Windhoek is the only city among the four, which reclaims domestic wastewater to potable drinking water standards at the Goreangab Water Reclamation plant, which was one of the sites visited under the city exchanges. The reclamation process began operations in 1968, when the plant was built by the CoW to reclaim waste directly from domestic sewage effluent [71]. The new Goreangab Water Reclamation plant was built in 2002 and has been based on extensive experience, local research, and input from international experts to assure compliance to the strictest water quality guidelines applied internationally [72]. The Resilience City Planning Framework (RCPF) is a complex phenomenon, non-deterministic, dynamic in structure, and uncertain in nature [73]. This context poses new opportunities for collaboration among public, private, civil institutions and organizations on all levels.
In addition, artificial recharge of aquifers implemented in the CoW provides another important lesson in groundwater abstraction and water management. The city supplies groundwater abstracted from municipal production boreholes, which is different from Harare, where water management is under the control of public entities, and water treatment and supply is the sole mandate of the city council. In Lusaka on the other hand, water is managed by a commercial utility, which is a private company wholly owned by the local authority [74]. Surface and groundwater resources in Harare and Lusaka are dwindling due to increase in demand and unregulated abstraction. In Harare, drilling a borehole requires a permit from the country’s raw water regulators, the Zimbabwe National Water Authority (ZINWA) but they are poor regulators and enforcers of this piece of legislation. As such individuals across Harare have drilled boreholes in their residences, in a similar way to Lusaka. In Lusaka, borehole drilling has only recently been regulated by the Water Resources Management Agency (WARMA), which issues permits for abstraction. The Water Resources Management Act Number 21 of 2011 requires all borehole owners to register their boreholes at a fee. This is being done in order to take stock of the number of boreholes and to monitor the abstraction levels of groundwater, which is at risk of contamination and depletion in Lusaka. In contrast, in Windhoek, permission for borehole abstraction is granted by the Ministry of Agriculture, Water and Forestry (MAWF), and the city has created an efficient groundwater abstraction and recharge system where water can be artificially recharged into city aquifers for storage purposes, since the evaporation rates are very high. The same water is treated to potable water standards before it is pumped into permissible boreholes in a scheme known as the Windhoek Managed Aquifer Recharge Scheme, providing a centralized borehole system which is easier to monitor and maintain; which again provides a good case of water management that other cities can learn from.
Another interesting difference was noted in water governance structures in Windhoek City which not only buys water from Namibia Water Corporation (NamWater), but also energy from NamPower and then sells these as services to residents but under government regulated rates. In contrast, ZINWA is responsible for overall management of all raw water forms in Zimbabwe including all cities. Harare City is solely responsible for the treatment, supply and therefore charging and collection of rates for potable water and purchases water from the national distributor, then redistributes at a slightly higher cost as part of the revenue collection. The Zambian situation presents a different scenario where water in Lusaka is supplied by a Commercial Utility (CU) - Lusaka Water and Sewerage Company (LWSC), which was created in 1988 although it only started functioning in 1990. Initially, water was supplied by the local authority which lacked capacity and could not attract professionals. The CU is responsible for the abstraction (from both surface and ground sources), bulk transportation, treatment and supply of water for which it charges fees under a regulated tariff structure Water reforms of 1997 created the National Water and Sanitation Council (NWASCO), which regulates the provision of water supply and sanitation services country wide. NWASCO regulates tariffs therefore the CU is not able to have its own fee structure for water.
Currently, Lusaka city cannot be said to have inadequate water, but the growing population and the expansion of unplanned settlements compound the difficulties currently encountered in the provision of water and sanitation services. Currently, only about 30% of the city is supplied with water by LWSC, which is serviced by a sewer network. Ninety percent (90%) of unplanned households use pit latrine toilets; 3% have no toilet facilities and use bush toilets. Pit latrines are shared among several households, and this reduces the latrine’s life span and because of inaccessibility to the unplanned settlements suction tankers cannot empty the majority of pit latrines. Local boreholes are unprotected, resulting in severe health risks when there is contamination from pit latrines.
City climate integration and planning
Durban is at the advanced stages of climate integration and mainstreaming into municipal planning and implementation of high provides a good case and practice that can be adopted by it. This was achieved through, political commitment and oversight, and climate champions in various line departments within the city. Mather et al. [75] attribute the success in Durban to the development of high-level technical expertise within the municipality as well as advocacy by political and technical champions, and broad based and appropriate communication with stakeholders. In contrast, the city of Windhoek has an environment desk which deals with issues to do with water reclamation and recycling and use of wastewater for green spaces are imminent. While Harare Municipality has a full department in charge of waste management, the authority has no department that deals with climate related issues, which exposes the authority when it comes to environmental protection and management. In addition, although climate change adaptation strategies are being crafted at the national level in Zimbabwe through the former Ministry of Environment, Water and Climate (MoEWC), climate change adaptation has received minimum attention at the local level (Harare City Council) with no adaptation strategies in place and like most cities a department dedicated to climate and environmental issues is imminent [76].
Lessons on mainstreaming climate adaptation can be applied from the CoW that is in the process of finalizing development and approval of the Integrated City Strategy and Action Plan on climate change bearing witness of a good example of cascading the national policy on climate change to city level. Climate integration and adaptation in Durban is done in two ways: firstly, through the Durban Climate Change Strategy (DCCS), which lays out a city-wide approach to address ten interrelated climate change themes (Water, Sea level rise, Biodiversity, Food security, Health, Energy, Waste and Pollution, Transport, Economic development, and Knowledge Generation and Understanding). This mainstreaming is overseen politically by the Municipal Climate Change Committee, and administratively by the Disaster Management Advisory Forum’s Municipal Adaptation Planning Technical Task Team [77].
Secondly, the Durban Adaptation Charter (DAC) is an international agreement that commits local governments to local climate action in their jurisdiction. The DAC was launched at COP17 hosted in Durban in December 2011. In Durban, the DAC is implemented through the maintenance and advancing of the Central KwaZulu-Natal Climate Change Compact [77], which is a partnership between Durban and its surrounding local and district municipalities to collaboratively address climate change at a regional scale in an integrated fashion [77]. The DAC has coined this method as the Hub and Compact approach. The climate adaptation work of eThekwini Municipality is coordinated under the Municipal Climate Protection Programme, by the Climate Protection Branch of the Environmental Planning and Climate Protection Department.
Discussion
Key issues in the urban ecosystems
Water and energy vulnerability and risk are significant issues for the cities except for Durban. For instance, the city of Harare particularly is dependent on a polluted source of water (Lake Chivero) and the Kariba Dam along the Zambezi River for its electricity. In addition, the city has limited capacity to deal with increased wastewater as the infrastructure has not been adequately expanded to accommodate the population expansion [66]; [78]; [79]. This resonates with the fact that, water stress is likely to adversely impact public health, water availability, energy, forestry and biodiversity, rangelands, human settlements and tourism [62]; [3]; [70]. Recently (2019), long power cuts, especially in Lusaka and Harare, have been the order of the day with those who can afford to turning to alternative sources such as liquid gas, generators and solar power while the poor use cheaper sources of energy such as wood and kerosene [66]; [67]. Energy issues conversely affect potable water supply as water treatment processes and the pumping supply systems are reliant on electricity.
Although the quantity and quality of water supply are central to water security [62]; [63]; [69], water governance has a central role in the issue of water security. While urban agriculture supplements the city’s food demand, it has implications on water demand given that agriculture production and horticulture draws significant amounts of water for irrigation [63]; [62]. Increased populations have found homes in informal settlements, which tend to have poor quality infrastructure and amenities such as roads, electricity, water, sanitation and good transport [63].
For all the cities, there is tacit recognition that complexity of issues threatening water security in the region cannot be addressed by any one actor or one sector alone and therefore, collective leadership is required. An innovative, multi-stakeholder approach to collaboration at all levels, now enshrined in Sustainable Development Goal (SDG) 17, is emerging whereby partners increased their understanding of water risks, raise awareness of these risks and advocate for change, and harmonize resources and capacities to engage in effective, on-the-ground projects. For the city of Lusaka, the water security initiative is a case in point and in Windhoek the efficacious water reclamation systems that are governed by a PPP resonate the importance of collaboration.
City learning points
Water and waste issues
The lessons and best practices of water conservation from the CoW are relevant to other FRACTAL cities such as Cape Town, Harare, Johannesburg and Lusaka, which are in the arid belt of the region and therefore susceptible to drought episodes as well as other southern African cities in the same zone [62]. This is not to say that the other cities are not acting towards water conservation, but CoW provides an excellent example of a city that is managing water scarcity well [71]. In this case cities like Harare that have a perpetual water crisis could draw lessons from CoW given the significantly higher amount of rainfall that the former receives per annum. Considering that the region has since 1960 been experiencing a decrease in annual rainfall [80] the status quo should not be maintained, and Lusaka and other cities in the region can learn from CoW where water conservation and wastewater reclamation is being done.
Green business opportunities at the community level can help create an enabling environment for active participation in climate change mitigation and adaptation projects [81; 82]. A key learning point from the cities of Harare, Lusaka and Durban is the concept of including the community in the cleaning which contributes towards better solid waste management. This appears to be a feasible option for Lusaka, where many actions have already formally involved communities; as well as more recently in Harare (and across Zimbabwe), where community cleaning efforts scheduled for the first Friday of every month (since November 2018) have begun to bear fruit.
Informal settlements
The multi-faceted and interconnected nature of several issues that cross the ecological-socio-economic divide resonate with situations across most cities in southern Africa. One lesson learnt through the exchange visits was how to address the challenge of informal settlements vis-à-vis building resilience in the cities as low-income households and informal households often located in unsuitable areas are most vulnerable to the compounding effects of both non-climatic and climate risks such as floods in Lusaka. The exchange visit brought out the advantages existing in CoW where temporary unplanned and illegal structures are constructed using corrugated iron sheets. These can easily be removed or moved for upgrading and planning given that most of these settlements are situated in unsuitable land.
A lesson for other southern African and African cities on dealing with informal settlements that mushroom as a result of population expansion and urbanization and the subsequent failure of service delivery can be drawn from Harare and Zimbabwe. Formalisation of informal settlements and building initiatives in Harare may provide lessons to other African cities that have problems with informal settlements and associated risks such as the famous Kibera in Nairobi, partially informal Khayelitsha township in Cape Town, and in Dar es Salaam that has an informal settlement areal coverage of 70% [83] comparable to Lusaka and to a lesser extent, Windhoek and Durban.
Energy issues
The City of Windhoek provides an exceptional case as the function of energy provision is designated at city level, whereas in most African countries the energy provider is often a public entity at national level. However, most southern African countries and indeed cities, which are large consumers of energy, rely on hydropower energy except for South Africa, and Botswana which mostly rely on fossil fuels, and coal in particular [84]. There is controversy over the continued use of coal in the region (with 90% of South Africa’s energy source being coal-powered), given its contribution to CO2 and greenhouse gases and ultimately global warming. We found comparable efforts towards use of renewable energy sources for Harare and Windhoek with projects such as the Southern African Solar Training and Demonstration Initiative (SOLTRAIN) and the developments at the SADC Centre for Renewable Energy and Efficiency (SACREE) that both Namibia and Zimbabwe are party to.
Water governance
Each city has taken up a water governance system which appears to be feasible and workable. There are several multiple roles of city authorities in governance which influence resilience. These include the role cities play as regulators, as taxation and licensing authorities; as strategic land-use planners and developers; consumers and providers of goods and services. This makes local authorities exceptionally well positioned to lead and influence climate adaptation interventions and stimulate behaviour change among citizens and businesses. Adaptation measures are needed in this and many cities in the region given projections of population exponential population growth.
The differing contexts of water governance demonstrated for the four cities of Harare, Windhoek, Lusaka and Durban are an example of the use of diverse solutions within African cities. Often, one size fits all solutions are advocated for and sometimes even funded for Africa, forgetting the different contextual realities. However, we acknowledge that there is still room for cities to learn from each other on implementation in order to improve on water service delivery and water resource management. Multiple actors, often through partnership, tend to intervene in urban climate change governance [81]; [82]. This suggests the use of new frameworks such as the Resilience City Planning Framework (RCPF), which is a network of interlinked multidisciplinary concepts. At the same time, governance systems in the cities need to be transparent, flexible, have integration and monitoring systems, and embrace continual learning and knowledge sharing to increase the likelihood of transformational adaptation.
City climate integration and planning
By engaging in compact partnerships for Durban with neighbouring municipalities, learning, resources and skills are shared and an integrated response to climate change has been developed in this city-region. This increases the scale at which work is done, often encapsulating whole catchments and substantially increasing the number of benefiting city-region residents. Lessons and good practice therefore emanated from Durban in the way in which climate change is integrated in planning processes and climate adaptation is facilitated. The structures and approaches in Durban present learning point as such efforts of integrating climate action into policy can be replicated in other southern African cities. It is worth noting though that similar efforts such as the development of Windhoek’s climate change response strategy; Lusaka’s water security initiative and some engagements on improving planning and mainstreaming national and transformative adaptation plans at the city level in Harare are all initiatives that have been borne partly from the FRACTAL engagements and from the learning experiences of the city exchanges.
Conclusion
Cities can be regarded as complex urban ecosystems, which, like other types of ecosystems, are threatened by climate change. Additionally, southern African cities face multiple stressors and complex challenges. As with natural ecosystems, resilience against climate change lies firstly in the healthy functioning of the city and secondly in the ability of the city to adapt to changes. A crucial element in adapting is having the ability to learn and implement best practices, often from other cities facing similar challenges. As indicated in this paper, some cities have come up with innovative ways of tackling challenges such as water insecurity, informal settlements and climate change. These provide learning points for other cities that are grappling with climate change and other, similar developmental issues, also bearing in mind that context matters. In this paper we identified five elements (called ‘city learning points’) of a city that need to be considered when grappling with and building resilience to climate change impacts in southern African cities. Among these learning points are the issue of public-private partnerships, which southern African cities can embrace in dealing with issues such as water scarcity and management issues and where great strides in improving water service delivery to the city residents through water reclamation, have been made in the case of the City of Windhoek. This has placed the city on a success trajectory, which promises to lessen water availability issues that are compounded by climatic risks.
Another learning point was that community engagement and inclusion to deal more successfully with solid waste allows for local participation and green job creation in cities as evidenced by Durban and Lusaka. Community engagement ensures better understanding of the context as the solutions are made together ‘with’ rather than ‘for’ the people on the ground and who are affected by the day to day challenges. There is, however, evidence of the need for continued capacity building and improvement of the model used to implement such approaches such as in Harare’s clean up campaigns. One other critical learning point is on decisive leadership in dealing with informal settlements as exemplified by Harare. Intolerance of informal settlements and upgrading of these settlements, are strategies that promise to address criminality and disease in the low-income areas of the cities, which other cities can emulate and implement to the extent possible. Lastly, as highlighted in Durban, development and approval of city strategies and action plans on climate change adaptation provide an opportunity for cities to integrate climate change in planning processes and cascade national policies to the city level for the benefit of city residents. Mainstreaming of climate change also directly or indirectly addresses other developmental challenges such as biodiversity loss and water security.
We conclude that the evidence of efforts towards environmental protection, improved urban amenities and infrastructure and ultimately service delivery in the southern African cities studied gives an indication that to a large extent, there is scope for these cities to learn from each other to build and develop resilience. Therefore, city to city learning provides a useful platform for the exchange and uptake of ideas, practices and strategies to enhance the resilience of urban ecosystems particularly across regions such as southern Africa where similar socio-environmental issues are encountered. These lessons can certainly be useful for similar cities and regions.
Supporting information
S1 File [doc]
Windhoek-Lusaka city learning exchange questionnaire.S2 File [doc]
Household questionnaire: Lusaka START GEC; flood occurrence, impacts and response at household level.S3 File [doc]
Lusaka START GEC household questionnaire.S4 File [doc]
Lusaka GEC key informants interview guide.S5 File [doc]
Lusaka GEC focus group discussion guide.S6 File [doc]
Harare GEC household questionnaire.S7 File [doc]
Harare START GEC interview guide for the stakeholders.S8 File [doc]
Agenda for FRACTAL Harare Team exchange visit, Windhoek, Namibia.S9 File [doc]
Agenda for Harare FRACTAL Team exchange visit, Lusaka, Zambia.S10 File [doc]
Lusaka-Windhoek visiting agenda.
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- Health-related quality of life in cancer patients treated with immune checkpoint inhibitors: A systematic review on reporting of methods in randomized controlled trials
- Environmental tobacco smoke (ETS) and hyperlipidemia modified by perceived work stress
- Association between opioid analgesic therapy and initiation of buprenorphine management: An analysis of prescription drug monitoring program data
- Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study
- Radiocarbon dating of two old African baobabs from India
- Improvement project in higher education institutions: A BPEP-based model
- An updated evaluation of serum sHER2, CA15.3, and CEA levels as biomarkers for the response of patients with metastatic breast cancer to trastuzumab-based therapies
- Genome-wide association study of metabolic syndrome in Korean populations
- The diagnostic accuracy of liver fibrosis in non-viral liver diseases using acoustic radiation force impulse elastography: A systematic review and meta-analysis
- Drug therapy problems and treatment satisfaction among ambulatory patients with epilepsy in a specialized hospital in Ethiopia
- Short- & long-term effects of monetary and non-monetary incentives to cooperate in public good games: An experiment
- Niche modeling reveals life history shifts in birds at La Brea over the last twenty millennia
- Morphological consequences of artificial cranial deformation: Modularity and integration
- Distributed flux balance analysis simulations of serial biomass fermentation by two organisms
- Plasma kynurenines and prognosis in patients with heart failure
- Occurrence and distribution of anthropogenic persistent organic pollutants in coastal sediments and mud shrimps from the wetland of central Taiwan
- Intensified visual clutter induces increased sympathetic signalling, poorer postural control, and faster torsional eye movements during visual rotation
- Restoration of cortical symmetry and binaural function: Cortical auditory evoked responses in adult cochlear implant users with single sided deafness
- A smartphone-enabled wireless and batteryless implantable blood flow sensor for remote monitoring of prosthetic heart valve function
- Gut microbiota composition alterations are associated with the onset of diabetes in kidney transplant recipients
- Shock index and TIMI risk index as valuable prognostic tools in patients with acute coronary syndrome complicated by cardiogenic shock
- Merit overrules theory of mind when young children share resources with others
- Economic burden of maternal morbidity – A systematic review of cost-of-illness studies
- Comparison of balance changes after inspiratory muscle or Otago exercise training
- Correction: Escherichia coli and Salmonella spp. isolated from Australian meat chickens remain susceptible to critically important antimicrobial agents
- Metabolic analysis of amino acids and vitamin B6 pathways in lymphoma survivors with cancer related chronic fatigue
- Cell-free DNA donor fraction analysis in pediatric and adult heart transplant patients by multiplexed allele-specific quantitative PCR: Validation of a rapid and highly sensitive clinical test for stratification of rejection probability
- Immunopathogenesis of canine chronic ulcerative stomatitis
- Correction: Quantification of speech and synchrony in the conversation of adults with autism spectrum disorder
- Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study
- Generalizing findings from a randomized controlled trial to a real-world study of the iLookOut, an online education program to improve early childhood care and education providers’ knowledge and attitudes about reporting child maltreatment
- Self-selection of food ingredients and agricultural by-products by the house cricket, Acheta domesticus (Orthoptera: Gryllidae): A holistic approach to develop optimized diets
- Machine learning detection of Atrial Fibrillation using wearable technology
- Comparative proteomic analysis of different stages of breast cancer tissues using ultra high performance liquid chromatography tandem mass spectrometer
- A cross-sectional study of psychopathy and khat abuse among prisoners in the correctional institution in Jimma, Ethiopia
- Head impulse compensatory saccades: Visual dependence is most evident in bilateral vestibular loss
- Complementarity of empirical and process-based approaches to modelling mosquito population dynamics with Aedes albopictus as an example—Application to the development of an operational mapping tool of vector populations
- Pepsin promotes laryngopharyngeal neoplasia by modulating signaling pathways to induce cell proliferation
- When and what to test for: A cost-effectiveness analysis of febrile illness test-and-treat strategies in the era of responsible antibiotic use
- Comparison of effects and safety in providing controlled hypotension during surgery between dexmedetomidine and magnesium sulphate: A meta-analysis of randomized controlled trials
- The gene encoding the ketogenic enzyme HMGCS2 displays a unique expression during gonad development in mice
- Seroepidemiological study of rubella in Vojvodina, Serbia: 24 years after the introduction of the MMR vaccine in the national immunization programme
- Efficacy of a mitochondrion-targeting agent for reducing the level of urinary protein in rats with puromycin aminonucleoside-induced minimal-change nephrotic syndrome
- Association of endothelial nitric oxide synthase (NOS3) gene polymorphisms with primary open-angle glaucoma in a Saudi cohort
- Antitrust analysis with upward pricing pressure and cost efficiencies
- Machine learning models for identifying preterm infants at risk of cerebral hemorrhage
- Natural selection contributes to food web stability
- Pyramiding QTLs controlling tolerance against drought, salinity, and submergence in rice through marker assisted breeding
- Diversity and plant growth-promoting functions of diazotrophic/N-scavenging bacteria isolated from the soils and rhizospheres of two species of Solanum
- Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression
- Sofosbuvir-based regimen for genotype 2 HCV infected patients in Taiwan: A real world experience
- The virulence domain of Shigella IcsA contains a subregion with specific host cell adhesion function
- Sequencing artifacts derived from a library preparation method using enzymatic fragmentation
- Analysis of the Rdr1 gene family in different Rosaceae genomes reveals an origin of an R-gene cluster after the split of Rubeae within the Rosoideae subfamily
- Concomitant phytonutrient and transcriptome analysis of mature fruit and leaf tissues of tomato (Solanum lycopersicum L. cv. Oregon Spring) grown using organic and conventional fertilizer
- Quantitative analysis of adsorption and desorption of volatile organic compounds on reusable zeolite filters using gas chromatography
- Comparing bioinformatic pipelines for microbial 16S rRNA amplicon sequencing
- TMEM98 is a negative regulator of FRAT mediated Wnt/ß-catenin signalling
- Modeling migration patterns in the USA under sea level rise
- Quo vadis Pantanal? Expected precipitation extremes and drought dynamics from changing sea surface temperature
- Cloud-computing and machine learning in support of country-level land cover and ecosystem extent mapping in Liberia and Gabon
- An exploratory study on the quality of patient screening and counseling for hypertension management in Tanzania
- Relation of fibroblast growth factor receptor 2 expression to hepatocellular carcinoma recurrence after liver resection
- The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study
- The impact of diabetes mellitus medication on the incidence of endogenous endophthalmitis
- Correction: Chl1 DNA helicase and Scc2 function in chromosome condensation through cohesin deposition
- Clinical and pathological features of thrombotic microangiopathy influencing long-term kidney transplant outcomes
- Multidisciplinary investigation of two Egyptian child mummies curated at the University of Tartu Art Museum, Estonia (Late/Graeco-Roman Periods)
- Occupational exposure to particulate matter from air pollution in the outdoor workplaces in Almaty during the cold season
- Morphological adjustment in free-living Steinernema feltiae infective juveniles to increasing concentration of Nemafric-BL phytonematicide
- Murine Surf4 is essential for early embryonic development
- Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries
- Algorithmic handwriting analysis of the Samaria inscriptions illuminates bureaucratic apparatus in biblical Israel
- Key necroptotic proteins are required for Smac mimetic-mediated sensitization of cholangiocarcinoma cells to TNF-α and chemotherapeutic gemcitabine-induced necroptosis
- Concurrent lipidomics and proteomics on malignant plasma cells from multiple myeloma patients: Probing the lipid metabolome
- Short treatment with antalarmin alters adrenal gland receptors in the rat model of endometriosis
- Is it really always only the others who are to blame? GP’s view on medical overuse. A questionnaire study
- Serum visfatin and vaspin levels in hepatocellular carcinoma (HCC)
- Retraction: SDR9C7 Promotes Lymph Node Metastases in Patients with Esophageal Squamous Cell Carcinoma
- iTRAQ proteomics reveals the regulatory response to Magnaporthe oryzae in durable resistant vs. susceptible rice genotypes
- A smartphone-based test for the assessment of attention deficits in delirium: A case-control diagnostic test accuracy study in older hospitalised patients
- Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis
- Incidence and predictors of loss to follow up among adult HIV patients on antiretroviral therapy in University of Gondar Comprehensive Specialized Hospital: A competing risk regression modeling
- Point-of-care diagnostic (POCD) method for detecting Bursaphelenchus xylophilus in pinewood using recombinase polymerase amplification (RPA) with the portable optical isothermal device (POID)
- Bioluminescent imaging of Arabidopsis thaliana using an enhanced Nano-lantern luminescence reporter system
- Biosynthetic pathway of indole-3-acetic acid in ectomycorrhizal fungi collected from northern Thailand
- Clinical implications of elevated serum interleukin-6 in IgG4-related disease
- Downscaling NLDAS-2 daily maximum air temperatures using MODIS land surface temperatures
- Sex-specific and opposite modulatory aspects revealed by PPI network and pathway analysis of ischemic stroke in humans
- Plasma Trimethylamine-N-oxide and impaired glucose regulation: Results from The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS)
- Self-esteem and other risk factors for depressive symptoms among adolescents in United Arab Emirates
- Control of the microsporidian parasite Nosema ceranae in honey bees (Apis mellifera) using nutraceutical and immuno-stimulatory compounds
- The effect of storage conditions on microbial communities in stool
- Role of donor genotype in RT-QuIC seeding activity of chronic wasting disease prions using human and bank vole substrates
- Influence of flow on phosphorus-dynamics and particle size in agricultural drainage ditch sediments
- A prospective, randomized, double-blind trial to compare body weight-adjusted and fixed doses of palonosetron for preventing postoperative nausea and vomiting in obese female patients
- Application of computerized 3D-CT texture analysis of pancreas for the assessment of patients with diabetes
- Predictive validation and forecasts of short-term changes in healthcare expenditure associated with changes in smoking behavior in the United States
- An information-based approach to handle various types of uncertainty in fuzzy bodies of evidence
- Oral magnesium supplementation for leg cramps in pregnancy—An observational controlled trial
- Health care professionals’ knowledge of commonly used sedative, analgesic and neuromuscular drugs: A single center (Rambam Health Care Campus), prospective, observational survey
- Campylobacter portucalensis sp. nov., a new species of Campylobacter isolated from the preputial mucosa of bulls
- OGG1 deficiency alters the intestinal microbiome and increases intestinal inflammation in a mouse model
- Transgenic interleukin 11 expression causes cross-tissue fibro-inflammation and an inflammatory bowel phenotype in mice
- Novel method to measure temporal windows based on eye movements during viewing of the Necker cube
- Whole blood transcriptomic analysis of beef cattle at arrival identifies potential predictive molecules and mechanisms that indicate animals that naturally resist bovine respiratory disease
- Effects of smoke flavoring using different wood chips and barbecuing on the formation of polycyclic aromatic hydrocarbons and heterocyclic aromatic amines in salmon fillets
- Sleep quality and sex modify the relationships between trait energy and fatigue on state energy and fatigue
- The role of peer, parental, and school norms in predicting adolescents’ attitudes and behaviours of majority and different minority ethnic groups in Croatia
- Filtered beauty in Oslo and Tokyo: A spatial frequency analysis of facial attractiveness
- The impact of rehabilitation frequency on the risk of stroke in patients with rheumatoid arthritis
- Availability, prices and affordability of selected antibiotics and medicines against non-communicable diseases in western Cameroon and northeast DR Congo
- The effect of mutations derived from mouse-adapted H3N2 seasonal influenza A virus to pathogenicity and host adaptation
- Detection of posttraumatic pneumothorax using electrical impedance tomography—An observer-blinded study in pigs with blunt chest trauma
- Educators’ perceptions of organisational readiness for implementation of a pre-adolescent transdisciplinary school health intervention for inter-generational outcomes
- Beyond the heterodimer model for mineralocorticoid and glucocorticoid receptor interactions in nuclei and at DNA
- The effects of sport expertise and shot results on basketball players’ action anticipation
- Framework and algorithms for identifying honest blocks in blockchain
- Efficacy and safety of anti-viral therapy for Hepatitis B virus-associated glomerulonephritis: A meta-analysis
- Selective transmission of some HIV-1 subtype C variants might depend on Envelope stimulating dendritic cells to secrete IL-10
- Noise reduction and quantification of fiber orientations in greyscale images
- Exploring the impact of terminology differences in blood and organ donor decision making
- Ontogenetic similarities between giraffe and sauropod neck osteological mobility
- Load transfer mechanism and critical length of anchorage zone for anchor bolt
- Income inequalities in stroke incidence and mortality: Trends in stroke-free and stroke-affected life years based on German health insurance data
- Community’s perception, experiences and health seeking behavior towards newborn illnesses in Debre Libanos District, North Shoa, Oromia, Ethiopia: Qualitative study
- Platelet indices significantly correlate with liver fibrosis in HCV-infected patients
- Reanalysis of the Bridge et al. study of suicide following release of 13 Reasons Why
- Validation of the easyscreen flavivirus dengue alphavirus detection kit based on 3base amplification technology and its application to the 2016/17 Vanuatu dengue outbreak
- The nitrate content of fresh and cooked vegetables and their health-related risks
- Bioreactor for mobilization of mesenchymal stem/stromal cells into scaffolds under mechanical stimulation: Preliminary results
- Serotonin transporter dependent modulation of food-seeking behavior
- Implicit task switching in Parkinson’s disease is preserved when on medication
- Root treatment with oxathiapiprolin, benthiavalicarb or their mixture provides prolonged systemic protection against oomycete foliar pathogens
- Real-world effectiveness and safety of ranibizumab for the treatment of myopic choroidal neovascularization: Results from the LUMINOUS study
- Non-gradient and genotype-dependent patterns of RSV gene expression
- Multiplex real-time PCR for the detection of Clavibacter michiganensis subsp. michiganensis, Pseudomonas syringae pv. tomato and pathogenic Xanthomonas species on tomato plants
- The 24-hour urinary cortisol in post-traumatic stress disorder: A meta-analysis
- Parasites modulate the gut-microbiome in insects: A proof-of-concept study
- The dynamics of shapes of vesicle membranes with time dependent spontaneous curvature
- Vascularization and biocompatibility of poly(ε-caprolactone) fiber mats for rotator cuff tear repair
- The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism
- Disease-specific out-of-pocket healthcare expenditure in urban Bangladesh: A Bayesian analysis
- Advanced biofilm analysis in streams receiving organic deicer runoff
- Upregulation of long non-coding RNA ROR1-AS1 promotes cell growth and migration in bladder cancer by regulation of miR-504
- Method development and validation for rapid identification of epigallocatechin gallate using ultra-high performance liquid chromatography
- Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens
- Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study
- Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data
- Health-related quality of life among patients with type 2 diabetes mellitus in Eastern Province, Saudi Arabia: A cross-sectional study
- Photocatalytic biocidal effect of copper doped TiO2 nanotube coated surfaces under laminar flow, illuminated with UVA light on Legionella pneumophila
- The interoceptive hippocampus: Mouse brain endocrine receptor expression highlights a dentate gyrus (DG)–cornu ammonis (CA) challenge–sufficiency axis
- Educational attainment and HIV testing and counselling service utilisation during antenatal care in Ghana: Analysis of Demographic and Health Surveys
- Dissection of flag leaf metabolic shifts and their relationship with those occurring simultaneously in developing seed by application of non-targeted metabolomics
- Centromeres of Cucumis melo L. comprise Cmcent and two novel repeats, CmSat162 and CmSat189
- Acute high-intensity and moderate-intensity interval exercise do not change corticospinal excitability in low fit, young adults
- “I like the way I am, but I feel like I could get a little bit bigger”: Perceptions of body image among adolescents and youth living with HIV in Durban, South Africa
- Nanoparticle-based ‘turn-on’ scattering and post-sample fluorescence for ultrasensitive detection of water pollution in wider window
- The relationship of moral sensitivity and patient safety attitudes with nursing students’ perceptions of disclosure of patient safety incidents: A cross-sectional study
- Insights into the strategy of micro-environmental adaptation: Transcriptomic analysis of two alvinocaridid shrimps at a hydrothermal vent
- Thirty-day readmission after medical-surgical hospitalization for people who experience imprisonment in Ontario, Canada: A retrospective cohort study
- The effect of long-term brine discharge from desalination plants on benthic foraminifera
- Hyper-spectral response and estimation model of soil degradation in Kenli County, the Yellow River Delta
- Prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017
- Significant changes in synovial fluid microRNAs after high tibial osteotomy in medial compartmental knee osteoarthritis: Identification of potential prognostic biomarkers
- Reassortment and adaptive mutations of an emerging avian influenza virus H7N4 subtype in China
- Ischemia and reperfusion injury in superficial inferior epigastric artery-based vascularized lymph node flaps
- High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania – A prospective cohort study
- Switchable resolution in soft x-ray tomography of single cells
- Mitochondrial DNA variations and mitochondrial dysfunction in Fanconi anemia
- Extended-spectrum beta-lactamase (ESBL)-producing and non-ESBL-producing Escherichia coli isolates causing bacteremia in the Netherlands (2014 – 2016) differ in clonal distribution, antimicrobial resistance gene and virulence gene content
- Molecular characterization of blaKHM-1 encoding plasmid in an Enterobacter hormaechei subsp. hoffmannii isolate from blood culture
- PR3 levels are impaired in plasma and PBMCs from Arabs with cardiovascular diseases
- Sex differences in self-regulation in early, middle and late adolescence: A large-scale cross-sectional study
- Interaction between elevated temperature and different types of Na-salicylate treatment in Brachypodium dystachion
- A highway crash risk assessment method based on traffic safety state division
- A brain connectivity characterization of children with different levels of mathematical achievement based on graph metrics
- Quantifying the level of difficulty to treat major depressive disorder with antidepressants: Treatment Resistance to Antidepressants Evaluation Scale
- Occupational gender segregation and economic growth in U.S. local labor markets, 1980 through 2010
- The association of telomere length and telomerase activity with adverse outcomes in older patients with non-ST-elevation acute coronary syndrome
- Construction of a high-density genetic map and fine mapping of a candidate gene locus for a novel branched-spike mutant in barley
- Alterations of aqueous humor Aβ levels in Aβ-infused and transgenic mouse models of Alzheimer disease
- Parameters impacting the live birth rate per transfer after frozen single euploid blastocyst transfer
- Deep2Full: Evaluating strategies for selecting the minimal mutational experiments for optimal computational predictions of deep mutational scan outcomes
- Economic compensation interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review and meta-analysis
- Distinctive effect of anesthetics on the effect of limb remote ischemic postconditioning following ischemic stroke
- Natural hybridization between Phyllagathis and Sporoxeia species produces a hybrid without reproductive organs
- Preliminary evaluation of a novel nine-biomarker profile for the prediction of autism spectrum disorder
- The impact of peer attachment on prosocial behavior, emotional difficulties and conduct problems in adolescence: The mediating role of empathy
- Spatial and climatic variables independently drive elevational gradients in ant species richness in the Eastern Himalaya
- What is the qualitative evidence concerning the risks, diagnosis, management and consequences of gastrointestinal infections in the community in the United Kingdom? A systematic review and meta-ethnography
- Naringenin protects AlCl3/D-galactose induced neurotoxicity in rat model of AD via attenuation of acetylcholinesterase levels and inhibition of oxidative stress
- Key barriers and enablers associated with uptake and continuation of oral pre-exposure prophylaxis (PrEP) in the public sector in Zimbabwe: Qualitative perspectives of general population clients at high risk for HIV
- Characterizing the University of California’s tenure-track teaching position from the faculty and administrator perspectives
- Restoration of Mal overcomes the defects of apoptosis in lung cancer cells
- Patient preferences for maintenance therapy in Crohn’s disease: A discrete-choice experiment
- Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia
- Hesperidin improves insulin resistance via down-regulation of inflammatory responses: Biochemical analysis and in silico validation
- Accuracy of intraocular lens power calculation formulas using a swept-source optical biometer
- Characterization of black patina from the Tiber River embankments using Next-Generation Sequencing
- Comparison of blood lactate and perceived exertion responses in two matched time-under-tension protocols
- Fibrin hydrogels are safe, degradable scaffolds for sub-retinal implantation
- Post-translational modifications of Drosophila melanogaster HOX protein, Sex combs reduced
- Problem gambling, associations with comorbid health conditions, substance use, and behavioural addictions: Opportunities for pathways to treatment
- Liganded T3 receptor β2 inhibits the positive feedback autoregulation of the gene for GATA2, a transcription factor critical for thyrotropin production
- Characterization of METTL16 as a cytoplasmic RNA binding protein
- Impact of long-term storage and freeze-thawing on eight circulating microRNAs in plasma samples
- Nanosheet wrapping-assisted coverslip-free imaging for looking deeper into a tissue at high resolution
- Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
- Early diagnosis of sepsis in emergency departments, time to treatment, and association with mortality: An observational study
- Validity of cerebrovascular ICD-9-CM codes in healthcare administrative databases. The Umbria Data-Value Project
- Tuberculoid leprosy: An in vivo microvascular evaluation of cutaneous lesions
- Neuromuscular blockers in the acute respiratory distress syndrome: A meta-analysis
- Identification of putative Type-I sex pheromone biosynthesis-related genes expressed in the female pheromone gland of Streltzoviella insularis
- Redefining transcriptional regulation of the APOE gene and its association with Alzheimer’s disease
- Disease-relevant mutations alter amino acid co-evolution networks in the second nucleotide binding domain of CFTR
- A bushel of viruses: Identification of seventeen novel putative viruses by RNA-seq in six apple trees
- Torque teno virus viral load is related to age, CMV infection and HLA type but not to Alzheimer's disease
- The variability of bacterial communities in both the endosphere and ectosphere of different niches in Chinese chives (Allium tuberosum)
- Tripartite factors leading to molecular divergence between human and murine smooth muscle
- Characterization of dermal skin innervation in fibromyalgia syndrome
- A neonatal nonhuman primate model of gestational Zika virus infection with evidence of microencephaly, seizures and cardiomyopathy
- A scoping review of importation and predictive models related to vector-borne diseases, pathogens, reservoirs, or vectors (1999–2016)
- Assessment of climate change impact on the malaria vector Anopheles hyrcanus, West Nile disease, and incidence of melanoma in the Vojvodina Province (Serbia) using data from a regional climate model
- Associations of cigarette smoking and burden of thoracic aortic calcification in asymptomatic individuals: A dose-response relationship
- Healthcare utilization of Mexican-American Medicare beneficiaries with and without Alzheimer’s disease and related dementias
- Evaluation of questionnaire as an instrument to measure the level of nutritional and weight gain knowledge in pregnant women in Poland. A pilot study
- TranCEP: Predicting the substrate class of transmembrane transport proteins using compositional, evolutionary, and positional information
- Non-Invasive Functional-Brain-Imaging with an OPM-based Magnetoencephalography System
- Expression of acyl-CoA-binding protein 5 from Rhodnius prolixus and its inhibition by RNA interference
- Transforming assessment of speech in children with cleft palate via online crowdsourcing
- High prevalence of off-label and unlicensed paediatric prescribing in a hospital in Indonesia during the period Aug.—Oct. 2014
- General practice management of rotator cuff related shoulder pain: A reliance on ultrasound and injection guided care
- Estimating the population size of female sex workers and transgender women in Sri Lanka
- Can helmet decrease mortality of craniocerebral trauma patients in a motorcycle accident?: A propensity score matching
- Obesity, smoking habits, and serum phosphate levels predicts mortality after life-style intervention
- Treatment of children under 4 years of age with medulloblastoma and ependymoma in the HIT2000/HIT-REZ 2005 trials: Neuropsychological outcome 5 years after treatment
- Can a semi-quantitative method replace the current quantitative method for the annual screening of microalbuminuria in patients with diabetes? Diagnostic accuracy and cost-saving analysis considering the potential health burden
- A two-arm parallel double-blind randomised controlled pilot trial of the efficacy of Omega-3 polyunsaturated fatty acids for the treatment of women with endometriosis-associated pain (PurFECT1)
- Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: Conditional effect of age
- Burden and risk factors of cutaneous leishmaniasis in a peri-urban settlement in Kenya, 2016
- Predicting strike susceptibility and collision patterns of the common buzzard at wind turbine structures in the federal state of Brandenburg, Germany
- Embryonic thermal manipulation has short and long-term effects on the development and the physiology of the Japanese quail
- High-order radiomics features based on T2 FLAIR MRI predict multiple glioma immunohistochemical features: A more precise and personalized gliomas management
- Human-raptor conflict in rural settlements of Colombia
- Regional adaptations and parallel mutations in Feline panleukopenia virus strains from China revealed by nearly-full length genome analysis
- Long-term ecological research in southern Brazil grasslands: Effects of grazing exclusion and deferred grazing on plant and arthropod communities
- Assessment of peritoneal microbial features and tumor marker levels as potential diagnostic tools for ovarian cancer
- Survival analysis of 230 patients with unresectable hepatocellular carcinoma treated with bland transarterial embolization
- Adverse drug reaction reporting practice and associated factors among medical doctors in government hospitals in Addis Ababa, Ethiopia
- TaWAK6 encoding wall-associated kinase is involved in wheat resistance to leaf rust similar to adult plant resistance
- Deficiency syndromes in top predators associated with large-scale changes in the Baltic Sea ecosystem
- The inhibitor of apoptosis proteins antagonist Debio 1143 promotes the PD-1 blockade-mediated HIV load reduction in blood and tissues of humanized mice
- Allele specific expression of Dof genes responding to hormones and abiotic stresses in sugarcane
- Perceived relative social status and cognitive load influence acceptance of unfair offers in the Ultimatum Game
- Quantitative evaluation of choriocapillaris using optical coherence tomography and optical coherence tomography angiography in patients with central serous chorioretinopathy after half-dose photodynamic therapy
- Structure-function analyses of candidate small molecule RPN13 inhibitors with antitumor properties
- Extracting lung function measurements to enhance phenotyping of chronic obstructive pulmonary disease (COPD) in an electronic health record using automated tools
- Multiple fragmented habitat-patch use in an urban breeding passerine, the Short-toed Treecreeper
- Histological and immunohistochemical characterization of the porcine ocular surface
- Household environmental tobacco smoke exposure in healthy young children in Hong Kong: Prevalence and risk factors
- Wind energy development and wildlife conservation in Lithuania: A mapping tool for conflict assessment
- Characteristics and prognosis of primary treatment-naïve oral cavity squamous cell carcinoma in Norway, a descriptive retrospective study
- Effect of epoch length on intensity classification and on accuracy of measurement under controlled conditions on treadmill: Towards a better understanding of accelerometer measurement
- Peer distribution of HIV self-test kits to men who have sex with men to identify undiagnosed HIV infection in Uganda: A pilot study
- Error rates of human reviewers during abstract screening in systematic reviews
- Faecal analyses and alimentary tracers reveal the foraging ecology of two sympatric bats
- Urethral realignment with maximal urethral length and bladder neck preservation in robot-assisted radical prostatectomy: Urinary continence recovery
- Error metrics determination in functionally approximated circuits using SAT solvers
- Spatial movement pattern recognition in soccer based on relative player movements
- A novel visual ranking system based on arterial spin labeling perfusion imaging for evaluating perfusion disturbance in patients with ischemic stroke
- Prospective Validation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score for Necrotizing Fasciitis of the Extremities
- The importance of transporters and cell polarization for the evaluation of human stem cell-derived hepatic cells
- Incidence, trends, and outcomes of infection sites among hospitalizations of sepsis: A nationwide study
- Morphological and functional characteristics of mitral annular calcification and their relationship to stroke
- And the nominees are: Using design-awards datasets to build computational aesthetic evaluation model
- Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review
- Multidimensional Scales of Perceived Self-Efficacy (MSPSE): Measurement invariance across Italian and Colombian adolescents
- Diversity of Mycobacteriaceae from aquatic environment at the São Paulo Zoological Park Foundation in Brazil
- A graph-based algorithm for RNA-seq data normalization
- Parents’ underestimation of their child’s weight status. Moderating factors and change over time: A cross-sectional study
- Pharmacokinetics, absolute bioavailability and tolerability of ketamine after intranasal administration to dexmedetomidine sedated dogs
- Spatial variation in fertilizer prices in Sub-Saharan Africa
- Knowledge, beliefs, and concerns about bone health from a systematic review and metasynthesis of qualitative studies
- Successful isolation of Treponema pallidum strains from patients’ cryopreserved ulcer exudate using the rabbit model
- Effects of size and elasticity on the relation between flow velocity and wall shear stress in side-wall aneurysms: A lattice Boltzmann-based computer simulation study
- Pupil response to noxious corneal stimulation
- Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients
- The impact of computed radiography and teleradiology on patients’ diagnosis and treatment in Mweso, the Democratic Republic of Congo
- Differential effects of synthetic psychoactive cathinones and amphetamine stimulants on the gut microbiome in mice
- Hepatitis B and C virus infection among HIV patients within the public and private healthcare systems in Chile: A cross-sectional serosurvey
- Increased episodes of aspiration on videofluoroscopic swallow study in children with nasogastric tube placement
- Obstructive sleep apnea and hypopnea syndrome in patients admitted in a tertiary hospital in Cameroon: Prevalence and associated factors
- Association of single nucleotide polymorphisms with dyslipidemia in antiretroviral exposed HIV patients in a Ghanaian population: A case-control study
- Sonic Hedgehog upregulation does not enhance the survival and engraftment of stem cell-derived cardiomyocytes in infarcted hearts
- The pharmacokinetic parameters and the effect of a single and repeated doses of memantine on gastric myoelectric activity in experimental pigs
- Blind method for discovering number of clusters in multidimensional datasets by regression on linkage hierarchies generated from random data
- Predictive factors of first dosage intravenous immunoglobulin-related adverse effects in children
- Description and characterization of the artisanal elasmobranch fishery on Guatemala’s Caribbean coast
- Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis
- Effects of rejection intensity and rejection sensitivity on social approach behavior in women
- The impact of IoT security labelling on consumer product choice and willingness to pay
- The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia
- Validity of the French version of the Autonomy Preference Index and its adaptation for patients with advanced cancer
- The epidemiological characteristics and spatio-temporal analysis of childhood hand, foot and mouth disease in Korea, 2011-2017
- Exponential random graph model parameter estimation for very large directed networks
- The implementation of community-based diabetes and hypertension management care program in Indonesia
- Effect of temperature variation on hospital admissions and outcomes in dogs with myxomatous mitral valve disease and new onset pulmonary edema
- The development of the Police Practices Scale: Understanding policing approaches towards street-based female sex workers in a U.S. City
- A capability approach to assess aquaculture sustainability standard compliance
- Pre-collecting lymphatic vessels form detours following obstruction of lymphatic flow and function as collecting lymphatic vessels
- Construct validity and reliability of the Talent Development Environment Questionnaire in Caribbean youth track and field athletes
- Optimization of cytotoxic activity of Nocardia sp culture broths using a design of experiments
- Tissue-resident macrophages can be generated de novo in adult human skin from resident progenitor cells during substance P-mediated neurogenic inflammation ex vivo
- Microbiota in foods from Inuit traditional hunting
- Investigating Italian disinformation spreading on Twitter in the context of 2019 European elections
- In vivo expression of peptidylarginine deiminase in Drosophila melanogaster
- Modelling zero-truncated overdispersed antenatal health care count data of women in Bangladesh
- Detection and density of breeding marsh birds in Iowa wetlands
- A lineage-specific rapid diagnostic test (Chagas Sero K-SeT) identifies Brazilian Trypanosoma cruzi II/V/VI reservoir hosts among diverse mammalian orders
- Aromatase deficiency in hematopoietic cells improves glucose tolerance in male mice through skeletal muscle-specific effects
- If host is refractory, insistent parasite goes berserk: Trypanosomatid Blastocrithidia raabei in the dock bug Coreus marginatus
- Antimicrobial resistance patterns and molecular resistance markers of Campylobacter jejuni isolates from human diarrheal cases
- Protective role of brain derived neurotrophic factor (BDNF) in obstructive sleep apnea syndrome (OSAS) patients
- An IL-18-centered inflammatory network as a biomarker for cerebral white matter injury
- Prevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis
- Chemical analysis of snus products from the United States and northern Europe
- Effect of prednisolone on glyoxalase 1 in an inbred mouse model of aristolochic acid nephropathy using a proteomics method with fluorogenic derivatization-liquid chromatography-tandem mass spectrometry
- Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study
- Aggregation of CAT tails blocks their degradation and causes proteotoxicity in S. cerevisiae
- Expression of concern: Compensatory increase of transglutaminase 2 is responsible for resistance to mTOR inhibitor treatment
- Common mental illness among epilepsy patients in Bahir Dar city, Ethiopia: A cross-sectional study
- Staging dementia based on caregiver reported patient symptoms: Implications from a latent class analysis
- Health-related quality of life and its determinants among ambulatory patients with epilepsy at Ambo General Hospital, Ethiopia: Using WHOQOL-BREF
- In silico analysis and high-risk pathogenic phenotype predictions of non-synonymous single nucleotide polymorphisms in human Crystallin beta A4 gene associated with congenital cataract
- Fungal diversity in canopy soil of silver beech, Nothofagus menziesii (Nothofagaceae)
- Referral decisions and its predictors related to orthopaedic care. A retrospective study in a novel primary care setting
- Readiness to prescribe: Using educational design to untie the Gordian Knot
- Influence of gelation on the retention of purple cactus pear extract in microencapsulated double emulsions
- Factors related to met needs for rehabilitation 6 years after stroke
- Association of cataract and sun exposure in geographically diverse populations of India: The CASE study. First Report of the ICMR-EYE SEE Study Group
- Investigation of injury severity in urban expressway crashes: A case study from Beijing
- Clinical outcomes of incident peritoneal dialysis patients coming from kidney transplantation program: A case-control study
- Evaluation of the factors influencing the housing safety awareness of residents in Shanghai
- Morphometric study of the diaphragmatic surface of the liver in the human fetus
- Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal
- Genetic characterization of Bacillus anthracis strains circulating in Italy from 1972 to 2018
- Promising antifungal activity of new oxadiazole against Candida krusei
- An atlas of personality, emotion and behaviour
- Long-term effects of intracranial islet grafting on cognitive functioning in a rat metabolic model of sporadic Alzheimer's disease-like dementia
- Compartmentalized profiling of amniotic fluid cytokines in women with preterm labor
- Comparison of the myometrial transcriptome from singleton and twin pregnancies by RNA-Seq
- Adverse reproductive effects of S100A9 on bovine sperm and early embryonic development in vitro
- Functional dynamics of bacterial species in the mouse gut microbiome revealed by metagenomic and metatranscriptomic analyses
- Astrocyte senescence promotes glutamate toxicity in cortical neurons
- Primary ciliary dyskinesia and psychological well-being in adolescence
- Dipeptidyl peptidase-4 is increased in the abdominal aortic aneurysm vessel wall and is associated with aneurysm disease processes
- Primary care physician knowledge, attitudes, and diagnostic testing practices for norovirus and acute gastroenteritis
- Microfluidic-prepared DOTAP nanoparticles induce strong T-cell responses in mice
- Intraocular scattering as a predictor of driving performance in older adults with cataracts
- Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors
- Correction: Extraversion personality, perceived health and activity participation among community-dwelling aging adults in Hong Kong
- A rainwater control optimization design approach for airports based on a self-organizing feature map neural network model
- Influence of inflammasome NLRP3, and IL1B and IL2 gene polymorphisms in periodontitis susceptibility
- 18F-FDG-PET/MRI in the diagnostic work-up of limbic encephalitis
- The socioeconomic impact of orthopaedic trauma: A systematic review and meta-analysis
- Treatment patterns among patients with moderate-to-severe ulcerative colitis in the United States and Europe
- City to city learning and knowledge exchange for climate resilience in southern Africa
- Nuclear translocation of Atox1 potentiates activin A-induced cell migration and colony formation in colon cancer
- Activity-dependent switches between dynamic regimes of extracellular matrix expression
- Molecular sequencing and morphological identification reveal similar patterns in native bee communities across public and private grasslands of eastern North Dakota
- A mathematical model for assessing the effectiveness of controlling relapse in Plasmodium vivax malaria endemic in the Republic of Korea
- Cryo-focused ion beam preparation of perovskite based solar cells for atom probe tomography
- Physiological and transcriptomic responses of Lanzhou Lily (Lilium davidii, var. unicolor) to cold stress
- Unusual genome expansion and transcription suppression in ectomycorrhizal Tricholoma matsutake by insertions of transposable elements
- Estimating associations between antidepressant use and incident mild cognitive impairment in older adults with depression
- The use of telephone communication between nurse navigators and their patients
- CNP mediated selective toxicity on melanoma cells is accompanied by mitochondrial dysfunction
- HIV RNA measurement in dried blood spots of HIV-infected patients in Thailand using Abbott m2000 system
- Retraction: Oncogenic Fibulin-5 Promotes Nasopharyngeal Carcinoma Cell Metastasis through the FLJ10540/AKT Pathway and Correlates with Poor Prognosis
- Ultra-rapid cooling of ibex sperm by spheres method does not induce a vitreous extracellular state and increases the membrane damages
- Some animals are more equal than others: Validation of a new scale to measure how attitudes to animals depend on species and human purpose of use
- Observation and quantification of the morphological effect of trypan blue rupturing dead or dying cells
- The visual perception of emotion from masks
- Hexavalent chromium removal and total chromium biosorption from aqueous solution by Quercus crassipes acorn shell in a continuous up-flow fixed-bed column: Influencing parameters, kinetics, and mechanism
- The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study
- Lean back and wait for the alarm? Testing an automated alarm system for nosocomial outbreaks to provide support for infection control professionals
- Regional disparities in health care resources in traditional Chinese medicine county hospitals in China
- Analysis on hydraulic characteristics of improved sandy soil with soft rock
- Development and use of a scale to assess gender differences in appraisal of mistreatment during childbirth among Ethiopian midwifery students
- Factors for starting biosimilar TNF inhibitors in patients with rheumatic diseases in the real world
- Correction: Force field generalization and the internal representation of motor learning
- Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria
- Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)
- Microbiome signatures in neonatal central line associated bloodstream infections
- Interventions for incarcerated adults with opioid use disorder in the United States: A systematic review with a focus on social determinants of health
- Opening gap width influences distal tibial rotation below the osteotomy site following open wedge high tibial osteotomy
- The impact of lowbush blueberry (Vaccinium angustifolium Ait.) and cranberry (Vaccinium macrocarpon Ait.) pollination on honey bee (Apis mellifera L.) colony health status
- Surveys of knowledge and awareness of antibiotic use and antimicrobial resistance in general population: A systematic review
- Managerial capacity among district health managers and its association with district performance: A comparative descriptive study of six districts in the Eastern Region of Ghana
- Knee joint distraction in regular care for treatment of knee osteoarthritis: A comparison with clinical trial data
- Reconstruction of a regulated two-cell metabolic model to study biohydrogen production in a diazotrophic cyanobacterium Anabaena variabilis ATCC 29413
- Cochlear dysfunction is associated with styrene exposure in humans
- Intra-individual variation of particles in exhaled air and of the contents of Surfactant protein A and albumin
- Revisits, readmissions, and outcomes for pediatric traumatic brain injury in California, 2005-2014
- Enhanced handover mechanism using mobility prediction in wireless networks
- Association between regular exercise and asthma control among adults: The population-based Northern Finnish Asthma Study
- Pharyngeal microbiome alterations during Neisseria gonorrhoeae infection
- Assessment of the clinical utility of four NGS panels in myeloid malignancies. Suggestions for NGS panel choice or design
- Assessment of time management practice and associated factors among primary hospitals employees in north Gondar, northwest Ethiopia
- Genetic diversity and population structure of feral rapeseed (Brassica napus L.) in Japan
- Are the current gRNA ranking prediction algorithms useful for genome editing in plants?
- Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain
- Heterogeneity in the distribution of 159 drug-response related SNPs in world populations and their genetic relatedness
- Metabolic and lipidomic profiling of steatotic human livers during ex situ normothermic machine perfusion guides resuscitation strategies
- Investigating cumulative effects of pre-performance routine interventions in beach volleyball serving
- Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: A simulated client method
- MicroRNA expression and DNA methylation profiles do not distinguish between primary and recurrent well-differentiated liposarcoma
- Assessment of acyl-CoA cholesterol acyltransferase (ACAT-1) role in ovarian cancer progression—An in vitro study
- Cytoplasmic factories, virus assembly, and DNA replication kinetics collectively constrain the formation of poxvirus recombinants
- The wavelet power spectrum of perfusion weighted MRI correlates with tumor vascularity in biopsy-proven glioblastoma samples
- Agreement between cardiovascular disease risk assessment tools: An application to the United Arab Emirates population
- Constructing HLM to examine multi-level poverty-contributing factors of farmer households: Why and how?
- Patterns of symptoms possibly indicative of cancer and associated help-seeking behaviour in a large sample of United Kingdom residents—The USEFUL study
- An automated alarm system for food safety by using electronic invoices
- Neural effects of acute stress on appetite: A magnetoencephalography study
- Use of magnetic resonance imaging to determine laterality of meniscal size in healthy volunteers
- Co-prevalence of extracranial carotid aneurysms differs between European intracranial aneurysm cohorts
- Thermal biology of two tropical lizards from the Ecuadorian Andes and their vulnerability to climate change
- When weight is an encumbrance; avoidance of stairs by different demographic groups
- Non-mycosis fungoides cutaneous lymphomas in a referral center in Taiwan: A retrospective case series and literature review
- From the host's point of view: Effects of variation in burying beetle brood care and brood size on the interaction with parasitic mites
- Kernel-based Gaussian process for anomaly detection in sparse gamma-ray data
- Unmet care needs of children with ADHD
- Accelerometer-assessed outdoor physical activity is associated with meteorological conditions among older adults: Cross-sectional results from the OUTDOOR ACTIVE study
- Identification of Korean cancer survivors’ unmet needs and desired psychosocial assistance: A focus group study
- Evaluation of inactivated Bordetella pertussis as a delivery system for the immunization of mice with Pneumococcal Surface Antigen A
- The role of moral reasoning & personality in explaining lyrical preferences
- Would you like to participate in this trial? The practice of informed consent in intrapartum research in the last 30 years
- Correction: Mutation spectrums of TSC1 and TSC2 in Chinese women with lymphangioleiomyomatosis (LAM)
- Forward lunge before and after anterior cruciate ligament reconstruction: Faster movement but unchanged knee joint biomechanics
- Challenges associated with homologous directed repair using CRISPR-Cas9 and TALEN to edit the DMD genetic mutation in canine Duchenne muscular dystrophy
- Integrated targeted serum metabolomic profile and its association with gender, age, disease severity, and pattern identification in acne
- A prospective case-control study on miRNA circulating levels in subjects born small for gestational age (SGA) evaluated from childhood into young adulthood
- Polymer-fiber-coupled field-effect sensors for label-free deep brain recordings
- Global depth perception alters local timing sensitivity
- How to detect a polytrauma patient at risk of complications: A validation and database analysis of four published scales
- Module for SWC neuron morphology file validation and correction enabled for high throughput batch processing
- Reduced gray matter volume and cortical thickness associated with traffic-related air pollution in a longitudinally studied pediatric cohort
- Recombinant human soluble thrombomodulin is associated with attenuation of sepsis-induced renal impairment by inhibition of extracellular histone release
- Human and climatic drivers affect spatial fishing patterns in a multiple-use marine protected area: The Galapagos Marine Reserve
- Correction: Leisure-time physical activity and sports in the Brazilian population: A social disparity analysis
- Application of the mixture item response theory model to the Self-Administered Food Security Survey Module for Children
- Numerical simulation of atmospheric CO2 concentration and flux over the Korean Peninsula using WRF-VPRM model during Korus-AQ 2016 campaign
- Feline irradiated diet-induced demyelination; a model of the neuropathology of sub-acute combined degeneration?
- Improved multi-parametric prediction of tissue outcome in acute ischemic stroke patients using spatial features
- Genome-wide association and epistatic interactions of flowering time in soybean cultivar
- Correction: Association between workplace bullying and burnout, professional quality of life, and turnover intention among clinical nurses
- Correction: Estimation of membrane bending modulus of stiffness tuned human red blood cells from micropore filtration studies
- Correction: Limited indirect effects of an infant pneumococcal vaccination program in an aging population
- Correction: Targeting of the Plzf Gene in the Rat by Transcription Activator-Like Effector Nuclease Results in Caudal Regression Syndrome in Spontaneously Hypertensive Rats
- Fieldwork-based determination of design priorities for point-of-use drinking water quality sensors for use in resource-limited environments
- Young women’s reproductive health conversations: Roles of maternal figures and clinical practices
- Correction: Differential recordings of local field potential: A genuine tool to quantify functional connectivity
- Survival of medial versus lateral unicompartmental knee arthroplasty: A meta-analysis
- Novel MscL agonists that allow multiple antibiotics cytoplasmic access activate the channel through a common binding site
- Is it time to stop sweeping data cleaning under the carpet? A novel algorithm for outlier management in growth data
- Changes in oak (Quercus robur) photosynthesis after winter moth (Operophtera brumata) herbivory are not explained by changes in chemical or structural leaf traits
- Mutual interaction between motor cortex activation and pain in fibromyalgia: EEG-fNIRS study
- Evaluation of liposomal ciprofloxacin formulations in a murine model of anthrax
- Analysis of cholesterol in mouse brain by HPLC with UV detection
- Sugar, amino acid and inorganic ion profiling of the honeydew from different hemipteran species feeding on Abies alba and Picea abies
- Exploring prior diseases associated with incident late-onset Alzheimer’s disease dementia
- Hypertension prevalence in patients attending tertiary pain management services, a registry-based Australian cohort study
- SRL pathogenicity island contributes to the metabolism of D-aspartate via an aspartate racemase in Shigella flexneri YSH6000
- Correction: Comprehensive genome-wide analysis of the pear (Pyrus bretschneideri) laccase gene (PbLAC) family and functional identification of PbLAC1 involved in lignin biosynthesis
- Epilepsy in a melanocyte-lineage mTOR hyperactivation mouse model: A novel epilepsy model
- Water consumption and prevalence of irritable bowel syndrome among adults
- Mixed evidence for the relationship between periodontitis and Alzheimer’s disease: A bidirectional Mendelian randomization study
- Correction: Health conditions associated with overweight in climacteric women
- Correction: Determining Glomerular Filtration Rate in Homozygous Sickle Cell Disease: Utility of Serum Creatinine Based Estimating Equations
- Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance
- Correction: Cumulative viral load as a predictor of CD4+ T-cell response to antiretroviral therapy using Bayesian statistical models
- Dominant negative effects by inactive Spa47 mutants inhibit T3SS function and Shigella virulence
- ICOS-deficient and ICOS YF mutant mice fail to control Toxoplasma gondii infection of the brain
- Diel patterns in swimming behavior of a vertically migrating deepwater shark, the bluntnose sixgill (Hexanchus griseus)
- Life history of northern Gulf of Mexico Warsaw grouper Hyporthodus nigritus inferred from otolith radiocarbon analysis
- Physiology education for intensive care medicine residents: A 15-minute interactive peer-led flipped classroom session
- Strengthening capacity for natural sciences research: A qualitative assessment to identify good practices, capacity gaps and investment priorities in African research institutions
- Systematic scoping review of the concept of ‘genetic identity’ and its relevance for germline modification
- Height of overburden fracture based on key strata theory in longwall face
- Laboratory strains of Bacillus anthracis lose their ability to rapidly grow and sporulate compared to wildlife outbreak strains
- Improvement of classification performance of Parkinson’s disease using shape features for machine learning on dopamine transporter single photon emission computed tomography
- Comparative pharmacokinetics and pharmacodynamics of the advanced Retinol-Binding Protein 4 antagonist in dog and cynomolgus monkey
- Correction: A handy method to remove bacterial contamination from fungal cultures
- Correction: Effect of statin on life prognosis in Japanese patients undergoing hemodialysis
- Retraction: Outer Membrane Protein A (OmpA) of Shigella flexneri 2a Induces TLR2-Mediated Activation of B Cells: Involvement of Protein Tyrosine Kinase, ERK and NF-κB
- Retraction: Biofabrication of streptomycin-conjugated calcium phosphate nanoparticles using red ginseng extract and investigation of their antibacterial potential
- Receiver operating characteristic curve analysis of clinical signs for screening of convergence insufficiency in young adults
- Correction: Drivers of deforestation in the basin of the Usumacinta River: Inference on process from pattern analysis using generalised additive models
- Efficacy of fertilizing method for different potash sources in cotton (Gossypium hirsutum L.) nutrition under arid climatic conditions
- Podocyte autophagy is associated with foot process effacement and proteinuria in patients with minimal change nephrotic syndrome
- Effect of Lactobacillus acidophilus D2/CSL (CECT 4529) supplementation in drinking water on chicken crop and caeca microbiome
- Retraction: MiR-30a-5p Antisense Oligonucleotide Suppresses Glioma Cell Growth by Targeting SEPT7
- Correction: Dynamics of plasma micronutrient concentrations and their correlation with serum proteins and thyroid hormones in patients with paracoccidioidomycosis
- Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population
- Correction: Prevalence of damaged and missing teeth among women in the southern plains of Nepal: Findings of a simplified assessment tool
- Correction: Tissue-Specific Expressed Antibody Variable Gene Repertoires
- Retraction: Immunoglobulin G Expression in Lung Cancer and Its Effects on Metastasis
- Correction: Causal knowledge promotes behavioral self-regulation: An example using climate change dynamics
- Retraction: Use of Granulocyte Colony-Stimulating Factor for the Treatment of Thin Endometrium in Experimental Rats
- Correction: Dynamic mechanical and nanofibrous topological combinatory cues designed for periodontal ligament engineering
- Correction: Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya
- From seed to flour: Sowing sustainability in the use of cantaloupe melon residue (Cucumis melo L. var. reticulatus)
- Core Scientific Dataset Model: A lightweight and portable model and file format for multi-dimensional scientific data
- Accounting for measurement error to assess the effect of air pollution on omic signals
- Leucine zipper transcription factor-like 1 binds adaptor protein complex-1 and 2 and participates in trafficking of transferrin receptor 1
- Barriers for tuberculosis case finding in Southwest Ethiopia: A qualitative study
- Genetic predisposition to celiac disease in Kazakhstan: Potential impact on the clinical practice in Central Asia
- A lower psoas muscle volume was associated with a higher rate of recurrence in male clear cell renal cell carcinoma
- Two angles of overqualification-the deviant behavior and creative performance: The role of career and survival job
- Cost-utility analysis of de-escalating biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis
- Efficient estimation of stereo thresholds: What slope should be assumed for the psychometric function?
- Learning efficient haptic shape exploration with a rigid tactile sensor array
- Effects of dietary supplementation with a microalga (Schizochytrium sp.) on the hemato-immunological, and intestinal histological parameters and gut microbiota of Nile tilapia in net cages
- Regional versus local wind speed and direction at a narrow beach with a high and steep foredune
- Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity
- Severe thiamine deficiency in eastern Baltic cod (Gadus morhua)
- Transfer entropy as a variable selection methodology of cryptocurrencies in the framework of a high dimensional predictive model
- Psychometric validation of Czech version of the Sport Motivation Scale
- Correction: Multiple innate antibacterial immune defense elements are correlated in diverse ungulate species
- Recognition of personality disorder and anxiety disorder comorbidity in patients treated for depression in secondary psychiatric care
- Correction: Strategies for achieving high sequencing accuracy for low diversity samples and avoiding sample bleeding using illumina platform
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- Chemical analysis of snus products from the United States and northern Europe
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- Effect of Lactobacillus acidophilus D2/CSL (CECT 4529) supplementation in drinking water on chicken crop and caeca microbiome
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