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Globally, major efforts are being made to restore peatlands to maximise their resilience to anthropogenic climate change, which puts continuous pressure on peatland ecosystems and modifies the geography of the environmental envelope that underpins peatland functioning. A probable effect of climate change is reduction in the waterlogged conditions that are key to peatland formation and continued accumulation of carbon (C) in peat. C sequestration in peatlands arises from a delicate imbalance between primary production and decomposition, and microbial processes are potentially pivotal in regulating feedbacks between environmental change and the peatland C cycle. Increased soil temperature, caused by climate warming or disturbance of the natural vegetation cover and drainage, may result in reductions of long-term C storage via changes in microbial community composition and metabolic rates. Moreover, changes in water table depth alter the redox state and hence have broad consequences for microbial functions, including effects on fungal and bacterial communities especially methanogens and methanotrophs. This article is a perspective review of the effects of climate change and ecosystem restoration on peatland microbial communities and the implications for C sequestration and climate regulation. It is authored by peatland scientists, microbial ecologists, land managers and non-governmental organisations who were attendees at a series of three workshops held at The University of Manchester (UK) in 2019–2020. Our review suggests that the increase in methane flux sometimes observed when water tables are restored is predicated on the availability of labile carbon from vegetation and the absence of alternative terminal electron acceptors. Peatland microbial communities respond relatively rapidly to shifts in vegetation induced by climate change and subsequent changes in the quantity and quality of below-ground C substrate inputs. Other consequences of climate change that affect peatland microbial communities and C cycling include alterations in snow cover and permafrost thaw. In the face of rapid climate change, restoration of a resilient microbiome is essential to sustaining the climate regulation functions of peatland systems. Technological developments enabling faster characterisation of microbial communities and functions support progress towards this goal, which will require a strongly interdisciplinary approach.

BackgroundOvercoming gender inequities is a global priority recognized as essential for improved health and human development. Gender-based violence (GBV) is an extreme manifestation of gender inequities enacted in real-world and internet-based environments. In Nigeria, GBV has come to the forefront of attention since 2020, when a state of emergency was declared due to increased reporting of sexual violence. Understanding GBV-related social narratives is important to design public health interventions. ObjectiveWe explore how gender-related internet-based conversations in Nigeria specifically related to sexual consent (actively agreeing to sexual behavior), lack of consent, and slut-shaming (stigmatization in the form of insults based on actual or perceived sexuality and behaviors) manifest themselves and whether they changed between 2017 and 2022. Additionally, we explore what role events or social movements have in shaping gender-related narratives in Nigeria. MethodsSocial listening was carried out on 12,031 social media posts (Twitter, Facebook, forums, and blogs) and almost 2 million public searches (Google and Yahoo search engines) between April 2017 and May 2022. The data were analyzed using natural language processing to determine the most salient conversation thematic clusters, qualitatively analyze time trends in discourse, and compare data against selected key events. ResultsBetween 2017 and 2022, internet-based conversation about sexual consent increased 72,633%, from an average 3 to 2182 posts per month, while slut-shaming conversation (perpetrating or condemning) shrunk by 9%, from an average 3560 to 3253 posts per month. Thematic analysis shows conversation revolves around the objectification of women, poor comprehension of elements of sexual consent, and advocacy for public education about sexual consent. Additionally, posters created space for sexual empowerment and expressions of sex positivity, pushing back against others who weaponize posts in support of slut-shaming narrative. Time trend analysis shows a greater sense of empowerment in advocating for education around the legal age of consent for sexual activity, calling out double standards, and rejecting slut-shaming. However, analysis of emotions in social media posts shows anger was most prominent in sexual consent (n=1213, 73%) and slut-shaming (n=226, 64%) posts. Organic social movements and key events (#ArewaMeToo and #ChurchToo, the #SexforGrades scandal, and the #BBNaija television program) played a notable role in sparking discourse related to sexual consent and slut-shaming. ConclusionsSocial media narratives are significantly impacted by popular culture events, mass media programs, social movements, and micro influencers speaking out against GBV. Hashtags, media clips, and other content can be leveraged effectively to spread awareness and spark conversation around evolving gender norms. Public health practitioners and other stakeholders including policymakers, researchers, and social advocates should be prepared to capitalize on social media events and discourse to help shape the conversation in support of a normative environment that rejects GBV in all its forms.

Summary: Background: Hepatic steatosis (HS) identified on CT may provide an integrated cardiometabolic and COVID-19 risk assessment. This study presents a deep-learning-based hepatic fat assessment (DeHFt) pipeline for (a) more standardised measurements and (b) investigating the association between HS (liver-to-spleen attenuation ratio

BackgroundBetween 2014 and 2018, the penetration of smartphones in sub-Saharan Africa increased from 10% to 30%, enabling increased access to the internet, Facebook, Twitter, Pinterest, and YouTube. These platforms engage users in multidirectional communication and provide public health programs with the tools to inform and engage diverse audiences on a range of public health issues, as well as monitor opinions and behaviors on health topics. ObjectiveThis paper details the process used by the U.S. Agency for International Development–funded Breakthrough RESEARCH to apply social media monitoring and social listening techniques in Burkina Faso, Côte d’Ivoire, Niger, and Togo for the adaptive management of the Merci Mon Héros campaign. We documented how these approaches were applied and how the lessons learned can be used to support future public health communication campaigns. MethodsThe process involved 6 steps: (1) ensure there is a sufficient volume of topic-specific web-based conversation in the target countries; (2) develop measures to monitor the campaign’s social media strategy; (3) identify search terms to assess campaign and related conversations; (4) quantitatively assess campaign audience demographics, campaign reach, and engagement through social media monitoring; (5) qualitatively assess audience attitudes, opinions, and behaviors and understand conversation context through social media listening; and (6) adapt campaign content and approach based on the analysis of social media data. ResultsWe analyzed posts across social media platforms from November 2019 to October 2020 based on identified key search terms related to family planning, reproductive health, menstruation, sexual activity, and gender. Based on the quantitative and qualitative assessments in steps 4 and 5, there were several adaptive shifts in the campaign’s content and approach, of which the following 3 shifts are highlighted. (1) Social media monitoring identified that the Facebook campaign fans were primarily male, which prompted the campaign to target calls to action to the male audience already following the campaign and shift marketing approaches to increase the proportion of female followers. (2) Shorter videos had a higher chance of being viewed in their entirety. In response to this, the campaign shortened video lengths and created screenshot teasers to promote videos. (3) The most negative sentiment related to the campaign videos was associated with beliefs against premarital sex. In response to this finding, the campaign included videos and Facebook Live sessions with religious leaders who promoted talking openly with young people to support intergenerational discussion about reproductive health. ConclusionsPrior to launching health campaigns, programs should test the most relevant social media platforms and their limitations. Inherent biases to internet and social media access are important challenges, and ethical considerations around data privacy must continue to guide the advances in this technology’s use for research. However, social listening and social media monitoring can be powerful monitoring and evaluation tools that can be used to aid the adaptive management of health campaigns that engage populations who have a digital presence.

Abstract Increasing dominance by purple moor grass, Molinia caerulea (‘Molinia’) on globally rare and protected blanket bogs of the United Kingdom and the South Pennines is a growing threat to diversity and carbon storage, as well as increasing the risk of wildfire. In a trial to increase diversity using Sphagnum plugs planted on three Molinia‐dominated sites in the South Pennines, an initial rapid increase in cover of plug‐derived Sphagnum (PDS) suggested an advantage over that of naturally occurring Sphagnum colonies, the latter remaining below 1% cover throughout; subsequent plateauing of PDS cover in areas of moderate Molinia cover (80%) suggested additional competition for light. The cover of Molinia was only weakly reduced by, and then completely recovered from, a baseline flailing treatment. Increasing cover of PDS in all of the treatments had no clear effect on the cover of Molinia. The cover of naturally occurring indicator species was strongly reduced by the baseline flailing treatment; subsequent recovery was not complete, even with contributions by PDS. There was a negative linear relationship between Molinia cover and indicator species cover, over all ranges of Molinia cover. Water table depths were lowered by PDS during the first 3 years of the trial, perhaps due to facilitated capillary conduction of water through the buried plug tissues. It was concluded that PDS can establish rapidly amongst Molinia, boosting the diversity and cover of indicator species, but that establishment is slower in areas of dense Molinia and also likely to be hampered by periods of severe drought stress. Prior flailing had no clear benefit on the growth of PDS but reduced the cover of naturally occurring indicator species. Further investigations should include the role of water stress, shading and phosphorus limitation in restricting the growth of PDS within Molinia‐dominated swards.

BackgroundContinuous positive airway pressure (CPAP) ventilation may be used as a potential bridge to invasive mechanical ventilation (IMV), or as a ceiling-of-care for persistent hypoxaemia despite standard oxygen therapy, according to UK guidelines. We examined the association of mode of respiratory support and ceiling-of-care on mortality.MethodsWe conducted a retrospective cohort analysis of routinely collected de-identified data of adults with nasal/throat SARs-CoV-2 swab-positive results, at the Calderdale and Huddersfield NHS Foundation Trust between 10th March-19th April 2020 (outcomes determined on 22nd May).FindingsOf 347 patients with SARs-CoV-2 swab-positive results, 294 (84.7%) patients admitted for Covid-19 were included in the study. Sixty-nine patients were trialled on CPAP, mostly delivered by face mask, either as an early ceiling of care instituted within 24 hours of admission (N = 19), or as a potential bridge to IMV (N = 44). Patients receiving a ceiling of care more than 24 hours after admission (N = 6) were excluded from the analysis. Two hundred and fifteen patients (73.1%) maximally received air/standard oxygen therapy, and 45 (15.3%) patients maximally received CPAP. Thirty-four patients (11.6%) required IMV, of which 24 had received prior CPAP. There were 138 patients with an early ceiling-of-care plan (pre-admission/within 24h). Overall, 103(35.0%) patients died and 191(65.0%) were alive at study end. Among all patients trialled on CPAP either as a potential bridge to IMV (N = 44) or as a ceiling-of-care (N = 19) mortality was 25% and 84%, respectively. Overall, there was strong evidence for higher mortality among patients who required CPAP or IMV, compared to those who required only air/oxygen (aOR 5.24 95%CI: 1.38, 19.81 and aOR 46.47 95%CI: 7.52, 287.08, respectively; pConclusionOur data suggest that among patients with no ceiling-of-care, an initial trial of CPAP as a potential bridge to IMV offers a favourable therapeutic alternative to early intubation. In contrast, among patients with a ceiling-of care, CPAP seems to offer little additional survival benefit beyond oxygen therapy alone. Information on ceilings of respiratory support is vital to interpreting mortality from Covid-19.Strengths and limitations of this studySample size relatively small.Study sample representative of hospitalised Covid-19 patients in UK.Previously unreported data on role of ceilings-of-care in hospitalised Covid-19 patients.Novel data on use of CPAP separated by indication.

Over the past 15 years there has been a proliferation of projects aiming to restore the structure and function of UK upland blanket mires, primarily by revegetation of bare peat and the blocking of erosion gullies. These restoration measures have potential to alter stormflow responses and contribute to Natural Flood Management, but their impacts on storm hydrographs are poorly quantified. This paper reports a before-after-control-intervention (BACI) study from three experimental headwater micro-catchments in the South Pennines (UK) representing the first rigorous experimental assessment of the impact of blanket peat restoration on catchment runoff. We evaluate the hydrological impacts of two standard restoration interventions; revegetation of bare peat, and revegetation of bare peat with additional gully blocking. Following revegetation there was a significant decrease in depth to water table and an increase in the prevalence of hillslope overland flow production. There were no significant changes in storm runoff coefficient following either restoration treatment. Storm hydrographs following revegetation had significantly longer lag times (106% increase relative to the control), reduced peak flows (27% decrease relative to the control), and attenuated hydrograph shapes. With the addition of gully blocking the effect is almost doubled. Lag times increased by a further 94% and peak flows reduced by an additional 24% relative to the control. We argue that the primary process controlling the observed changes in storm hydrograph behaviour is retardation of overland stormflow due to increased surface roughness. The significant changes to lag times and peak flow provide evidence that the restoration of degraded headwater peatlands can contribute to Natural Flood Management and the reduction of downstream flood risk, subject to wider catchment scale effects and sub-catchment storm hydrograph synchronicity. Keywords: Flood risk management, Natural flood management, Re-vegetation, Gully blocking, Water tables, Peatland hydrology

The assassination of a priest called Giulio Cazzari in Venice in 1622 is described. The distance between the experience of death and representation of death is confronted and possible connection between understanding of death and time is explored.