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River-mouth systems and deltas are hotspots where many of the coastal syndromes can be found. Moreover, these systems provide essential ecosystem services (e.g., recreation, food provisioning, protection against natural hazards). The present study focuses on the socio-ecological system at the delta of the Magdalena River in the central Caribbean Region in Colombia. This research seeks to assess the multidimensional sustainability of the Magdalena river-mouth system (MRm-SES) to improve the knowledge basis for its integrated management. To do so, an assessment tool named "Circles of Coastal Sustainability" (CCS) was used to evaluate the system splitting it into four domains (environmental, social, economic and governance) that were divided into 5 categories each. These domains were evaluated through a total of 52 indicators distributed like this: 16 for the Environmental domain, 16 for the Economic domain, 12 for the Social and Cultural domain and, 8 for the Governance domain. The results show that the overall sustainability of the MRm-SES is classified as "Satisfactory." None of the domains is in "Excellent" or "Bad" conditions. However, the evaluation of the categories shows that four (4) of them have "Poor" conditions (i.e., Social Benefits, Demographics, Economic Security, and Resources Management). Hence, it is recommended to put those categories at the centre of the discussion to define management strategies (e.g., Preserving and restoring habitats; tackling sources of pollution and excessive sediment; local reduction of net Greenhouse Gas and adaptation to climate change; participation of local communities in the management design and implementation), without disregarding the interrelation with the other categories and dimensions. Finally, it is argued that despite all the improvement opportunities, the CCS is a valuable tool to evaluate and communicate with different stakeholders (academic community, managers and decision-makers, local communities, etc.), to improve the sustainability of coastal systems in Colombia and the world. European Commission Joint Research Centre586596-EPP-1-2017-1-IT-EPPKA1-JMD-MOB, Fundação para a Ciência e a Tecnologia (FCT) LA/P/0069/2020, info:eu-repo/semantics/publishedVersion

Peer reviewed: True, Acknowledgements: We thank all the hospital staff and research teams who helped conduct this trial (for a complete list, see the online supplemental appendix), all the families who agreed to participate; Dr Shobha Cherian, consultant neonatologist and principal investigator at University Hospital of Wales, Cardiff, and Anna Hendrickson, research nurse at St. Mary’s Hospital, Manchester, both of whom died in 2015 and 2016, respectively, for their valued contributions to and enthusiasm in the success of the trial; the National Health Service Blood and Transplant Clinical Trials Unit team, including Anna Sidders and Heather Smethurst (trial coordinators), Nikki Dallas (database manager), Louise Choo, Brennan Kahan, Helen Thomas, Laura Pankhurst and Agne Zarankaite (trial statisticians), and Colin Morley, Sandy Calvert and Anthony Emmerson (trial steering committee) for their support; and Adrian Newland, Henry Halliday, Paul White, Gavin Murphy, Michael Greaves, Keith Wheatley and Marc Turner (the data and safety monitoring committee)., Funder: National Institute for Health Research; FundRef: http://dx.doi.org/10.13039/501100000272, Funder: Addenbrooke's Charitable Trust, Cambridge University Hospitals; FundRef: http://dx.doi.org/10.13039/501100002927, OBJECTIVE: Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one. DESIGN: Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group. SETTING: 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland. PATIENTS: 660 infants born at less than 34 weeks' gestation with platelet counts less than 50×109/L. INTERVENTIONS: Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group). MAIN OUTCOMES MEASURES: Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age. RESULTS: Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017). CONCLUSIONS: Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. TRIAL REGISTRATION NUMBER: ISRCTN87736839.

Half the population of China live in coastal zones where 70% of large cities are also located. Intensive human activities pose significant environmental and ecological hazards to these cities that are already vulnerable to natural hazards and climate change. The sustainable development of coastal cities is thus both a national and international issue. Rongcheng is a typical coastal city in east China. It is a national marine ranch demonstration area that is subjected to multi-stressors from human activities and climate change. The dominant economic sectors include aquaculture and fisheries, agriculture, shipping and tourism. A multitude of resulting pressures come mainly from intensified human activities, such as intensive aquaculture, overfishing, industrial pollutants, agricultural runoff, land reclamation and port expansion. In addition, Rongcheng is also facing exogenic pressures from extreme climate events such as intensified storms, storm surges, droughts and sea ice. A growing awareness of these problems brought together a trans-disciplinary group from local government, research institutions, local practitioners and coastal representatives to jointly explore and co-design adaptive coastal management options. In this transdisciplinary study, a social-ecological analysis based on a combination of the Systems Approach Framework and the Drivers-Pressures-States-Impacts-Responses framework was used to analyze and formulate an adaptive management plan for the sustainability of Rongcheng. More than 40 stakeholders including government, companies, civil society and institutions participated in the study through questionnaires and on-site meetings. A statistical analysis of the results identified urgent issues impeding the sustainable development of Rongcheng. The issues identified were poorly regulated aquaculture, loss of shoreline, and the decline of seagrass and cultural heritage.The study identified management options and measures, some of which were adopted by the local government in a co-designed management plan. The measures included upgrading of aquaculture industry, habitat conservation and restoration, and the development of cultural tourism. Another outcome was the increased knowledge exchange between stakeholders to inform management, policy, and decision making, as well as raised awareness of vulnerability to natural hazards and climate change. The success of this case study provides a reference for the adaptive management of other coastal cities and their sustainable development in a changing climate. info:eu-repo/semantics/publishedVersion

Additional file 1: Appendix 1. Additional information on the GENIE™ intervention (taken from James E, Kennedy A, Vassilev I, Ellis J, Rogers A. Mediating engagement in a social network intervention for people living with a long-term condition: A qualitative study of the role of facilitation. Health Expect. 2020;23(3):681-690. doi:10.1111/hex.13048).

Additional file 2: Appendix 2. Example interview questions.

Letter to the Editor

In this study, Algal Pigment Index 2 (API2) is investigated in Sagres, an area located in the Atlantic off the southwestern Iberian Peninsula. Standard results provided by MEdium Resolution Image Spectrometer (MERIS) ocean color sensor were compared with alternative data products, determined through a regional inversion scheme, using both MERIS and in situ remote sensing reflectances (Rrs) as input data. The reference quantity for performance assessment is in situ total chlorophyll a (TChla) concentration estimated through phytoplankton absorption coefficient (i.e., equivalent to API2). Additional comparison of data products has also been addressed to TChlaconcentration determined by High Performance Liquid Chromatography. The MERIS matchup analysis revealed a systematic underestimation of TChla, which was confirmed with an independent comparison of product maps analysis. The study demonstrates the importance of regional algorithms for the study area that could complement upcoming standard results of the present Sentinel-3/OLCI space mission.

The Mediterranean region is of fundamental importance to Europe given its strategic position. The responsibility for its overall ecosystem integrity is shared by European Union Member States (EU-MS) and other Mediterranean countries. A juxtaposition of overlapping governance instruments occurred recently in the region, with the implementation of both the Marine Strategy Framework Directive (MSFD) for EU-MS and the Ecosystem Approach Strategy (ECAP) for all Mediterranean countries, including EU-MS. Both MSFD and ECAP are structured around vision-driven processes to achieve Good Environmental Status and a Healthy Environment, respectively. These processes have clear ecosystem-based, integrated policy objectives to guarantee the preservation and integrity of Mediterranean marine ecosystem goods and services. However, adoption of these instruments, especially those related to the new EUMS directives on marine policy, could result in a governance gap in addition to the well-known economic gap between the EU and the non-EU political blocs. We identify two complementary requirements for effective implementation of both MSFD and ECAP that could work together to reduce this gap, to ensure a better alignment between MSFD and ECAP and better planning for stakeholder engagement. These are key issues for the future success of these instruments in a Mediterranean region where discrepancies between societal and ecological objectives may pose a challenge to these processes.

Upwelling events off the Southwest coast of Portugal can trigger phytoplankton blooms that are important for the fisheries and aquaculture sectors in this region. However, climate change scenarios forecast fluctuations in the intensity and frequency of upwelling events, thereby potentially impacting these sectors. Shifts in the phytoplankton community were analysed from the end of 2008 until the beginning of 2012 by examining the bio-optical properties of the water column, namely the absorption coefficients for phytoplankton, non-algal particles and coloured dissolved organic matter (CDOM). The phytoplankton community was assessed by microscopy, with counts from an inverted microscope, and by chemotaxonomic methodologies, using pigment concentrations determined by High-Performance Liquid Chromatography (HPLC). Results both from microscopy and from chemotaxonomic methods showed a shift from diatom dominance related to bloom conditions matching upwelling events, to small flagellate dominance related to no-bloom conditions matching relaxation of upwelling. During bloom conditions, light absorption from phytoplankton increased markedly, while non-algal particles and CDOM absorption remained relatively constant. The dynamics of CDOM in the study area was attributed to coastal influences rather than from phytoplankton origin. Changes in phytoplankton biomass and consequent alterations in phytoplankton absorption coefficients were attributed to upwelling regimes in the area. Bio-optical parameters can contribute to environmental monitoring of coastal and oceanic waters, which in the case of the European Union, involves the implementation of the Water Framework, Marine Strategy Framework and Marine Spatial Planning Directives.

This study relates sea surface temperature (SST) to the upwelling conditions off the southwest coast of Portugal using statistical analyses of publically available data. Optimum Interpolation (OI) of daily SST data were extracted from the United States (US) National Oceanic and Atmospheric Administration (NOAA) and data for wind speed and direction were from the US National Climatic Data Center. Time series were extracted at a daily frequency for a time horizon of 26 years. Upwelling indices were estimated using westerly (Qx) and southerly (Qy) Ekman transport components. In the first part of the study, time series were inspected for trend and seasonality over the whole period. The seasonally adjusted time series revealed an increasing slope for SST (0.15 °C per decade) and decreasing slopes for Qx (− 84.01 m3 s− 1 km− 1 per decade) and Qy (− 25.20 m3 s− 1 km− 1 per decade), over the time horizon. Structural breaks analysis applied to the time series showed that a statistically significant incremental increase in SST was more pronounced during the last decade. Cross-correlation between upwelling indices and SST revealed a time delay of 5 and 2 days between Qx and SST, and between Qy and SST, respectively. A spectral analysis combined with the previous analysis enabled the identification of four oceanographic seasons. Those seasons were later recognised over a restricted time period of 4 years, between 2008 and 2012, when there was an extensive sampling programme for the validation of ocean colour remote sensing imagery. The seasons were defined as: summer, with intense and regular events of upwelling; autumn, indicating relaxation of upwelling conditions; and spring and winter, showing high interannual variability in terms of number and intensity of upwelling events.