Spectrum of cardiac disease in maternity in a low-resource cohort in South Africa

Background: Lack of evidence-based data on the spectrum of cardiovascular disease (CVD) in pregnancy or in the postpartum period, as well as on maternal and fetal outcome, provides challenges for treating physicians, particularly in areas of low resources. The objectives of this study were to investigate the spectrum of disease, mode of presentation and maternal and fetal outcome of patients referred to a dedicated Cardiac Disease and Maternity Clinic (CDM). Methods: The prospective cohort study was conducted at a single tertiary care centre in South Africa. Two hundred and twenty-five women presenting with CVD in pregnancy, or within 6 months postpartum, were studied over a period of 2 years. Clinical assessment, echocardiography and laboratory tests were performed at baseline and follow-up visits. Prepartum, peripartum and postpartum complications were grouped into cardiac, neonatal and obstetric events. Results: Ethnicity was black African (45%), mixed ethnicity (32%), white (15%), Indian/others (8%) and 12% were HIV positive. Of the 225 consecutive women (mean age 28.8±6.4), 196 (86.7%) presented prepartum and 73 in modified WHO class I. The 152 women presenting in a higher risk group (modified WHO class II-IV) were offered close follow-up at the CDM clinic and were diagnosed with congenital heart disease (32%, 15 operated previously), valvular heart disease (26%, 15 operated previously), cardiomyopathy (27%) and other (15%). Women presenting with symptoms of CVD or heart failure postpartum (n=30) presented in a higher New York Heart Association, had higher heart rates (p42 days postpartum. Perinatal death occurred in 1/152 (0.7%) - translating to a perinatal mortality rate of 7/1000 live births. Conclusions: Disease patterns were markedly different to that seen in the developed world. However, joint obstetric-cardiac care in the low-resource cohort was associated with excellent survival outcome rates of pregnant mothers (even with complex diseases) and their offspring and was similar to that seen in the western world. Mortality typically occurred in the postpartum period, beyond the standard date of recording maternal death

Political transition and emergent forest-conservation issues in Myanmar.

Political and economic transitions have had substantial impacts on forest conservation. Where transitions are underway or anticipated, historical precedent and methods for systematically assessing future trends should be used to anticipate likely threats to forest conservation and design appropriate and prescient policy measures to counteract them. Myanmar is transitioning from an authoritarian, centralized state with a highly regulated economy to a more decentralized and economically liberal democracy and is working to end a long-running civil war. With these transitions in mind, we used a horizon-scanning approach to assess the 40 emerging issues most affecting Myanmar's forests, including internal conflict, land-tenure insecurity, large-scale agricultural development, demise of state timber enterprises, shortfalls in government revenue and capacity, and opening of new deforestation frontiers with new roads, mines, and hydroelectric dams. Averting these threats will require, for example, overhauling governance models, building capacity, improving infrastructure- and energy-project planning, and reforming land-tenure and environmental-protection laws. Although challenges to conservation in Myanmar are daunting, the political transition offers an opportunity for conservationists and researchers to help shape a future that enhances Myanmar's social, economic, and environmental potential while learning and applying lessons from other countries. Our approach and results are relevant to other countries undergoing similar transitions

Political transition and emergent forest-conservation issues in Myanmar.

Political and economic transitions have had substantial impacts on forest conservation. Where transitions are underway or anticipated, historical precedent and methods for systematically assessing future trends should be used to anticipate likely threats to forest conservation and design appropriate and prescient policy measures to counteract them. Myanmar is transitioning from an authoritarian, centralized state with a highly regulated economy to a more decentralized and economically liberal democracy and is working to end a long-running civil war. With these transitions in mind, we used a horizon-scanning approach to assess the 40 emerging issues most affecting Myanmar's forests, including internal conflict, land-tenure insecurity, large-scale agricultural development, demise of state timber enterprises, shortfalls in government revenue and capacity, and opening of new deforestation frontiers with new roads, mines, and hydroelectric dams. Averting these threats will require, for example, overhauling governance models, building capacity, improving infrastructure- and energy-project planning, and reforming land-tenure and environmental-protection laws. Although challenges to conservation in Myanmar are daunting, the political transition offers an opportunity for conservationists and researchers to help shape a future that enhances Myanmar's social, economic, and environmental potential while learning and applying lessons from other countries. Our approach and results are relevant to other countries undergoing similar transitions

Evolutionary History of the Odd-Nosed Monkeys and the Phylogenetic Position of the Newly Described Myanmar Snub-Nosed Monkey Rhinopithecus strykeri

Odd-nosed monkeys represent one of the two major groups of Asian colobines. Our knowledge about this primate group is still limited as it is highlighted by the recent discovery of a new species in Northern Myanmar. Although a common origin of the group is now widely accepted, the phylogenetic relationships among its genera and species, and the biogeographic processes leading to their current distribution are largely unknown. To address these issues, we have analyzed complete mitochondrial genomes and 12 nuclear loci, including one X chromosomal, six Y chromosomal and five autosomal loci, from all ten odd-nosed monkey species. The gene tree topologies and divergence age estimates derived from different markers were highly similar, but differed in placing various species or haplogroups within the genera Rhinopithecus and Pygathrix. Based on our data, Rhinopithecus represent the most basal lineage, and Nasalis and Simias form closely related sister taxa, suggesting a Northern origin of odd-nosed monkeys and a later invasion into Indochina and Sundaland. According to our divergence age estimates, the lineages leading to the genera Rhinopithecus, Pygathrix and Nasalis+Simias originated in the late Miocene, while differentiation events within these genera and also the split between Nasalis and Simias occurred in the Pleistocene. Observed gene tree discordances between mitochondrial and nuclear datasets, and paraphylies in the mitochondrial dataset for some species of the genera Rhinopithecus and Pygathrix suggest secondary gene flow after the taxa initially diverged. Most likely such events were triggered by dramatic changes in geology and climate within the region. Overall, our study provides the most comprehensive view on odd-nosed monkey evolution and emphasizes that data from differentially inherited markers are crucial to better understand evolutionary relationships and to trace secondary gene flow

Hoolock gibbon and biodiversity survey and training in southern Rakhine Yoma, Myanmar

This is a report on a training course introducing the methodology to be used in the Hoolock Gibbon Status Review project (of the Myanmar Conservation Program), which was field tested on a short hoolock gibbon and biodiversity survey in southern Rakhine Yoma, south-west Myanmar. The survey served to fine-tune skills learned by course participants, and as a test run for the project which aims to assess the status of the hoolock gibbons (genus Hoolock) in Myanmar. Although the country still holds large intact areas of prime gibbon habitat and is believed to support the largest remaining populations of hoolock gibbons, there is no significant data on the conservation status of the species in Myanmar. This first survey was carried out during the dry season (November 2008) in southern Rakhine Yoma. The study confirms the occurrence of hoolock gibbons in what appears to be the southernmost locality recorded so far, and supports their identification as western hoolock gibbon (Hoolock hoolock). Hoolock gibbons were confirmed present in very low densities, and several possible explanations for this finding are discussed. However, the main reason for the low density is believed to be low habitat quality. As a further result of the survey, several mammal and bird species were confirmed for the first time for this region of Myanmar, and a potentially new fish species was observed

Hoolock gibbon and biodiversity survey and training in southern Rakhine Yoma, Myanmar: preliminary report

This is a report on a training course introducing the methodology to be used in the Hoolock Gibbon Status Review project (of the Myanmar Conservation Program), which was field tested on a short hoolock gibbon and biodiversity survey in southern Rakhine Yoma, south-west Myanmar. The survey served to fine-tune skills learned by course participants, and as a test run for the project which aims at assessing the status of the hoolock gibbons (genus Hoolock) in Myanmar. Although the country still holds large intact areas of prime gibbon habitat and is believed to support the largest remaining populations of hoolock gibbons, there is no significant data on the conservation status of the species in Myanmar. This first survey was carried out during the dry season (November 2008) in southern Rakhine Yoma. The study confirms the occurrence of hoolock gibbons in what appears to be the southernmost locality recorded so far, and supports their identification as Western Hoolock Gibbon (Hoolock hoolock). Hoolock gibbons were confirmed present in very low densities, and several possible explanations for this finding are discussed. However, the main reason for the low density is believed to be low habitat quality. As a further result of the survey, several mammal and bird species were confirmed for the first time for this region of Myanmar, and a potentially new fish species was observed

(Table 1) Chlorophyll a content and microalgae abundance and biovolume in pack ice in the Bellingshausen Sea

Pack ice in the Bellingshausen Sea contained moderate to high stocks of microalgal biomass (3-10 mg Chl a/m**2) spanning the range of general sea-ice microalgal microhabitats (e.g., bottom, interior and surface) during the International Polar Year (IPY) Sea Ice Mass Balance in the Antarctic (SIMBA) studies. Measurements of irradiance above and beneath the ice as well as optical properties of the microalgae therein demonstrated that absorption of photosynthetically active radiation (PAR) by particulates (microalgae and detritus) had a substantial influence on attenuation of PAR and irradiance transmission in areas with moderate snow covers (0.2-0.3 m) and more moderate effects in areas with low snow cover. Particulates contributed an estimated 25 to 90% of the attenuation coefficients for the first-year sea ice at wavelengths less than 500 nm. Strong ultraviolet radiation (UVR) absorption by particulates was prevalent in the ice habitats where solar radiation was highest - with absorption coefficients by ice algae often being as large as that of the sea ice. Strong UVR-absorption features were associated with an abundance of dinoflagellates and a general lack of diatoms - perhaps suggesting UVR may be influencing the structure of some parts of the sea-ice microbial communities in the pack ice during spring. We also evaluated the time-varying changes in the spectra of under-ice irradiances in the austral spring and showed dynamics associated with changes that could be attributed to coupled changes in the ice thickness (mass balance) and microalgal biomass. All results are indicative of radiation-induced changes in the absorption properties of the pack ice and highlight the non-linear, time-varying, biophysical interactions operating within the Antarctic pack ice ecosystem

Spectrum of cardiac disease in maternity in a low-resource cohort in South Africa

Background Lack of evidence-based data on the spectrum of cardiovascular disease (CVD) in pregnancy or in the postpartum period, as well as on maternal and fetal outcome, provides challenges for treating physicians, particularly in areas of low resources. The objectives of this study were to investigate the spectrum of disease, mode of presentation and maternal and fetal outcome of patients referred to a dedicated Cardiac Disease and Maternity Clinic (CDM). Methods The prospective cohort study was conducted at a single tertiary care centre in South Africa. Two hundred and twenty-five women presenting with CVD in pregnancy, or within 6 months postpartum, were studied over a period of 2 years. Clinical assessment, echocardiography and laboratory tests were performed at baseline and follow-up visits. Prepartum, peripartum and postpartum complications were grouped into cardiac, neonatal and obstetric events. Results Ethnicity was black African (45%), mixed ethnicity (32%), white (15%), Indian/others (8%) and 12% were HIV positive. Of the 225 consecutive women (mean age 28.8+/-6.4), 196 (86.7%) presented prepartum and 73 in modified WHO class I. The 152 women presenting in a higher risk group (modified WHO class II-IV) were offered close follow-up at the CDM clinic and were diagnosed with congenital heart disease (32%, 15 operated previously), valvular heart disease (26%, 15 operated previously), cardiomyopathy (27%) and other (15%). Women presenting with symptoms of CVD or heart failure postpartum (n=30) presented in a higher New York Heart Association, had higher heart rates (p42 days postpartum. Perinatal death occurred in 1/152 (0.7%)-translating to a perinatal mortality rate of 7/1000 live births. Conclusions Disease patterns were markedly different to that seen in the developed world. However, joint obstetric-cardiac care in the low-resource cohort was associated with excellent survival outcome rates of pregnant mothers (even with complex diseases) and their offspring and was similar to that seen in the western world. Mortality typically occurred in the postpartum period, beyond the standard date of recording maternal death