Integration of Ecological and Socioeconomic Factors in Securing Wildlife Dispersal Corridors in the Kavango-Zambezi Transfrontier Conservation Area, Southern Africa

Transfrontier conservation areas (TFCAs) are being established throughout southern Africa to integrating biodiversity conservation and rural development at the transboundary landscape scale. Among the nine TFCAs that have been established over the past 20 years, the Kavango-Zambezi (KAZA) TFCA) is the most grandiose in terms of size (≈ 520,000 Km2), number of partner countries involved (five), elephant (Loxodonta africana) population (≈ 199,031, which is the largest on the African continent), and encompasses 36 protected areas of various categories, interspaced by communal and private lands. The TFCA concept aims to ensure that key ecological processes continue to function where borders have divided ecosystems, and wildlife migration corridors. Attainment of this ecological objective is however being constrained by the anthropogenic threats, mostly poaching, and habitat fragmentation. These threats are being aggravated by the increasing human population, climate variability and underdeveloped rural livelihoods. To restore ecological processes, the following tactics have been recommended: (a) strengthening of transboundary law enforcement to effectively reduce poaching, and illegal offtake of timber; (b) establishment of “Stepping Stones” in the form of conservancies and fishing protected zones at wildlife crossing point on the major river systems; (c) reducing dependence on wood-fuel, and ensuring sustainable provision of affordable and reliable modern sources of energy; (d) adoption of the commodity-based trade standards in the production of beef for the export market to reduce the impact of veterinary fences on the dispersing wildlife; (e) implementation of early-season burning around all the sensitive biomes to protect them from the destructive late dry season fires; (f) adoption of conservation agriculture as a tool for improving land husbandry, intensification of agriculture, and decreasing the likelihood of cutting down forested areas to plant new agriculture fields; and (g) reducing the impact of climate variability on wildlife by providing artificial water – guided by environmental impact assessments. To enhance the socioeconomic development of the local communities and win them as allies in securing the wildlife dispersal corridors, the following actions should be adopted: (a) promotion of community-private partnerships in ecotourism development – alongside the establishment of a revolving loan fund to enable local communities’ access flexible source of capital for investment in ecotourism and auxiliary business opportunities; (b) promotion of biodiversity stewardship as an incentive for the local communities to commit their land to the sustenance of the wildlife dispersal corridors; (c) reducing human wildlife conflicts, through macro, meso and micro-level land-use planning to spatially delineate land committed to various categories, including protected areas, wildlife dispersal areas, and developed and communal areas; and (d) promotion of harmonised enabling policies and legislation to facilitate slowing down of human population growth, which is one of the prime triggers of habitat fragmentation in the KAZA TFCA

Dyspnea-related cues engage the prefrontal cortex - evidence from functional brain imaging in COPD

Dyspnea is the major source of disability in chronic obstructive pulmonary disease (COPD). In COPD, environmental cues (e.g. the prospect of having to climb stairs) become associated with dyspnea, and may trigger dyspnea even before physical activity commences. We hypothesised that brain activation relating to such cues would be different between COPD patients and healthy controls, reflecting greater engagement of emotional mechanisms in patients. Methods: Using FMRI, we investigated brain responses to dyspnea-related word cues in 41 COPD patients and 40 healthy age-matched controls. We combined these findings with scores of self-report questionnaires thus linking the FMRI task with clinically relevant measures. This approach was adapted from studies in pain that enables identification of brain networks responsible for pain processing despite absence of a physical challenge. Results: COPD patients demonstrate activation in the medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC) which correlated with the visual analogue scale (VAS) response to word cues. This activity independently correlated with patient-reported questionnaires of depression, fatigue and dyspnea vigilance. Activation in the anterior insula, lateral prefrontal cortex (lPFC) and precuneus correlated with the VAS dyspnea scale but not the questionnaires. Conclusions: Our findings suggest that engagement of the brain's emotional circuitry is important for interpretation of dyspnea-related cues in COPD, and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and our findings suggest such mechanisms may be relevant in COPD

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification