The use of natural resources to improve household income, health, and nutrition within the forests of Kianjavato, Madagascar

Understanding natural resource extraction in Madagascar is key to developing wider conservation and management strategies that ensure the continued delivery of essential ecosystem services, and the development of health and economic strategies to meet the demands of a growing human population. In the Kianjavato lowland rainforest of southeastern Madagascar, 78% of lemur species, 83% of native carnivoran species, and 67% of frugivorous bat species are threatened with extinction. All three of these groups of mammals are commonly hunted for food in other regions of Madagascar, yet we know little about current levels of hunting or whether the use of forest resources significantly affects human welfare in this region. We used health assessments of 1267 Kianjavato residents and semi-structured interviews of members of 336 households in 17 communities in Kianjavato to investigate human-environmental interactions. We found high prevalence of child and teenage malnutrition. More than half of the population under 20 years old was stunted, more than half was underweight, and more than one fifth was wasted. Further, one in six residents were anemic. We found that Kianjavato’s forests provided essential ecosystem services for its rural communities. As Kianjavato’s forests are altered to meet the needs of a growing human population, these direct-use ecosystem services (such as the use of wild animals for food or plants for medicine) are unable to similarly expand to meet the basic needs of the families living in these forests. A worrying proportion of the Kianjavato population depends on forests to meet their healthcare, nutritional, and economic needs, yet they may be failing to do so. All surveyed households (100%) depended on forests to meet their healthcare needs and 40% of the regional economy involved the extraction of finite forest resources (i.e., precious stones). Most households consumed very little wildlife (two animals per household per year) and the great majority (83%) of the forest animals they ate were not threatened with extinction. Forty percent of wildlife were caught illegally. Although hunting is likely not imperiling local wildlife at present, 16% of the Kianjavato population hunts wildlife and 20% are malnourished. The ecosystem services of Kianjavato’s forests may currently be insufficient to meet the needs of residents. Therefore, targeted efforts to increase local access to the healthcare system and to improve household nutrition and economy by improving the production and stability of local agricultural products may increase the long-term sustainability of both wildlife hunting, household incomes, and regional food security. Efforts such as these that can expand with the growing population to meet future needs may help secure the sustainable use of essential ecosystem services for the long term, improving the health of local people and maintaining the integrity of the forests in which they live. RésuméComprendre l'utilisation des ressources naturelles à Madagascar est essentiel pour développer des stratégies de conservation et de gestion plus larges qui permettent à la fois de fournir des services écosystémiques et de développer des stratégies sanitaires et économiques afin de répondre aux besoins d'une population humaine toujours croissante. Dans la forêt tropicale humide de basse altitude de Kianjavato dans le sud-est de Madagascar, 78% des espèces de lémuriens, 83% des espèces de carnivores indigènes et 67% des espèces de chauves-souris frugivores sont menacés d'extinction. Ces trois groupes de mammifères sont généralement chassés dans d'autres régions de Madagascar, mais nous en savons peu sur les niveaux actuels de chasse ou si l'utilisation des ressources forestières affecte significativement le bien-être humain dans cette région. Nous avons conduit une évaluation sanitaire sur 1267 habitants de Kianjavato, ainsi que des entretiens semi-structurés avec des membres de 336 ménages dans 17 communautés de Kianjavato afin d’étudier les interactions entre l’Homme et l’environnement. Nous avons constaté une forte prévalence de la malnutrition chez les enfants et les adolescents. Plus de la moitié de la population âgée de moins de 20 ans souffre d'un retard de croissance, plus de la moitié d’une insuffisance pondérale et plus d'un cinquième d’émaciation. En outre, un résident sur six est anémique. Nous avons constaté que les forêts de Kianjavato fournissent des services écosystémiques essentiels à ces communautés rurales. Comme les forêts de Kianjavato sont altérées pour répondre aux besoins d'une population croissante, ces services écosystémiques à usage direct (tels que la consommation d'animaux sauvages ou des plantes médicinales) ne peuvent plus couvrir les besoins fondamentaux des familles qui y vivent. Une proportion inquiétante de la population de Kianjavato dépend des forêts quant à ses besoins sanitaires, nutritionnels et économiques, cependant ces dernières ne peuvent plus y pourvoir entièrement. Tous les ménages enquêtés (100%) comptent sur la forêt pour la satisfaction de leurs besoins sanitaires. Par ailleurs, l’exploitation de ressources forestières finies (extraction de pierres précieuses) représente 40% de l’économie régionale. La plupart des ménages consommaient très peu d'animaux sauvages (deux animaux par ménage par an) et la grande majorité (83%) des animaux forestiers qu'ils mangeaient n'étaient pas menacés d'extinction. Cependant, 40% de ces animaux forestiers ont été capturés de manière illicite. Certes la chasse ne menace pas actuellement la faune locale mais 16% de la population de Kianjavato reconnaît s’y adonner et 20% souffrent de malnutrition. Les services écosystémiques s’avèrent actuellement insuffisants pour répondre aux besoins des résidents. Il est par conséquent nécessaire de cibler les efforts pour accroître l’accès local au système de santé, ensuite pour améliorer la nutrition et l’économie des ménages (améliorer la production et la stabilité des produits agricoles locaux), et tout ceci dans le but d’augmenter la viabilité à long terme de la chasse, des revenus et de la sécurité alimentaire dans cette région. De tels efforts lorsqu’ils prennent en compte la croissance de la population - et donc ses besoins futurs accrus —peuvent aider à assurer l’utilisation durable des services écosystémiques, à améliorer la santé des populations locales, et en fin de compte, à maintenir l’intégrité des forêts dans lesquelles elles vivent

The use of natural resources to improve household income, health, and nutrition within the forests of Kianjavato, Madagascar

Understanding natural resource extraction in Madagascar is key to developing wider conservation and management strategies that ensure the continued delivery of essential ecosystem services, and the development of health and economic strategies to meet the demands of a growing human population. In the Kianjavato lowland rainforest of southeastern Madagascar, 78% of lemur species, 83% of native carnivoran species, and 67% of frugivorous bat species are threatened with extinction. All three of these groups of mammals are commonly hunted for food in other regions of Madagascar, yet we knew little about current levels of hunting or whether the use of forest resources significantly affects human welfare in this region. We used health assessments of 1 267 Kianjavato residents and semi-structured interviews of members of 336 households in 1 7 communities in Kianjavato to investigate human-environmental interactions. We found high prevalence of child and teenage malnutrition. More than half of the population under 20 years old was stunted, more than half was underweight, and more than one fifth was wasted. Further, one in six residents were anemic. We found that Kianjavato’s forests provided essential ecosystem services for its rural communities. As Kianjavato’s forests are altered to meet the needs of a growing human population, these direct-use ecosystem services (such as the use of wild animals for food or plants for medicine) are unable to similarly expand to meet the basic needs of the families living in these forests. A worrying proportion of the Kianjavato population depends on forests to meet their healthcare, nutritional, and economic needs, yet they may be failing to do so. All surveyed households (1 00%) depended on forests to meet their healthcare needs and 40% of the regional economy involved the extraction of finite forest resources (i.e., precious stones). Most  households consumed very little wildlife (two animals per household per year) and the great majority (83%) of the forest animals they ate were not threatened with extinction. Forty percent of wildlife were caught illegally. Although hunting is likely not imperiling local wildlife at present, 1 6% of the Kianjavato population hunts wildlife and 20% are malnourished. The ecosystem services of Kianjavato’s forests may currently be insufficient to meet the needs of residents. Therefore, targeted efforts to increase local access to the healthcare system and to improve household nutrition and economy by improving the production and stability of local agricultural products may increase the long-term sustainability of wildlife hunting, household incomes, and regional food security. Efforts such as these that can expand with the growing population to meet future needs may help secure the sustainable use of essential ecosystem services for the long term, improving the health of local people and maintaining the integrity of the forests in which they live

Species-level view of population structure and gene flow for a critically endangered primate (Varecia variegata)

Lemurs are among the world\u27s most threatened mammals. The critically endangered black-and-white ruffed lemur (Varecia variegata), in particular, has recently experienced rapid population declines due to habitat loss, ecological sensitivities to habitat degradation, and extensive human hunting pressure. Despite this, a recent study indicates that ruffed lemurs retain among the highest levels of genetic diversity for primates. Identifying how this diversity is apportioned and whether gene flow is maintained among remnant populations will help to diagnose and target conservation priorities. We sampled 209 individuals from 19 sites throughout the remaining V. variegata range. We used 10 polymorphic microsatellite loci and ∼550 bp of mtDNA sequence data to evaluate genetic structure and population dynamics, including dispersal patterns and recent population declines. Bayesian cluster analyses identified two distinct genetic clusters, which optimally partitioned data into populations occurring on either side of the Mangoro River. Localities north of the Mangoro were characterized by greater genetic diversity, greater gene flow (lower genetic differentiation) and higher mtDNA haplotype and nucleotide diversity than those in the south. Despite this, genetic differentiation across all sites was high, as indicated by high average FST (0.247) and ΦST (0.544), and followed a pattern of isolation-by-distance. We use these results to suggest future conservation strategies that include an effort to maintain genetic diversity in the north and restore connectivity in the south. We also note the discordance between patterns of genetic differentiation and current subspecies taxonomy, and encourage a re-evaluation of conservation management units moving forward

Cardiovascular Outcomes in Aortopathy: GenTAC Registry of Genetically Triggered Aortic Aneurysms and Related Conditions.

BACKGROUND: The GenTAC (Genetically Triggered Thoracic Aortic Aneurysm and Cardiovascular Conditions) Registry enrolled patients with genetic aortopathies between 2007 and 2016. OBJECTIVES: The purpose of this study was to compare age distribution and probability of elective surgery for proximal aortic aneurysm, any dissection surgery, and cardiovascular mortality among aortopathy etiologies. METHODS: The GenTAC study had a retrospective/prospective design. Participants with bicuspid aortic valve (BAV) with aneurysm (n = 879), Marfan syndrome (MFS) (n = 861), nonsyndromic heritable thoracic aortic disease (nsHTAD) (n = 378), Turner syndrome (TS) (n = 298), vascular Ehlers-Danlos syndrome (vEDS) (n = 149), and Loeys-Dietz syndrome (LDS) (n = 121) were analyzed. RESULTS: The 25% probability of elective proximal aortic aneurysm surgery was 30 years for LDS (95% CI: 18-37 years), followed by MFS (34 years; 95% CI: 32-36 years), nsHTAD (52 years; 95% CI: 48-56 years), and BAV (55 years; 95% CI: 53-58 years). Any dissection surgery 25% probability was highest in LDS (38 years; 95% CI: 33-53 years) followed by MFS (51 years; 95% CI: 46-57 years) and nsHTAD (54 years; 95% CI: 51-61 years). BAV experienced the largest relative frequency of elective surgery to any dissection surgery (254/33 = 7.7), compared with MFS (273/112 = 2.4), LDS (35/16 = 2.2), or nsHTAD (82/76 = 1.1). With MFS as the reference population, risk of any dissection surgery or cardiovascular mortality was lowest in BAV patients (HR: 0.13; 95% CI: 0.08-0.18; HR: 0.13; 95%: CI: 0.06-0.27, respectively). The greatest risk of mortality was seen in patients with vEDS. CONCLUSIONS: Marfan and LDS cohorts demonstrate age and event profiles congruent with the current understanding of syndromic aortopathies. BAV events weigh toward elective replacement with relatively few dissection surgeries. Nonsyndromic HTAD patients experience near equal probability of dissection vs prophylactic surgery, possibly because of failure of early diagnosis

Managing Multiple Funding Streams and Agendas to Achieve Local and Global Health and Research Objectives: Lessons From the Field

Multiple funding sources provide research and program implementation organizations a broader base of funding and facilitate synergy, but also entail challenges that include varying stakeholder expectations, unaligned grant cycles, and highly variable reporting requirements. Strong governance and strategic planning are essential to ensure alignment of goals and agendas. Systems to track budgets and outputs as well as procurement and human resources are required. A major goal is to transition leadership and operations to local ownership. This article details successful approaches used by the newly independent non-governmental organization, the Centre for Infectious Disease Research in Zambia (CIDRZ)

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Factors influencing terrestriality in primates of the Americas and Madagascar

Among mammals, the order Primates is exceptional in having a high taxonomic richness in which the taxa are arboreal, semiterrestrial, or terrestrial. Although habitual terrestriality is pervasive among the apes and African and Asian monkeys (catarrhines), it is largely absent among monkeys of the Americas (platyrrhines), as well as galagos, lemurs, and lorises (strepsirrhines), which are mostly arboreal. Numerous ecological drivers and species-specific factors are suggested to set the conditions for an evolutionary shift from arboreality to terrestriality, and current environmental conditions may provide analogous scenarios to those transitional periods. Therefore, we investigated predominantly arboreal, diurnal primate genera from the Americas and Madagascar that lack fully terrestrial taxa, to determine whether ecological drivers (habitat canopy cover, predation risk, maximum temperature, precipitation, primate species richness, human population density, and distance to roads) or species-specific traits (bodymass, group size, and degree of frugivory) associate with increased terrestriality. We collated 150,961 observation hours across 2,227 months from 47 species at 20 sites in Madagascar and 48 sites in the Americas. Multiple factors were associated with ground use in these otherwise arboreal species, including increased temperature, a decrease in canopy cover, a dietary shift away from frugivory, and larger group size. These factors mostly explain intraspecific differences in terrestriality. As humanity modifies habitats and causes climate change, our results suggest that species already inhabiting hot, sparsely canopied sites, and exhibiting more generalized diets, are more likely to shift toward greater ground use

The Evolution of the Major Hepatitis C Genotypes Correlates with Clinical Response to Interferon Therapy

Patients chronically infected with hepatitis C virus (HCV) require significantly different durations of therapy and achieve substantially different sustained virologic response rates to interferon-based therapies, depending on the HCV genotype with which they are infected. There currently exists no systematic framework that explains these genotype-specific response rates. Since humans are the only known natural hosts for HCV-a virus that is at least hundreds of years old-one possibility is that over the time frame of this relationship, HCV accumulated adaptive mutations that confer increasing resistance to the human immune system. Given that interferon therapy functions by triggering an immune response, we hypothesized that clinical response rates are a reflection of viral evolutionary adaptations to the immune system.We have performed the first phylogenetic analysis to include all available full-length HCV genomic sequences (n = 345). This resulted in a new cladogram of HCV. This tree establishes for the first time the relative evolutionary ages of the major HCV genotypes. The outcome data from prospective clinical trials that studied interferon and ribavirin therapy was then mapped onto this new tree. This mapping revealed a correlation between genotype-specific responses to therapy and respective genotype age. This correlation allows us to predict that genotypes 5 and 6, for which there currently are no published prospective trials, will likely have intermediate response rates, similar to genotype 3. Ancestral protein sequence reconstruction was also performed, which identified the HCV proteins E2 and NS5A as potential determinants of genotype-specific clinical outcome. Biochemical studies have independently identified these same two proteins as having genotype-specific abilities to inhibit the innate immune factor double-stranded RNA-dependent protein kinase (PKR).An evolutionary analysis of all available HCV genomes supports the hypothesis that immune selection was a significant driving force in the divergence of the major HCV genotypes and that viral factors that acquired the ability to inhibit the immune response may play a role in determining genotype-specific response rates to interferon therapy