Congo Basin peatlands: threats and conservation priorities

The recent publication of the first spatially explicit map of peatlands in the Cuvette Centrale, central Congo Basin, reveals it to be the most extensive tropical peatland complex, at ca. 145,500 km2. With an estimated 30.6 Pg of carbon stored in these peatlands, there are now questions about whether these carbon stocks are under threat and, if so, what can be done to protect them. Here, we analyse the potential threats to Congo Basin peat carbon stocks and identify knowledge gaps in relation to these threats, and to how the peatland systems might respond. Climate change emerges as a particularly pressing concern, given its potential to destabilise carbon stocks across the whole area. Socio-economic developments are increasing across central Africa and, whilst much of the peatland area is protected on paper by some form of conservation designation, the potential exists for hydrocarbon exploration, logging, plantations and other forms of disturbance to significantly damage the peatland ecosystems. The low level of human intervention at present suggests that the opportunity still exists to protect the peatlands in a largely intact state, possibly drawing on climate change mitigation funding, which can be used not only to protect the peat carbon pool but also to improve the livelihoods of people living in and around these peatlands

Recommendations for the diagnosis of pediatric tuberculosis

Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease

The severity of pandemic H1N1 influenza in the United States, from April to July 2009: A Bayesian analysis

Background: Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings: We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data - medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York - were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%-0.096%), sCIR of 0.239% (0.134%-0.458%), and sCHR of 1.44% (0.83%-2.64%). Using self-reported ILI, we obtained estimates approximately 7-96lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5-17 y. sCHR appears to be lowest in persons aged 5-17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions: These estimates suggest that an autumn-winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0-4 and adults 18-64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed.published_or_final_versio

Sediment production and transport from in situ-produced cosmogenic Be-10 and river loads in the Napo River basin, an upper Amazon tributary of Ecuador and Peru

Cosmogenic nuclide-based denudation rates and published erosion rates from recent river gauging in the Napo River basin (Peruvian Amazonia) are used to decipher erosion and sedimentation processes along a 600 km long transect from the headwaters to the lowlands. The sediment-producing headwaters to the Napo floodplain are the volcanically active Ecuadorian Andes, which discharge sediment at a cosmogenic nuclide-based denudation rate of 0.49 +/- 0.12 mm/yr. This denudation rate was calculated from an average Be-10 nuclide concentration of 2.2 +/- 0.5 x 10(4) at/g((Qz)) that was measured in bedload-derived quartz. Within the Napo lowlands, a significant drop in trunk stream Be-10 nuclide concentrations relative to the Andean hinterland is recorded, with an average concentration of 1.2 +/- 0.5 x 10(4) at/g((Qz)). This nuclide concentration represents a mixture between the Be nuclide concentration of eroded floodplain deposits, and that of sediment eroded from the Andean hinterland that is now carried in the trunk stream. Evidence for addition of sediment from the floodplain to the trunk stream is provided by published decadal-scale sediment flux measurements from gauging stations operated in the Napo basin, from which an increase from 12 x 10(6) t/yr at the outflow of the Andes to 47 x 10(6) t/yr at the confluence with the Solimoes (upper Amazon River) is recorded. Therefore, approximately 35 x 10(6) t of floodplain sediment are added annually to the active Napo trunk stream. Combined with our nuclide concentration measurements, we can estimate that the eroded floodplain deposits yield a nuclide concentration of similar to 0.9 x 10(4) at/g(Q) only. Under steady state surface erosion conditions, this nuclide concentration would translate to a denudation rate of the floodplain of similar to 0.47 mm/yr. However, we have no geomorphologic explanation for this high denudation rate within the low relief floodplain and thus suggest that this low-nuclide concentrated sediment is Andean-derived and would have been deposited in the floodplain at a time when erosion rates of the Andes were elevated. Therefore, the recently eroded floodplain sediment provides an Andean "paleo denudation rate" of 1.2 mm/yr that was calculated for high Andean production rates. A likely period for elevated erosion rates is the LGM, where climate and vegetation cover of the Andes differed from that of the Holocene. A possible cause for the erosion of the floodplain is the tectonic uplift of the Eastern Andes, which progressively shifts the Napo River northwards. Hence, the river cuts into ancient lowland sediment, which is admixed to the Andean sediment carried in the main Napo River