Best practices are never best: Evaluating primate conservation education programs (PCEPs) with a decolonial perspective

Who do we aim to educate with primate conservation education programs (PCEPs)? In a commentary published in a recent AJP, Annette Lanjouw suggested that many efforts to "educate" habitat-country communities can be neocolonial in their approaches. Forest destruction and habitat loss are a result of global consumption and expansion. We therefore need to approach conservation education from many angles including local stakeholders, policy makers, government officials, and the humans living in industrialized nations who are major consumers of the items that shrink primate habitats. In this review, we investigate PCEPs to determine if the conservation education goals, education methods, and assessment processes are proceeding within a neocolonial context. We reviewed the last 20 years of primate conservation literature and looked for publications that were focused on education programs. We found that in 50 of 52 publications published between 2001 and 2021, the education programs take place in habitat-country local communities. We also reviewed primate field researcher and field site websites, and in most cases, education programs were also focused on educating local communities living near or in nonhuman primate habitats. Exceptions were student clubs, zoo programs, and a high school outreach program. Many PCEP providers presented a list of "lessons learned" and we compiled their wisdom in combination with our experience to provide a framework for moving forward. We conclude that as conservation primatologists, we must think beyond our field sites to create opportunities for educational outreach. We can reach global consumers by linking to zoos, television/motion picture, print media, social media, and working with schools on curricula. Primatologists can engage our undergraduates to establish clubs and create meaningful assignments that reach beyond the classroom. We encourage primatologists from the Global North to consider their positionality and the history of conservation exclusion in their attempts to conserve primates.

Parasites and Other Infectious Agents in Non-human Primates of Argentina

Purpose of Review

In Argentina, there are five non-human primate (NHP) species: Sapajus nigritus cucullatus, Sapajus cay, Alouatta caraya, Alouatta guariba clamitans, and Aotus azarae. All of them inhabit protected and non-protected areas and face severe threats due anthropization. We aim to summarize the information available about parasites and infectious diseases of these NHPs and suggest further research on primate diseases in Argentina.

Recent Findings

NHPs of Argentina are hosts of several parasites and pathogens important for conservation as well as public health. Alouatta species are lethally susceptible to yellow fever virus, which makes them suitable health sentinels of possible outbreaks. For other primate species, few parasite surveys have been carried out.

Summary

Assessing the presence of infectious diseases and long-term surveillance on NHP allow the development of strategies to help in the early detection of pathogens that may threat public health. Increasing the knowledge about parasites and infectious diseases and their consequences in NHP of Argentina is needed, considering a One Health approach.

Long-term survival benefit of SAVR over TAVR in low-risk elective patients

Background

Aortic valve (AV) stenosis can be treated either by surgical AV replacement (SAVR) or since 2002 by transcatheter aortic valve implantation (TAVI). Due to lower invasiveness, TAVI is a preferred approach in high- and prohibitive risk surgical candidates, yet outcome data is conflicting when lower risk patients are considered and in particular at long-term.

Purpose

Our study evaluates long-term survival in elective low-risk patients after AV replacement with severe AV stenosis.

Methods

We conducted a registry data analyses of patients scheduled for elective isolated AV with AV stenosis between 2015 and 2019 and underwent TAVI or SAVR. Urgent, emergent and salvage procedures were excluded. In TAVI group only transfemoral access was considered. Propensity score matching to determine SAVR controls for TAVI group in 1:3 ratio with caliper 0.2 of standardized deviation (figure 1).

Results

Study group included 2393 elective AVR patients 1765 was in SAVR group and 628 in TAVI group. Median follow-up was 2.72 years ([IQR: 1.32–4.08], max 6.0). Propensity matching with replacement returned 329 TAVI cases and 593 SAVR controls with median age 76 (Interquartile range [IQR:71–73]) and EuroScore II 1.81 [IQR:1.36–2.53]). 30-day mortality was 11/329 (3.32%) vs 18/593 (3.03%) in the TAVI vs SAVR respectively (RR 1.10 [0.52–2.37]; p=0.801). At two years, there was no difference between SAVR and TAVI in terms of mortality (HR 1.23 [0.83–1.83] P=0.309). At 6 years, overall survival analysis favored SAVR which was associated with 30% lower mortality (HR 0.70 [0.496–0.997]; p=0.048, see figure 2).

Conclusions

TAVI as compared to SAVR is equally safe in elective low-risk patients up to 2 years post-op. After that time survival is better in surgically managed patients. Extended observations from randomized trials in low-risk patients are warranted to draw definite conclusions regarding long-term safety of TAVI in this population.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The work was supported by the research non-commercial grant from Medical University of Silesia Figure 1Figure 2

Relationship between age-sex classes and prevalence of Giardia spp. and Blastocistys spp. in black and gold howler monkeys inhabiting fragmented forests

Studies have shown that as age increases, parasitism could also be more frequent, on the other hand, the lack of immunity can increase the risk of infection in younger individuals.  Regarding sex, there is a general tendency for males to be more parasitized than females, in the case of primates, this is related to the effort made by males into attaining and maintain a high rank, implying high levels of testosterone, a hormone with immunosuppressive effects. Immunosuppressive effects of stress hormones can also increase susceptibility in dominant or subordinate individuals, nevertheless, in a study, the level of exposure to parasites seems to be more important than the immunosuppressive effects of stress in explaining why dominant females have more infections from directly transmitted parasites.  In this study, we investigated the relationship between the prevalence of Giardia spp. and Blastocystis spp. and the categories of age and sex in black and golden howler monkeys (Alouatta caraya) of Argentina.  We analyzed 375 fecal samples from 27 individuals (juveniles and adults of both sexes), using microscopy and techniques of flotation and sedimentation.  To analyze the relationship between age, sex, and infection prevalence, a Generalized Linear Mixed Model was used.  In adults, the prevalence of infection was 78.5 % while in juveniles, all individuals (100 %) were infected with both protozoa.  Males had a infection prevalence 84.6%, in females it was 92.8 %.  When comparing infection prevalence between ages and between sexes, no significant differences were found (P > 0.05).  Research suggests that parasite infection rates may be influenced by specific form of transmission, in this sense, these protozoa, are transmitted through ingestion of cysts which are infectious immediately after defecation has occurred.  On the other hand, all members of the group tend to defecate simultaneously, leaving all the members of the group exposed to infection.  Therefore, we suggest that physiological or behavioral factors do not appear to be important in the risk of protozoan infection.

Expansion of the Distribution of Aedes albopictus (Diptera: Culicidae): New Records in Northern Argentina and Their Implications From an Epidemiological Perspective

Since the last yellow fever (YF) outbreak was detected in Argentina in 2009, vector surveillance and studies of arbovirus infections are carried out intermittently specifically in areas where nonhuman primates of the Alouatta genus are present. We report in these areas of Corrientes province the detection of Haemagogus leucocelaenus (Dyar and Shannon) (Diptera: Culicidae) and Sabethes albiprivus (Theobald) (Diptera: Culicidae), both species involved in the forest YF cycle, and also the presence of Aedes albopictus (Skuse) in new areas in Argentina, which represents the southernmost citation for this species in South America. Aedes albopictus, a mosquito species native to Asia, was reported for the first time in Argentina in 1998, in Misiones province. Since then, no other report has indicated the extension of the distribution of this mosquito. This report shows the importance of performing continual entomological and arboviruses surveillance and highlights the impact that could result from the expansion of Ae. albopictus across Argentina.

Global phylogeography and ancient evolution of the widespread human gut virus crAssphage

Microbiomes are vast communities of microorganisms and viruses that populate all natural ecosystems. Viruses have been considered to be the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared with that of other environments. Here, we investigate the origin, evolution and epidemiology of crAssphage, a widespread human gut virus. Through a global collaboration, we obtained DNA sequences of crAssphage from more than one-third of the world's countries and showed that the phylogeography of crAssphage is locally clustered within countries, cities and individuals. We also found fully colinear crAssphage-like genomes in both Old-World and New-World primates, suggesting that the association of crAssphage with primates may be millions of years old. Finally, by exploiting a large cohort of more than 1,000 individuals, we tested whether crAssphage is associated with bacterial taxonomic groups of the gut microbiome, diverse human health parameters and a wide range of dietary factors. We identified strong correlations with different clades of bacteria that are related to Bacteroidetes and weak associations with several diet categories, but no significant association with health or disease. We conclude that crAssphage is a benign cosmopolitan virus that may have coevolved with the human lineage and is an integral part of the normal human gut virome.

Global phylogeography and ancient evolution of the widespread human gut virus crAssphage

Microbiomes are vast communities of microorganisms and viruses that populate all natural ecosystems. Viruses have been considered to be the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared with that of other environments. Here, we investigate the origin, evolution and epidemiology of crAssphage, a widespread human gut virus. Through a global collaboration, we obtained DNA sequences of crAssphage from more than one-third of the world's countries and showed that the phylogeography of crAssphage is locally clustered within countries, cities and individuals. We also found fully colinear crAssphage-like genomes in both Old-World and New-World primates, suggesting that the association of crAssphage with primates may be millions of years old. Finally, by exploiting a large cohort of more than 1,000 individuals, we tested whether crAssphage is associated with bacterial taxonomic groups of the gut microbiome, diverse human health parameters and a wide range of dietary factors. We identified strong correlations with different clades of bacteria that are related to Bacteroidetes and weak associations with several diet categories, but no significant association with health or disease. We conclude that crAssphage is a benign cosmopolitan virus that may have coevolved with the human lineage and is an integral part of the normal human gut virome.

Social play among black and gold howler monkey (Alouatta caraya) immatures during intergroup encounters

We studied intergroup social play (IGSP) among immatures in wild black and gold howler monkeys (Alouatta caraya) in northeastern Argentina. IGSP events are one form of affiliative interaction that can occur during intergroup encounters. The main goal of this study was to analyze IGSP in A. caraya immatures and assess how intrinsic (e.g., age and sex) and extrinsic (e.g., seasonality) factors can influence the development of this type of social behavior. We followed 12 groups between 2008 and 2015 and recorded 182 encounters and 61 events of IGSP. Considering the composition of play partners, most IGSP events occurred among juveniles of both sexes (33%), followed by juveniles that were only-male (31%), and finally between mixed-sex juveniles and infants (20%) interactions. Additionally, most IGSP events occurred mainly in summer (56%), followed by spring (29%), with fewer events occurring in autumn (15%) and no IGSP events recorded in winter. Our results suggest that IGSP constitutes a beneficial activity in wild A. caraya that promotes behavioral flexibility, where immatures acquire social skills, such as tolerance, by interacting with unknown individuals. Moreover, the higher participation of young males in IGSP is consistent with the fact that adult black and gold howler males tend to be more actively involved in group encounters than females, supporting the hypothesis that social play provides benefits in the development of motor and social skills. Finally, seasonality in the frequencies of IGSP might be related to availability of foods with high and easily mobilized energy content in summer and spring.

The Effects of Captivity on the Mammalian Gut Microbiome

Recent studies increasingly note the effect of captivity or the built environment on the microbiome of humans and other animals. As symbiotic microbes are essential to many aspects of biology (e.g., digestive and immune functions), it is important to understand how lifestyle differences can impact the microbiome, and, consequently, the health of hosts. Animals living in captivity experience a range of changes that may influence the gut bacteria, such as diet changes, treatments, and reduced contact with other individuals, species and variable environmental substrates that act as sources of bacterial diversity. Thus far, initial results from previous studies point to a pattern of decreased bacterial diversity in captive animals. However, these studies are relatively limited in the scope of species that have been examined. Here we present a dataset that includes paired wild and captive samples from mammalian taxa across six Orders to investigate generalizable patterns of the effects captivity on mammalian gut bacteria. In comparing the wild to the captive condition, our results indicate that alpha diversity of the gut bacteria remains consistent in some mammalian hosts (bovids, giraffes, anteaters, and aardvarks), declines in the captive condition in some hosts (canids, primates, and equids), and increases in the captive condition in one host taxon (rhinoceros). Differences in gut bacterial beta diversity between the captive and wild state were observed for most of the taxa surveyed, except the even-toed ungulates (bovids and giraffes). Additionally, beta diversity variation was also strongly influenced by host taxonomic group, diet type, and gut fermentation physiology. Bacterial taxa that demonstrated larger shifts in relative abundance between the captive and wild states included members of the Firmicutes and Bacteroidetes. Overall, the patterns that we observe will inform a range of disciplines from veterinary practice to captive breeding efforts for biological conservation. Furthermore, bacterial taxa that persist in the captive state provide unique insight into symbiotic relationships with the host.

PET-CT derived Artificial Neural Network can predict mediastinal lymph nodes metastases in Non-Small Cell Lung Cancer patients. Preliminary report and scoring model

AIM

Mediastinal lymph nodes staging in NSCLC (non small cell lung cancer) is of undisputable importance. Although relatively precise, diagnostic modalities, mediastinoscopy and EBUS/EUS - TBNA (endobronchial/endoscopic ultrasound guided--transbronchial needle aspiration) still employ certain level of invasiveness. Artificial Neural Network (ANN) is an established predictor tool which, due to underlying distribution and relationship among the given variables, allow for construction of multidimensional models trained in prognosis of given outcome. Their performance in mediastinal staging based on radiological data only, remains limited to single studies.

METHODS

We obtained 467 groups of lymph nodes from 160 patients with primary NSCLC by means of EBUS--TBNA, mediastinoscopy or lymphadenectomy during thoracotomy and analyzed them microscopically. ANN models were created and prospectively validated on unmatched cohort of 50 consecutive patients (158 groups of lymph nodes). To identify factors correlated with nodal involvement single factor tests and logistic regression analyzes were performed. Additionally, logistic regression analysis allowed for construction of scoring model with certain parameters corresponding to risk thresholds of metastatic disease.

RESULTS

Size and standard uptake value (SUV) of the node along with primary tumour T characteristics were identified as the most sensitive variables regardless of the analysis conducted. Two ANN models predicted metastatic involvement with 89% and 92% accuracy. Single factor tests maintained high accuracy only for 2 out of 4 most sensitive variables (SUV >2.8 and length >15mm) in prospective validation.

CONCLUSIONS

ANN is a repeatable and accurate diagnostic tool in mediastinal staging in NSCLC patients. Before its role in clinical practice will be established in large multi--centre study, findings of this preliminary report should be considered as exploratory only.

Male reproductive strategies in black and gold howler monkeys (Alouatta caraya)

Behavioral and demographic factors such as group size, social structure, dispersal patterns, and mating systems affect male reproductive success. In the present study, we analyze the relationship between social structure, genetic relatedness of adult males and offspring paternity in one population of Alouatta caraya inhabiting a continuous forest in Northern Argentina. After 14 months of behavioral studies and genotyping 11 microsatellites, we found that dominant or central males achieved greater mating success and fathered all the offspring conceived during our study in two multimale-multifemale groups (both including three adult males). Although skewed toward the dominant males, females copulated with almost all resident males and with extra group males. We found significantly fewer agonistic interactions between adult males in the group with fewer females and where males were more genetically related to each other (average relatedness r = 0.237; 0.015 int/ind/hr vs. r = 0.02; 0.029 int/ind/hr). Paternity was also analyzed in two other neighboring groups which also showed strong skew to one male over a 2-year period. These results reveal that even though female black and gold howlers mate with many males, infants are typically fathered by one dominant male.

Thermally-induced structural and chemical alteration of organic-walled microfossils: an experimental approach to understanding fossil preservation in metasediments

The identification and confirmation of bona fide Archean-Paleoproterozoic microfossils can prove to be a challenging task, further compounded by diagenetic and metamorphic histories. While structures of likely biological origin are not uncommon in Precambrian rocks, the search for early fossil life has been disproportionately focused on lesser thermally altered rocks, typically greenschist or lower-grade metamorphism. Recently, however, an increasing number of inferred micro- and macrofossils have been reported from higher-grade metasediments, prompting us to experimentally test and quantify the preservability of organic-walled microfossils over varying durations of controlled heating and under two differing redox conditions. Because of their relatively low-intensity natural thermal alteration, acritarchs from the Mesoproterozoic Ruyang Group were chosen as subjects for experimental heating at approximately 500°C, with durations ranging from 1 to 250 days and in both oxic (normal present day conditions) and anoxic conditions. Upon extraction, the opacity, reflectivity, color, microchemistry, and microstructures of the heated acritarchs were characterized using optic microscopy, scanning electron microscopy, Raman spectroscopy, and X-ray photoelectron spectroscopy. The results differ for acritarchs prepared under oxic vs. anoxic conditions, with the anoxic replicates surviving experimental heating longer and retaining biological morphologies better, despite an increasing degree of carbonization with continuous heating. Conversely, the oxic replicates show aggressive degradation. In conjunction with fossils from high-grade metasediments, our data illustrate the preservational potential of organic-walled microfossils subjected to metamorphism in reducing conditions, offer insights into the search for microfossils in metasediments, and help to elucidate the influence of time on the carbonization/graphitization processes during thermal alteration.

Possible fruit protein effects on primate communities in madagascar and the neotropics

BACKGROUND

The ecological factors contributing to the evolution of tropical vertebrate communities are still poorly understood. Primate communities of the tropical Americas have fewer folivorous but more frugivorous genera than tropical regions of the Old World and especially many more frugivorous genera than Madagascar. Reasons for this phenomenon are largely unexplored. We developed the hypothesis that Neotropical fruits have higher protein concentrations than fruits from Madagascar and that the higher representation of frugivorous genera in the Neotropics is linked to high protein concentrations in fruits. Low fruit protein concentrations in Madagascar would restrict the evolution of frugivores in Malagasy communities.

METHODOLOGY/PRINCIPAL FINDINGS

We reviewed the literature for nitrogen concentrations in fruits from the Neotropics and from Madagascar, and analyzed fruits from an additional six sites in the Neotropics and six sites in Madagascar. Fruits from the Neotropical sites contain significantly more nitrogen than fruits from the Madagascar sites. Nitrogen concentrations in New World fruits are above the concentrations to satisfy nitrogen requirements of primates, while they are at the lower end or below the concentrations to cover primate protein needs in Madagascar.

CONCLUSIONS/SIGNIFICANCE

Fruits at most sites in the Neotropics contain enough protein to satisfy the protein needs of primates. Thus, selection pressure to develop new adaptations for foods that are difficult to digest (such as leaves) may have been lower in the Neotropics than in Madagascar. The low nitrogen concentrations in fruits from Madagascar may contribute to the almost complete absence of frugivorous primate species on this island.

[The influence of upright position on heart rate variability parameters in adolescents with hypertension and type 1 diabetes]

BACKGROUND

The autonomic regulation of heart rate variability (HRV) is impaired not only in patients with type 1 diabetes but either in nondiabetic hypertensive patients.

AIM

The aim of the study was to evaluate the HRV parameters in adolescents with type 1 diabetes depending on appearance of hypertension.

MATERIAL AND METHODS

The study group included of 34 patients with diabetes and hypertension aged 15+/-2.2, and 38 patients with diabetes without hypertension aged 15+/-2.9. The control group consisted of 55 healthy persons aged 15+/-2.2. In every examined person were performed tests of autonomic nervous system in accordance to Ewing battery and frequency-domain analysis of HRV during supine and standing position.

RESULTS

The HRV parameters: total power (TP), low (LF) and high frequency (HF) were significantly decreased in patients with hypertension during supine and standing as compared to control group (p<0.001). There were differences between diabetics without hypertension and autonomic neuropathy and control group. The appearance of CAN in patients without hypertension caused the decrease all HRV indices during supine (p<0.001), however the standing position only decrease of TP and HF (p<0.01). TP value was depending on glycated haemoglobin concentration (p<0.001), but there was no correlation between HRV indices and left ventricular mass index.

CONCLUSIONS

The decrease of HRV parameters in adolescents with diabetes type 1 is connected not only with autonomic neuropathy but also with appearance of arterial hypertension.

The clinical efficacy of the local, deep insufflation of an oxygen-ozone mixture in the prevention and treatment of infections in the locomotor system

Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc.<br /> Material and methods. In the Orthopedic and Rehabilitation Department of the Medical Faculty No. 2 and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical Academy of Warsaw in the period from January 2000 until November 2001, 49 patients with extensive injuries to the locomotor system and septic complications after surgical procedures were treated with ozone. The ozone therapy was administered using an authorial technique of deep ozone application. Two groups of patients were treated: posttraumatic patients at risk for primary deep infections (e.g. open fractures without skin losses) and patients with declared postoperative infections in the locomotor system. The first group involved 31 patients; the second group, 18.<br /> Results. In the first group, three patients had septic complications despite mixed treatment, including one case of osteomyelitis. In the second group, all the patients experienced much faster than normal wound healing with inhibition of septic processes. In two cases, the septic process was reactivated after 6 and 9 months respectively, and these patients are still undergoing treatment.<br /> Conclusions. Our data confirm the advantages resulting from the deep application of ozone in the prevention and combined treatment for septic complications in the locomotor system. Our technique of deep ozone application makes it possible to reduce the risk of posttraumatic infections and promotes quicker healing of post-surgical complications and chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures.

Why do at-risk mothers fail to reach referral level? Barriers beyond distance and cost

In southern Tanzania, few high-risk pregnancies are channeled through antenatal care to the referral level. We studied the influences that make pregnant women heed or reject referral advice. Semi-structured interviews with sixty mothers-to-be, twenty-six health workers and six key-informants to identify barriers to use of referral level were conducted. Expert-defined risk-status was found to have little influence on a woman's decision to seek hospital care. Besides well known geographical and financial barriers, we found that pregnant women have different perceptions and interpretations of danger signs. Furthermore, rural women avoid the hospital because they fear discrimination. We conclude that a more individualised antenatal consultation could be provided by taking into account women's perception of risk and their explanatory models. Hospital services should be reorganised to address rural women's feelings of fear and insecurity.

[The value of the head-up tilt table test for with unexplained syncope in children and young adolescents]

Syncope occurs in about 15% of children and young adolescents. The diagnosis of syncope of unknown origin is frequently difficult. In 1986, Kenny et al. introduced the Head-up Tilt Table Test (HUT), which enables to reproduce syncope. The aim of the study was to evaluate HUT in diagnosis of syncope in children and young adolescents. Ninety five children and young adolescents (57 females, 38 males, age range 7-18 years) with recurrent syncope of unexplained etiology were referred for HUT. The study group was divided into two subgroups: A--with history consistent with vasovagal syncope (VVS) and B--with non-characteristic symptoms for VVS. HUT was performed according to the Westminster protocol. The patient was tilted at 60 degree for 45 min. or until syncope occurred. Positive response to HUT was 36%. Negative outcome occurred in 59%. Non-diagnostic HUT was observed in 5%. The vasodepressive type of VVS was recognised in 35%, cardioinhibitory in 12% and mixed in 53%. In group A positive response of HUT occurred in 65% of pts., negative in 31%. In group B positive HUT was observed in 4% of pts. and negative in 89%.

CONCLUSIONS

1. In children and young adolescents head-up tilt test is a very useful diagnostic method. 2. In patients referred for the head-up tilt test the history of syncope should be taken into consideration.

[Is infection with group A streptococcus the only reason for rheumatic fever?--a case report of rheumatic fever coexisting with Coxsackie B1 virus infection]

The course of rheumatic fever in 11 years old boy is described. The significance of cellular immunity in rheumatic fever pathogenesis and the importance of virus infection coexistence is emphasized in discussion.

Obstetric care in southern Tanzania: does it reach those in need?

OBJECTIVE

To assess whether antenatal care achieves identification and timely referral of high-risk pregnancies in southern Tanzania.

METHODS

We compared the risk profiles of pregnant women in general with those attending obstetric care and investigated the reasons for seeking care. The risk profile of inpatients was drawn up through interviews with maternity cases and analysis of their antenatal records at the regional referral hospital (n = 415); population-based data on the prevalence of specific risk factors were obtained from entries in antenatal care registers (n = 1630) and from literature.

RESULTS

A significant risk selection towards obstetric referral level care was observed only for previous caesarean section (prevalence hospital 6.7%, all pregnancies 1.5%, P < 0.005) and for nulliparity (hospital 42.8%, all pregnancies 25.0%, P < 0.005). No significant differences were observed for other risk factors such as previous perinatal death, height < 150 cm, multiple gestation and breech presentation. Prevalence of the risk factors age > 34 years and grand multiparity was significantly lower among hospital users. Coverage of obstetric care was below 50% for all risk factors except previous caesarean section (91.5%).

CONCLUSION

Despite pursuing the risk approach and very good coverage, antenatal care in Tanzania has only limited effect on extending obstetric care to high-risk mothers. A critical review of the present screening and counselling practices, including a more focused and client-centred application of risk assessment, is warranted.

Article

The interface magnetic energy in fcc Cu/Co/Cu(001) and Pd/Co/Pd(001) and the interlayer exchange coupling in bcc Fe/Cu/Fe(001) will be discussed and compared to recent theoretical models. The effect of interface magnetostriction and interface magnetic anisotropy will be described using a model proposed by Victora and MacClaren. The Victora-MacLaren theory of magnetic anisotropies is based on a generalized Néel pair interaction model that allows one to express the total interface energy in terms of the interface anisotropy and interface magnetoelastic contributions. It will be argued that the change in the sign of the interface anisotropy Ks as a result of replacing Cu atoms by Pd atoms is caused primarily by the enhanced role of the spin-orbit interaction in the Co-Pd pair interaction and in the tendency of Pd to acquire a significant magnetic moment in the proximity of ferromagnetic atoms. It will be shown that the interface lattice separations play an important role and the balance between these two magnetoelastic terms determines the total magnetoelastic contribution to the interface energy. The magnetoelastic interface contributions to Ks are +0.08 ergs/cm2 and +0.17 ergs/cm2 for the fcc Cu/Co/Cu(001) and Pd/Co/Pd(001) structures, respectively. The interlayer exchange coupling has been investigated in bcc trilayer structures Fe/Cu/XcCu1 - c/Cu/Fe where XcCu1 - c represents an alloyed atomic layer with X = Fe, Cr, Ag. The purpose of these studies was to determine the effect of foreign atoms inside a nonmagnetic spacer on the direct interlayer exchange coupling between the outside Fe layers mediated by the valence electrons of the Cu spacer. The experimental results will be compared with recent first principles calculations using the Layer Korringa-Kohn-Rostoker (LKKR) method. It will be shown that the local electron potential of the foreign atoms affects the spin transport across the spacer and is chiefly responsible for the observed behavior of the interlayer exchange coupling in Fe/Cu/XcCu1 - c/Cu/Fe. The interlayer e cxchange coupling depends very strongly on the magnetic state of the foreign atoms within the spacer. For foreign atoms with no long-range ferromagnetic order the exchange coupling is mainly affected by the 3d valence band electrons. Foreign atoms that are isoelectronic with the spacer atoms modify the strength of the exchange coupling only due to lattice relaxations that are associated with their atomic size.Key words: ultrathin metallic magnetic films, magnetic anisotropy, exchange interaction, Molecular Beam Epitaxy.

[Treatment of 3 patients with arrhythmias using "radiofrequency" ablation]

In 3 patients radiofrequency (RF) ablation of AV node (n = 2) and left sided accessory pathway (n = 1) was performed because of intractable tachyarrhythmias. RF ablation was made in the first patient (ablation of AV node) using 135 Watts during 72 sec., in the second patient (AV node ablation) 331 Watts during 185 sec., and in the last patient 883 Watts during 695 sec. In the last patient ablation of accessory pathway was unsuccessful and the patient has been successfully operated. AV conduction was interrupted in 2 cases. No complications were noted. General anesthesia was not required. All the patients were discharged in a good state.