The global distribution of plants used by humans.

Plants sustain human life. Understanding geographic patterns of the diversity of species used by people is thus essential for the sustainable management of plant resources. Here, we investigate the global distribution of 35,687 utilized plant species spanning 10 use categories (e.g., food, medicine, material). Our findings indicate general concordance between utilized and total plant diversity, supporting the potential for simultaneously conserving species diversity and its contributions to people. Although Indigenous lands across Mesoamerica, the Horn of Africa, and Southern Asia harbor a disproportionate diversity of utilized plants, the incidence of protected areas is negatively correlated with utilized species richness. Finding mechanisms to preserve areas containing concentrations of utilized plants and traditional knowledge must become a priority for the implementation of the Kunming-Montreal Global Biodiversity Framework.

The likely extinction of hundreds of palm species threatens their contributions to people and ecosystems.

Protecting nature's contributions to people requires accelerating extinction risk assessment and better integrating evolutionary, functional and used diversity with conservation planning. Here, we report machine learning extinction risk predictions for 1,381 palm species (Arecaceae), a plant family of high socio-economic and ecological importance. We integrate these predictions with published assessments for 508 species (covering 75% of all palm species) and we identify top-priority regions for palm conservation on the basis of their proportion of threatened evolutionarily distinct, functionally distinct and used species. Finally, we explore palm use resilience to identify non-threatened species that could potentially serve as substitutes for threatened used species by providing similar products. We estimate that over a thousand palms (56%) are probably threatened, including 185 species with documented uses. Some regions (New Guinea, Vanuatu and Vietnam) emerge as top ten priorities for conservation only after incorporating machine learning extinction risk predictions. Potential substitutes are identified for 91% of the threatened used species and regional use resilience increases with total palm richness. However, 16 threatened used species lack potential substitutes and 30 regions lack substitutes for at least one of their threatened used palm species. Overall, we show that hundreds of species of this keystone family face extinction, some of them probably irreplaceable, at least locally. This highlights the need for urgent actions to avoid major repercussions on palm-associated ecosystem processes and human livelihoods in the coming decades.

Treatment of chronic inflammatory rheumatism by biotherapy in Gabon : eligibility and follow-up of the first 8 patients in sub-Saharan Africa.

OBJECTIVE: to clarify the eligibility criteria for biotherapies in patients with chronic inflammatory rheumatism (CIR) in sub-Saharan Africa and to describe the characteristics of the first 8 patients treated with biotherapy in Gabon. MATERIALS AND METHODS: Patients who responded inadequately to treatments by cDMARDs (EULAR criteria) had a face-to-face interview to inform them about and obtain their consent to biotherapy for at least 3 months, with details of the cost and side effects of each available biotherapy and a certificate of "necessity of biotherapy". The inclusion and follow-up of patients took place in the outpatient rheumatology consultations at the University Hospital of Libreville (Gabon) between January 2010 and December 2016. RESULTS: Of the 30 patients who failed cDMARDs and required biologic treatment, 8 (26.6%) were able to start a biotherapy: 4 men and 4 women with rheumatoid arthritis (n = 4.50%), spondyloarthritis or psoriatic rheumatism (n = 2.25% each). The biotherapy was etanercept (n = 4, 50%), adalimumab, golimumab, infliximab and rituximab (n = 1, 12.5% each). The average duration of the biotherapy was 27.4 months (9-54). Biotherapy was stopped in 4 cases (50%), one each (12.5%) for multifocal tuberculosis, pregnancy, financial reasons, and remission. CONCLUSION: Our study shows that biotherapies, which are currently very expensive, can be prescribed in Africa provided that the usual recommendations are followed strictly. Here, access to biotherapies is only possible through private insurance and the rheumatologist must play the role of facilitator for needy and consenting patients.