A Revision of Aristolochia Linn. from E. & S. Asia

This revision deals with the system, evolution, distribution, cytotaxonomy and taxonomic treatment of the genus Aristolochia Linn. from E. & S. Asia, which covers Japan, USSR (Far East), China, Viet Nam, Laos, Cambodia, Thailand, Burma, India, Bhutan, Nepal, Sikkim, Bangladesh and Pakistan. Total 2 subgenera, 7 sections, 4 series, 68 species and 1 variety (cultivated species not included) are recognized in this treatment, of which 3 sections and 2 species are described as new. In addition, 13 new synonyms and some new records to this region are also included. Ystem Having estimated all the works dealing with the subdivision of the genus by the previous authors, the system of O. C. Schmidt (1935) is chosen as the basis, with a change of the sequence of the subdivisions. The subgenus Pararistolochia (Hutch. & Dalz.) O. C. Schmidt, which has indefinite stamens and gynandrous lobes, seems to be better considered as the most primitive one in the genus, while the subgenus Siphisia (Raf.) Duch., which has definite stamens and gynandrous lobes, anthers arranged in 3 pairs and more modifications of the perianth, seems to be the most advanced one. The perianth of the subgenus Siphisia has differentiated into several types, and it is more rational using this character to classify sections than lobes of the gynostemium. In this way, three new sections has been established. A suggested system of the genus is summarized as follows: Subgen. 1. Pararistolochia (Hutch. & Dalz.) O. C. Schmidt Subgen. 2. Aristolochia: Sect. 1. Aristolochia (2 series), Sect. 2. Gymnolobus Duch. Subgen. 3. Siphisia (Raf.) Duch.: Sect. 3. Pentodon Klotz, Sect. 4. Odontosiphisia J. S. Ma, Sect. 5. Leptosiphisia J. S. Ma, Sect. 6. Nepenthesia Klotz., Sect. 7. Obliquosiphisia J. S. Ma, Sect. 8. Siphisia (2 series). Evolution According to the character analysis of the genera of Aristolochiaceae, the evolutionary trends of the family are proposed as follows: 1, the perianth from double to single, from cup-like to tubular, 2, stamens from indefinite to definite, from separate from pistil to united into a gynostemium with pistil, which is a major evolutionary line in the family, 3, ovary from half-superior to inferior, and 4, fruit from a follicle to a capsule. It is evident that the genus Aristolochia, with a tubular perianth, stamens 6, a gynostemium, an inferior ovary and a capsule, is in highly advanced position in the family. The subgenus Pararistolochia, which has more stamens and more lobes of gynostemium, is very similar to the genus Thottea Rottb. and thus better considered as the most primitive subgenus in the genus. The subgenus Siphisia, which has definite stamens (6) in 3 pairs and 6 lobes of gynostemium as well as the polyploid feature (2n=4x=28), is the most advanced subgenus. As a result of the character analysis, the evolutionary trends of the subgenera in the genus, which are in accordance with those of the family, are proposed as follows: 1. stamens from indefinite to definite, and 2. gynostemium lobes from more to less. Distribution The more primitive subgenus Pararistolochia is only distributed in West Africa (except 1 species in Malesia), the subgenus Aristolochia in the tropical and subtropical regions, rarely in the temperate one, and the most advanced subgenus Siphisia occurs mainly in E. Asia, occasionally in N. America. The result of this work shows that the Hengduan Mountains is the second center of distribution after South America. The second center of distribution is of following features: 1. complex composition of taxa, among 3 subgenera and 8 sections, 2 subgenera and 7 sections have been recorded here, 2. rich in species, more than half of the total E. & S. Asian species, i.e. about 42 species have been found in this region, and 3. numerous endemics, more than 85 percent of the total number of species in the region, i.e. about 35 species, are endemic. Cytotaxonomy and taxonomic treatment The known chromosome numbers in 43 species, with 34 reported by Gregory (1956) and Fedorov (1969), together with 9 species newly reported in this work, show that Subgen. Aristolochia with 2n=2x=14, rarely 12, is apparently more primitive than Subgen. Siphisia with 2n=2x=28.     

Précisions paléontologiques et stratigraphiques sur divers inocérames cénomaniens et,en particulier,sur ceux de la Sarthe figurés par E. Guéranger en 1867

Modern determinations are given for the Inocerams figured by E. Guéranger in his work «Album paléontologique du département de la Sarthe.The validity of I. angulatus d'Orb. and I. scalprum J. Böhm is discussed as well as the variability of I. virgatusSchlüter.     

Association of Daily Growth Hormone Injection Adherence and Height Among Children With Growth Hormone Deficiency

ObjectiveRecombinant human growth hormone (somatropin) is recommended for children with growth hormone deficiency (GHD) to normalize adult height. Prior research has indicated an association between adherence to somatropin and height velocity. Further research is needed using real-world data to quantify this relationship; hence the objective of this study was to investigate the association between adherence to somatropin and change in height among children with GHD.MethodsThis retrospective cohort study included patients in the IQVIA PharMetrics Plus and Ambulatory Electronic Medical Records databases aged 3 to 15 years, with ≥1 GHD diagnosis code claim and newly initiated on somatropin between January 1, 2007 and November 30, 2019. Adherence was measured over the follow-up using the medication possession ratio (MPR); patients were classified as adherent (MPR ≥ 0.8) or nonadherent (MPR < 0.8).ResultsAmong 201 patients initiated on somatropin, 74.6% were male, mean age was 11.4 years, and the mean follow-up was 343.3 days. Approximately 76.6% of patients were adherent to somatropin over the follow-up period. Adjusted growth trajectories were similar between adherent and nonadherent patients pre-treatment initiation (P = .15). Growth trajectories post-initiation were significantly different (P = .001). On average, adherent patients gained an additional 1.8 cm over 1 year compared with nonadherent patients, adjusted for covariates.ConclusionGreater adherence to somatropin therapy is associated with improved height velocity. As suboptimal adherence to daily somatropin therapy is an issue for children with GHD, novel strategies to improve adherence may improve growth outcomes.     

A new Chinese species of Eostrobilops Pilsbry, 1927 with a checklist of Eostrobilops and Enteroplax Gude, 1897 species (Gastropoda,Pulmonata, Strobilopsidae)

Eostrobilops humicolus Páll-Gergely & Hunyadi, sp. n. is described from Guangxi Province, China. It is characterized by the combination of a small shell (diameter: 2.3–2.4 mm), strongly ribbed dorsal surface, an infraparietal lamella not reaching the callus, and long basal folds. The new species is found approximately 500 and 800 km from the two nearest species Eostrobilops infrequens (northern Vietnam), and Eostrobilops diodontina (Hunan, China), respectively. A checklist of extant Eostrobilops Pilsbry, 1927 and Enteroplax Gude, 1899 species is provided. Enteroplax yaeyamensis Habe & Chinen, 1974, Enteroplax kanjiokuboi Minato & Tada, 1992 and Enteroplax taiwanica Minato & Tada, 1992 are moved to the genus Eostrobilops because of the lack of an elevated parietal callus and a peripheral thread. A map showing all Eostrobilops records is provided.     

Xanthidae MacLeay, 1838 (Decapoda: Brachyura: Xanthoidea) systematics: A multi-gene approach with support from adult and zoeal morphology

Currently, 13 subfamilies are recognised in the brachyuran family Xanthidae: Actaeinae, Antrocarcininae, Chlorodiellinae, Cymoinae, Etisinae, Euxanthinae, Kraussiinae, Liomerinae, Polydectinae, Speocarcininae, Xanthinae, Zalasiinae and Zosiminae. This classification has been based on shared adult features like a transversely ovate carapace, well defined dorsal carapace regions, usually with lateral dentition, stout chelipeds and relatively short ambulatory legs. Such characters are now considered to be convergent. Consequently a number of higher xanthid taxa may be artifical and not monophyletic. A broad sample of 147 xanthid species representing 75 out of 124 genera from all 13 xanthid subfamilies were sampled in a multi-gene analysis. Four markers (three mitochondrial and one nuclear) were used and yielded a tree with ca. 30 xanthid clades. Monophyletic support was demonstrated for the Antrocarcininae (although substantially redefined), Cymoinae, and Polydectinae. Almost every other subfamily was para- or polyphyletic. Furthermore, the two other families of the Xanthoidea, Pseudorhombilidae and Panopeidae, were found nested within the Xanthidae. The molecular results were consistent with phylogenetic relationships implied by a suite of novel and/or neglected “ventral” adult characters including sternal characters, position of genital openings and morphology of the first zoea, instead of “dorsal” characters traditionally used to infer xanthid relationships.     

Application of Novel Design Bone Grafting for Treatment of Segmental Acetabular Rim Defects During Revision Total Hip Arthroplasty

The study aimed to develop efficient techniques with different novel graft structures to enhance the treatment of acetabular bone deficiency.The inhomogeneous material properties Finite Element Analysis(FEA)model was reconstructed according to computed tomography images based on a healthy patient without any peri-acetabular bony defect according to the Ameri-can Academy of Orthopedic Surgeons(AAOS).The FEA model of acetabular bone deficiency was performed to simulate and evaluate the mechanical performances of the grafts in different geometric structures,with the use of fixation implants(screws),along with the stress distribution and the relative micromotion of graft models.The stress distribution mainly con-centrated on the region of contact of the screws and superolateral bone.Among the different structures,the mortise-tenone structure provided better relative micromotion,with suitable biomechanical property even without the use of screws.The novel grafting structures could provide sufficient biomechanical stability and bone remodeling,and the mortise-tenone structure is the optimal treatment option for acetabulum reconstruction.     

Monographic treatment of Paraholosticha muscicola (Ciliophora,Keronopsidae), including morphological and molecular biological characterization of a brackish water population from Korea

Paraholosticha muscicola, type species of Paraholosticha Wenzel, inhabits mainly terrestrial habitats, but also freshwater. A brackish water population from Korea is described, the first record from such a habitat. Principal component analysis shows that this population is more similar to a terrestrial population from Denmark than to a population from Antarctic soil. Keronopsids have two strong morphological/ontogenetic apomorphies (frontal corona formed from anlagen I–III; division in cysts). However, the SSU rRNA sequence of the Korean population does not cluster with that of the Antarctic population in the phylogenetic tree, but both branch off consecutively and immediately before a mixture of other non-dorsomarginalian hypotrichs, including two further keronopsids. Furthermore, the keronopsids cluster in the phylogenetic network, providing phylogenetic conflicts, which cannot be exemplified in the conventional gene tree. To complete the picture of P. muscicola, we provide a detailed overview about nomenclature, history, taxonomy, and its geographic distribution. From the four synonyms proposed so far, we tentatively accept only P. lichenicola and P. ovata. Paraholosticha algivora is likewise very similar. Thus we propose to include these three taxa as members of the P. muscicola complex. Stylonethes sterkii and P. algivora are transferred to Paraholosticha Wenzel. A key to the Paraholosticha species is provided.     

Validation of Diagnostic Coding for Diabetes Mellitus in Hospitalized Patients

ObjectiveSome studies have shown that there is an undercoding of diabetes mellitus among hospitalized patients, which can have adverse clinical and financial implications for health systems. We aimed to validate the discharge diagnostic coding of diabetes mellitus in hospitalized patients using clinical and laboratory-based diagnostic indicators as the reference.MethodsThis was a retrospective cohort study of 83 690 discharges of 48 615 unique adult patients who were hospitalized in an academic medical center over 4.5 years and had at least 4 blood glucose measurements during admission. A missing diabetes code (MDC) was defined using 2 criteria. MDC₁ was defined as the presence of any of the following: blood glucose ≥200 (x2), A1C ≥6.5%, home antihyperglycemic medication, or preadmission code for diabetes, whereas MDC₂ was defined as preadmission diabetes or at least 2 other criteria in MDC₁. Multivariable logistic regression was used to identify factors associated with MDC compared to the present diabetes code.ResultsMDC₁ and MDC₂ were present in 12 186 (14.6%) and 3542 (4.7%) discharges, respectively. Factors associated with both MDC₁ and MDC₂ were medium-dose steroid use [adjusted odds ratio (aOR) 2.11, 2.01], high-dose steroid use (aOR 4.70, 2.50), intermediate medical care service (aOR 1.65, 1.55), infection (aOR 1.21, 1.34), and hepatic disease (aOR 1.93, 1.92).ConclusionIn this retrospective study, MDC ranged from 5% to 15% and was associated with various clinical factors. Further prospective studies are needed to validate these findings, explore the mechanisms behind these associations, and understand the clinical and financial implications.