The dwarf succulent genus Conophytum N.E.Br.: distribution, habitat and conservation.

The dwarf succulent genus Conophytum N.E.Br. is one of the most species rich in the Aizoaceae. Primarily restricted to the arid winter-rainfall region of the Northern and Western Cape Provinces of South Africa and southwestern Namibia, the genus is most closely associated with the Succulent Karoo biome, a region of high floral endemism and biodiversity. Many taxa are niche-specialists and almost a third of all Conophytum are severely range-restricted and can be considered to be pointendemics. The genus as a whole is vulnerable to anthropogenic impacts and many species are threatened by activities such as mining, agriculture and climate change

Conophytum bachelorum and its relatives: the introduction of a new conophytum from Namaqualand, C. confusum.

Summary: A reassessment of a group of four closely related taxa of the dwarf succulent genus Conophytum from Namaqualand, South Africa has been undertaken. This has resulted in the description of a newly discovered taxon, namely Conophytum confusum

Conophytum crateriforme - a new dumpling from Namaqualand

Summary: A new taxon in the dwarf succulent genus Conophytum from Namaqualand, South Africa is described – Conophytum crateriforme. The plant is named for its distinctive bowl shape

A new pubescent variety of Conophytum from the southern Richtersveld: Conophytum flavum subsp. novicium var. kosiesense.

Here we introduce a new, distinctive variety of Conophytum: C. flavum subsp. novi- cium var. kosiesense, named for the Kosies moun- tain where it grows. This taxon is characterized by the prominent covering of the bodies by a dense layer of trichomes, resulting in a greyish-white appearance. This feature can be seen with the naked eye but is especially evident when the epi- dermis is viewed using scanning electron mi- croscopy

The need for early referral to palliative care especially for Black, Asian and minority ethnic groups in a COVID-19 pandemic:Findings from a service evaluation

Background: Palliative care services face challenges in adapting and responding to the COVID-19 pandemic. Understanding how palliative care needs and outcomes have changed during the pandemic compared to before the pandemic is crucial to inform service planning and research initiatives. Aim: To evaluate the impact of COVID-19 on symptoms, clinical characteristics, and outcomes for patients referred to a hospital-based palliative care service in a district general hospital in London, UK. Design: A retrospective service evaluation. Data were extracted from the electronic patient records. Setting/participants: The first 60 inpatients with confirmed COVID-19 infection, referred to the hospital palliative care service between 1 March 2020 and 23 April 2020, and another 60 inpatients, referred to the hospital palliative care service between 11 March 2019 and 23 April 2019, were included from a district general hospital in East London, UK. Results: Patients with COVID-19 have lower comorbidity scores, poorer performance status, and a shorter time from referral to death compared to patients without COVID-19. Breathlessness, drowsiness, agitation, and fever are the most prevalent symptoms during COVID-19 compared to pain and drowsiness pre-COVID-19. Time from admission to referral to palliative care is longer for Black, Asian and minority ethnic patients, especially during COVID-19. Conclusion: Early referral to palliative care is essential in COVID-19, especially for Black, Asian and minority ethnic groups. There is urgent need to research why Black, Asian and minority ethnic patients are referred late; how palliative care services have changed; and possible solutions to setting up responsive, flexible, and integrated services

Review article: Use of ultrasound in the developing world

As portability and durability improve, bedside, clinician-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, nurses and medical officers have demonstrated the ability to perform and interpret a large variety of ultrasound exams, and a growing body of literature supports the use of point-of-care ultrasound in developing nations. We review, by region, the existing literature in support of ultrasound use in the developing world and training guidelines currently in use, and highlight indications for emergency ultrasound in the developing world. We suggest future directions for bedside ultrasound use and research to improve diagnostic capacity and patient care in the most remote areas of the globe

Predicting In Vivo Efficacy of Potential Restenosis Therapies by Cell Culture Studies: Species-Dependent Susceptibility of Vascular Smooth Muscle Cells

Although drug-eluting stents (DES) are successfully utilized for restenosis therapy, the development of local and systemic therapeutic means including nanoparticles (NP) continues. Lack of correlation between in vitro and in vivo studies is one of the major drawbacks in developing new drug delivery systems. The present study was designed to examine the applicability of the arterial explant outgrowth model, and of smooth muscle cells (SMC) cultures for prescreening of possible drugs. Elucidation of different species sensitivity (rat, rabbit, porcine and human) to diverse drugs (tyrphostins, heparin and bisphsophonates) and a delivery system (nanoparticles) could provide a valuable screening tool for further in vivo studies. The anticipated sensitivity ranking from the explant outgrowth model and SMC mitotic rates (porcine>rat>>rabbit>human) do not correlate with the observed relative sensitivity of those animals to antiproliferative therapy in restenosis models (rat≥rabbit>porcine>human). Similarly, the inhibitory profile of the various antirestenotic drugs in SMC cultures (rabbit>porcine>rat>>human) do not correlate with animal studies, the rabbit- and porcine-derived SMC being highly sensitive. The validity of in vitro culture studies for the screening of controlled release delivery systems such as nanoparticles is limited. It is suggested that prescreening studies of possible drug candidates for restenosis therapy should include both SMC cell cultures of rat and human, appropriately designed with a suitable serum