External validation of prediction models for pneumonia in primary care patients with lower respiratory tract infection: an individual patient data meta-analysis

Pneumonia remains difficult to diagnose in primary care. Prediction models based on signs and symptoms (S&S) serve to minimize the diagnostic uncertainty. External validation of these models is essential before implementation into routine practice. In this study all published S&S models for prediction of pneumonia in primary care were externally validated in the individual patient data (IPD) of previously performed diagnostic studies

Similar efficacy and safety of artemether-lumefantrine (Coartem®) in African infants and children with uncomplicated falciparum malaria across different body weight ranges

<p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy, including artemether-lumefantrine (AL), is currently recommended for the treatment of uncomplicated <it>Plasmodium falciparum </it>malaria. The objectives of the current analysis were to compare the efficacy and safety of AL across different body weight ranges in African children, and to examine the age and body weight relationship in this population.</p> <p>Methods</p> <p>Efficacy, safety and pharmacokinetic data from a randomized, investigator-blinded, multicentre trial of AL for treatment of acute uncomplicated <it>P. falciparum </it>malaria in infants and children in Africa were analysed according to body weight group.</p> <p>Results</p> <p>The trial included 899 patients (intent-to-treat population 886). The modified intent-to-treat (ITT) population (n = 812) comprised 143 children 5 to < 10 kg, 334 children 10 to < 15 kg, 277 children 15 to < 25 kg, and 58 children 25 to < 35 kg. The 28-day PCR cure rate, the primary endpoint, was comparable across all four body weight groups (97.2%, 98.9%, 97.8% and 98.3%, respectively). There were no clinically relevant differences in safety or tolerability between body weight groups. In the three AL body weight dosing groups (5 to < 15 kg, 15 to < 25 kg and 25 to < 35 kg), 80% of patients were aged 10-50 months, 46-100 months and 90-147 months, respectively.</p> <p>Conclusion</p> <p>Efficacy of AL in uncomplicated falciparum malaria is similar across body weight dosing groups as currently recommended in the label with no clinically relevant differences in safety or tolerability. AL dosing based on body weight remains advisable.</p

Ecology of Paphiopedilum rothschildianum at the type locality in Kinabalu Park (Sabah, Malaysia)

Rothschild's slipper orchid (Paphiopedilum rothschildianum), originating from Kinabalu Park in the Malaysian state of Sabah, on Borneo Island, is one of the most famous orchid species in the world. It caused a sensation when it was first discovered in the nineteenth century, and the precise details of its habitat were long kept a (trade) secret. The species is now widely available as a result of artificial propagation in culture, but the ecology of this species in the wild remained largely unknown. An expedition was organised by the authors to collect detailed habitat information, and to perform chemical analysis on P. rothschildianum leaves and associated rhizosphere soils. The species occurs on serpentinite (ultramafic) landslides at 500-1800 m asl on slightly acidic (means ranging from pH 5.8-6.7) soils with a cation exchange complex dominated by magnesium. The nutrient status (rhizosphere soil concentrations of phosphorus and potassium) is low, both the plant-available fraction and the total concentrations. The extreme soil chemistry was also reflected in the P. rothschildianum leaf chemistry with low concentrations of these elements and low foliar nitrogen, potassium and phosphorus. Reciprocal transplantation of P. rothschildianum on non-ultramafic soils has proven successful, which shows that soil chemistry is not limiting its growth, at least in culture. Rather, P. rothschildianum is restricted to open vegetation with a lack of competition brought about by a very unusual combination of factors: recurring landslides setting back vegetation succession, and extreme soil chemistry limiting plant establishment. Finally, the IUCN Red List status of P. rothschildianum and other Paphiopedilum-species of Kinabalu Park was provisionally assessed

Phytogeography of New Guinean orchids: richness, turnover, collection density

The aims of this study were (1) to assess the spatial distribution of orchid species richness in New Guinea, and (2) to examine patterns of species turnover in the orchid community through phytogeographical regionalization. We aimed to achieve these goals using botanical collection records, species distribution models (SDMs) and partitioning around medoids (PAM) clustering

Traps as treats : a traditional sticky rice snack persisting in rapidly changing Asian kitchens

Background: An accessory to modern developing economies includes a shift from traditional, laborious lifestyles and cuisine to more sedentary careers, recreation and convenience-based foodstuffs. Similar changes in the developed western world have led to harmful health consequences. Minimization of this effect in current transitional cultures could be met by placing value on the maintenance of heritage-rich food. Vitally important to this is the preservation and dissemination of knowledge of these traditional foods. Here, we investigate the history and functionality of a traditional rice snack cooked in Nepenthes pitchers, one of the most iconic and recognizable plants in the rapidly growing economic environment of Southeast Asia. Methods: Social media was combined with traditional ethnobotanical surveys to conduct investigations throughout Malaysian Borneo. Interviews were conducted with 25 market customers, vendors and participants from various ethnical groups with an in-depth knowledge of glutinous rice cooked in pitcher plants. The acidity of pitcher fluid was measured during experimental cooking to analyze possible chemical avenues that might contribute to rice stickiness. Results: Participants identifying the snack were almost all (96%) from indigenous Bidayuh or Kadazandusun tribal decent. They prepare glutinous rice inside pitcher traps for tradition, vessel functionality and because they thought it added fragrance and taste to the rice. The pH and chemical activity of traps analyzed suggest there is no corresponding effect on rice consistency. Harvest of pitchers does not appear to decrease the number of plants in local populations. Conclusions: The tradition of cooking glutinous rice snacks in pitcher plants, or peruik kera in Malay, likely carries from a time when cooking vessels were more limited, and persists only faintly in tribal culture today because of value placed on maintaining cultural heritage. Social media proved a valuable tool in our research for locating research areas and in interviewing respondents, and we endorse its further use in ethnobotanical investigations. Our gathered data urges for the preservation of sustainable, tribal plant use for the prosperity of both health and culture

Evolution of wood anatomical characters in Nepenthes and close relatives of Caryophyllales

Background and AimsNepenthes attracts wide attention with its spectacularly shaped carnivorous pitchers, cultural value and horticultural curiosity. Despite the plant’s iconic fascination, surprisingly little anatomical detail is known about the genus beyond its modified leaf tip traps. Here, the wood anatomical diversity of Nepenthes is explored. This diversity is further assessed with a phylogenetic framework to investigate whether the wood characters within the genus are relevant from an evolutionary or ecological perspective, or rather depend on differences in developmental stages, growth habits, substrates or precipitation. Methods Observations were performed using light microscopy and scanning electron microscopy. Ancestral states of selected wood and pith characters were reconstructed using an existing molecular phylogeny for Nepenthes and a broader Caryophyllales framework. Pairwise comparisons were assessed for possible relationships between wood anatomy and developmental stages, growth habits, substrates and ecology. Key Results Wood anatomy of Nepenthes is diffuse porous, with mainly solitary vessels showing simple, bordered perforation plates and alternate intervessel pits, fibres with distinctly bordered pits (occasionally septate), apotracheal axial parenchyma and co-occurring uni- and multiseriate rays often including silica bodies. Precipitation and growth habit (stem length) are linked with vessel density and multiseriate ray height, while soil type correlates with vessel diameter, vessel element length and maximum ray width. For Caryophyllales as a whole, silica grains, successive cambia and bordered perforation plates are the result of convergent evolution. Peculiar helical sculpturing patterns within various cell types occur uniquely within the insectivorous clade of non-core Caryophyllales. Conclusions The wood anatomical variation in Nepenthes displays variation for some characters dependent on soil type, precipitation and stem length, but is largely conservative. The helical-banded fibre-sclereids that mainly occur idioblastically in pith and cortex are synapomorphic for Nepenthes, while other typical Nepenthes characters evolved convergently in different Caryophyllales lineages. This is a pre-copyedited, author-produced version of an article accepted for publication in nnals of Botany following peer review. The version of record is available online at: https://doi.org/10.1093/aob/mcx01

Antimicrobial Activity of Necklace Orchids is Phylogenetically Clustered and can be Predicted With a Biological Response Method

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