Osteology and relationships of Rhinopycnodus gabriellae gen. et sp. nov. (Pycnodontiformes) from the marine Late Cretaceous of Lebanon

The osteology of Rhinopycnodus gabriellae gen. and sp. nov., a pycnodontiform fish from the marine Cenomanian (Late Cretaceous) of Lebanon, is studied in detail. This new fossil genus belongs to the family Pycnodontidae, as shown by the presence of a posterior brush-like process on its parietal. Its long and broad premaxilla, bearing one short and very broad tooth is the principal autapomorphy of this fish. Within the phylogeny of Pycnodontidae, Rhinopycnodus occupies an intermediate position between Ocloedus and Tepexichthys

Gladiopycnodontidae, a new family of pycnodontiform fi shes from the Late Cretaceous of Lebanon, with the description of three genera

The osteology of Gladiopycnodus karami gen. et sp. nov., of Monocerichthys scheuchzeri gen. et sp. nov. and of Rostropycnodus gayeti gen. et sp. nov., three new fossil fishes from the marine Cenomanian (Late Cretaceous) of Lebanon, is studied in detail. Some of their cranial characters and the presence of a postcoelomic bone clearly refer these fishes to the order Pycnodontiformes. However, they differ from all other described Pycnodontiformes by two important characters. Their snout is elongated as a rostrum, formed by the enlarged prefrontal and the toothless premaxilla, with this premaxilla sutured by its upper margin to the lower margin of the prefrontal. Their pectoral fin is replaced by a strong spine articulated with the cleithrum. These two apomorphies justify the erection of a new family, the Gladiopycnodontidae. The skull of Monocerichthys scheuchzeri sp. nov. does not differ greatly from a classical pycnodontiform skull and this species seems to be the more primitive member of this new family. Gladiopycnodus karami gen. et sp. nov. and Rostropycnodus gayeti gen. et sp. nov. are much more specialized. They share some apomorphies not present in Monocerichthys scheuchzeri gen. et sp. nov., i. e., an extremely long rostrum and an elongated first anal pterygiophore that sustains with the postcoelomic bone a strong and long anal spine. Gladiopycnodontidae fam. nov. and Coccodontidae share a series of apomorphies that justify the erection of a new superfamily, Coccodontoidea, grouping these two families

Implementing funding modalities for free access: The case for a "purchasing fund system" to cover medical care

The principle of free access to ARVs was recognized in Senegal in 2003. Debate now focuses on its expansion to cover all therapeutic care (consultations, exams, treatment for opportunistic infections). Expenditures incurred by this complementary packet often impede access to care. The main difficulty does not really arise from the need for funding but rather from how this treatment is managed and its impact on the current financing systems. In fact, four types of possible funding exist: (1) provision in kind of products necessary for the consumption of free services; (2) providing equipment that allows other revenues in compensation for losses created by free access; (3) increased public budgetary grants; (4) reimbursement for services by a third party. In this last solution, the third party may be the State or an ad hoc organism (NGO, insurance, designated fund). The study compares these different modalities across specific conditions in Senegal and describes their possible impact on the present and future health system. In effect, this analysis fits into a much broader debate since the principle of free access has already expanded to other domains, particularly childbirth (2003) and care for the elderly (2006). The study shows that the multiplication of parallel supplies, the coexistence of various “free” stocks and insufficient accounting of services might create serious disturbances in current management and financing systems. On the other hand, invoice reimbursements set up in some districts by various partners preserve financial autonomy and strengthen the managerial capacities of health structures. Nevertheless, with the increased number of people who are treated and the expansion of free access to other services, there is a risk of letting the number of individual mechanisms multiply when common services would be more effective. Given the financial limitations of community financing schemes and the difficulties to develop insurance systems in a very informal economy, it is now necessary to envisage the implementation of “purchasing funds,” for which the study proposes basic guidelines. Based on the logic of insurance, they rely on purchasing a predetermined service package (contractualization and accreditation), using the sectoral approach (by “pooling” public, private and international resources), funding based on results (a payment for services rendered) and management that is independent of public budgetary blockages (with the participation of civil society). Complete medical treatment for PLWHA may be the best way to progressively start this process because the service package is clearly predetermined, its cost has been assessed and the number of beneficiaries, in a country like Senegal, is still low. Moreover, if proper management of this fund can be ensured, institutional sustainability will ensure its financial sustainability. Therefore the fight against HIV/AIDS could contribute to reflection on health system reform.VIH ; sida ; accès aux soins ; financement de la santé ; fonds d'achat ; gratuité ; Sénégal

The cost of universal free access for treating HIV/AIDS in low-income countries: the case of Senegal

Since late 2003 in Senegal, voluntary tests, ARVs and CD4 counts have been provided free of charge by the State within the framework of public health services. Debate now focuses on expanding free access to other components of care (consultations, hospitalizations, complementary exams for opportunistic infections). A preliminary study assessed the supplementary cost needed to fund all care and appraised this measure's impact on the national program. Direct costs for treatment were calculated using two different methods: (1) by calculating total expenditures for a sample of 299 patients over a 22-month period (July 2003 to April 2005) treated by HAART (2 NRTI + 1 PI or NNRTI); and (2) by assessing the theoretical costs necessary to apply the national treatment protocols. Furthermore, national budgetary projections were analyzed to estimate possible margins available to officials. In 2006, the total cost of medical care for someone taking ARVs falls around 412€ per year; 84% of the cost covers the price of ARVs and reagents for CD4 counts. The total annual cost of medical care for a PLWHA who does not need ARV drugs is approximately 40€ per year, with 90% of this amount covering biological exams. Projections concerning changes in the number of PLWHA and treatment needs and analysis of budget estimations for 2007-2011 demonstrate that supplementary costs incurred by complete free access could be easily covered without disrupting the proposed funding plan. Complete free access for medical care for all PLWHA in the country is therefore economically feasible; what remains is to define this decision's integration into the current paying health system without causing disturbances that render the decision ineffective.VIH ; sida ; mdicaments antirétroviraux ; prise en charge médicale ; accès aux soins ; financement de la santé ; gratuité ; payement par les usagers ; Sénégal

<i>Ridewoodichthys</i>, a new genus for <i>Brychaetus caheni</i> from the marine Paleocene of Cabinda (Africa): re-description and comments on its relationships within the Osteoglossidae (Teleostei, Osteoglossomorpha)

The marine osteoglossid “Brychaetus” caheni from the Lower Paleocene of Cabinda (Africa) is re-studied. It does not belong to the genus Brychaetus because of differences in teeth and premaxilla shape. It is assigned to the new genus Ridewoodichthys on the basis of its caudal skeleton, which differs from that of all other known fossil and Recent Osteoglossidae

Considerations about the Late Cretaceous genus <i>Chirocentrites</i> and erection of the new genus <i>Heckelichthys</i> (Teleostei, Ichthyodectiformes) - A new visit inside the ichthyodectid phylogeny

The author describes briefly the osteology of the three valid species of the Late Cretaceous genus Chirocentrites. He shows that only the type species, C. coroninii, belongs to this genus. He creates the new genus Heckelichthys for the two other species, C. microdon and C. vexillifer, with the latter as type species. The phylogeny of the Ichthyodectidae is studied. The systematic position of Chirocentrites and Heckelichthys is specified

Les Ichthyodectidae (Teleostei, Ichthyodectiformes) des schistes bitumineux de l’Aptien (Crétacé inférieur) de Guinée Équatoriale et du Gabon

L’ostéologie et les relations phylogénétiques de trois ichthyodectidés des schistes bitumineux de l’Aptien de Guinée Équatoriale et du Gabon sont étudiés. La première espèce était déjà connue sous le nom de Chirocentrites guinensis. Cette espèce est valable mais son squelette montre qu’elle appartient non pas à Chirocentrites mais à Chiromystus, un genre caractérisé par des rayons pectoraux élargis et branchus et un axe vertébral court. Les différences entre Chiromystus et Cladocyclus sont soulignées pour démontrer la validité de Chiromystus. La deuxième espèce n’est connue que par quelques fragments crâniens, en particulier les mâchoires. Elle est nouvelle et représente un nouveau genre, Africathrissops weileri, qui paraît primitif et proche de Thrissops. Sa fossette d’articulation pour le carré est formée par le rétroarticulaire et l’articulaire sans participation de l’angulaire. La troisième espèce est inédite et représente aussi un nouveau genre, Verraesichthys bloti, caractérisé également par un squelette axial court mais son crâne et sa ceinture scapulaire diffèrent nettement de ceux de Chiromystus. Le squelette caudal d’un ichthyodectidé indéterminé mais évolué est également décrit

Sur la position systématique et les affinites de Greenwood- della Tockensis Taverne, L. et Ross, P.H. 1973 (Pisces Elopiformes) de l’Aptien inférieur de l’Ile d’Helgoland (Allemagne)

The relationships of Greenwoodella tockensis TAVERNE, L. and Ross, P. H., 1973 are discussed. This fish is referred to a new family, Greenwoodellidae,and placed in the sub-order Albuloidei (Pisces Elopiformes) as an ancestor of the Albulidae and Pterothrissidae

Ostéologie et relations de <i>Ligulella</i> (Halecostomi, Ligulelliformes nov. ord.), poisson du Jurassique moyen de Kisangani (Formation de Stanleyville) en République Démocratique du Congo

The osteology of Ligulella, a very small halecostome fish from the Middle Jurassic of Kisangani (Stanleyville Formation) in the Democratic Republic of Congo, is studied in detail on the basis of more than 100 specimens. It is shown that the genus is monospecific and that Ligulella fourmarieri is a junior synonym of Ligulella sluysi. The dermic bones of the skull roof are covered by a thin and smooth layer of ganoin. The lateral borders of the skull roof are ornamented with a fringe of large bony spines. A small toothed laterodermethmoid is located medially at the symphysis of the upper jaw and rejects laterally the premaxillae. The quadrate is devoid of a bony quadratic process. Both quadrate and symplectic articulate with the lower jaw. Based on its characters Ligulella has to be positioned in the neopterygian phylogenetic tree between the Pachycormiformes and the "Pholidophoriformes", allowing the creation of a new and peculiar ordinal status for it, the Ligulelliformes nov. ord

Ostéologie et relations de <i>Catervariolus</i> (Teleostei, "Pholidophoriformes") du Jurassique moyen de Kisangani (Formation de Stanleyville) en République Démocratique du Congo

The osteology of Catervariolus, a small fish from the Middle Jurassic of Kisangani (Stanleyville Formation) in the Democratic Republic of Congo, is studied in detail on the basis of more than 600 specimens. It is shown that the genus is monospecific and that Catervariolus passaui is a junior synonym of Catervariolus hornemani. Catervariolus is less evolved than the "classical" teleosts. Indeed, its ural vertebra 1 is still divided into two distinct centra. It still has an opisthotic, a surangular, a prearticular, coronoids, a Meckelian bone, six epurals and nine hypurals. Its scales are lepisosteid and not cycloid. The inclusion of Catervariolus in the order "Pholidophoriformes" is justified by some specialized characters of its skeleton. It possesses an impair vomer, an ossified supraoccipital, a quadrate with a quadratic process, a toothed dermobasihyal and a foramen for the efferent pseudobranchial artery pierced in the parasphenoid. Long epineurals are fused with the neural arches. Indeed, these apomorphies separate the "Pholidophoriformes" from the Pachycormiformes, their plesiomorphic sister-order. The toothed laterodermethmoids of Catervariolus form the middle of the upper jaw and reject laterally the premaxillae. The African fossil fish does not yet have an hypoethmoid associated with the vomer, neither a subtemporal fossa nor a bony prootico-intercalar bridge. It has three supraorbitals, three large postorbitals, a unique small supramaxilla and three toothed coronoids on the lower jaw. The toothed part of its dentary is elongated and not descending ventrally. The leptolepid notch of the oral border of the dentary is feebly developed or even absent. The combination of these characters shows that Catervariolus is the most primitive of all hitherto described "Pholidophoriformes"