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Abstract We aim to explore the effect of head-down position (HDP), initiated within 24 hours of onset, in moderate anterior circulation stroke patients with probable large artery atherosclerosis (LAA) etiology. This investigator-initiated, multi-center trial prospective, randomized, open-label, blinded-endpoint, multi-center and phase-2 trial was conducted in China and completed in 2021. Eligible patients were randomly assigned (1:1) into the HDP group receiving −20° Trendelenburg, or control group receiving standard care according to national guideline. The primary endpoint was proportion of modified Rankin Scale (mRS) of 0 to 2 at 90 days, which is a scale for measuring the degree of disability after stroke. 90-day mRS was assessed by a certified staff member who was blinded to group assignment. A total of 96 patients were randomized (47 in HDP group and 49 in control group) and 94 (97.9%) patients were included in the final analysis: 46 in HDP group and 48 in control group. The proportion of favorable outcome was 65.2% (30/46) in the HDP group versus 50.0% (24/48) in the control group (unadjusted: OR 2.05 [95%CI 0.87-4.82], P = 0.099). No severe adverse event was attributed to HDP procedures. This work suggests that the head-down position seems safe and feasible, but does not improve favorable functional outcome in acute moderate stroke patients with LAA. This trial was registered with ClinicalTrials.gov, NCT03744533.

Bredia reniformis, a new species of Melastomataceae from Guangxi, China, is described and illustrated. Bredia reniformis is similar to B. plagiopetala (C. Chen) R. C. Zhou & Ying Liu and B. gracilis (Hand.‐Mazz.) Diels by having axillary inflorescences and flowers with eight isomorphic stamens, but differs from the latter two in having glandular‐puberulous indumentum, reniform calyx lobes and shortly falcate yellowish anthers with obconical dorsal appendages. [ABSTRACT FROM AUTHOR]

Spiradiclis quanzhouensis, a new species of Rubiaceae from northeastern Guangxi, China is described and illustrated. It is similar to S. umbelliformis, but can be distinguished by its rosulate habit, subglabrous stems, leaf blades that are pubescent on both surfaces, lanceolate purple‐pubescent stipules that are undivided or sometimes bifid in apical 1/3, an inflorescence with 2–4 flowers, lanceolate 4–5 mm long calyx lobes that are purple‐pubescent outside, a salveriform corolla that is light purple‐pubescent outside, a semi‐inferior ovary, and capsules that are light purple‐pubescent with persistent calyx lobes 5–6 mm, in fruit 2 × as long as capsule. [ABSTRACT FROM AUTHOR]

The karst area in South China is notable for its fragile vegetation and unique flora with many narrow endemic species, and is one of the most threatened biodiversity hotspots in the world. However, the biodiversity of acid soil areas scattered in the karst area have previously been underestimated. With a recent increase of new discoveries of plants and animals, the conservation of biodiversity in these acid soil areas has become urgent. This study deals with a new species, Impatiens longlinensis. The new species is similar to I. yui and I. lasiophyton in having pubescence, two lateral sepals, funnelform lower sepal, and linear capsule. But it can be distinguished by having orbicular to obovate dorsal sepals and oblong to elliptic lower and upper lobes of lateral united petals. Moreover, molecular data and micro-morphological evidence also support that the species is new to science. The new species is only known from a valley near the summit of Mt. Jinzhongshan within an area of less than 5 km2. Based on the Red List categories and criteria developed by the International Union for Conservation of Nature, and the threat posed by exploitation for tourism development, we categorize it as Critically Endangered (CR). [ABSTRACT FROM AUTHOR]