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In 1965, Bukit Anak Takun was surrounded by primary lowland rain forest and the cave ecosystem harboured six cave bat species and a diverse invertebrate fauna. By 1970, the forest had been cleared for opencast tin-mining, now replaced by a golf course. The karst is 130 m high with a basal area of 0.618 km2. The 1970s saw a great reduction in invertebrate species and cave bats, and the discovery of possibly new taxa of a psychodid fly, a small blind cockroach and a phalangid. The bat population dwindled to one bat species with about 100 bats in 1987, to only a few bats by 2006. Bukit Anak Takun is the second locality for the Critically Endangered Liphistius batuensis. Its population has also declined. Plant collection from 1969 has accumulated 142 species of vascular plants (two selaginellas; 19 ferns; two gymonsperms and 119 species of flowering plants) representing about 11% of the total Peninsular Malaysian limestone flora. Of these species, 16 are calciphiles and 21 usually occur on limestone substrate. Seventeen (17) species are endemic in Peninsular Malaysia of which eight are calciphiles. Three species, Peperomia maxwellana, Davallia pectinata and Elatostema sp. 4 grow on Bukit Anak Takun, but not on Batu Caves nor Bukit Takun. Five species are endangered by extinction. Some populations are threatened by their small population size (Goodyera hispida 35 plants and Monophyllaea hirticalyx 23 plants). Bukit Anak Takun lies on state land outside of any Totally Protected Area. It was recently declared a Malaysian geosite, which may result in increased accessibility that will threaten Monophyllaea hirticalyx, Peperomia maxwellana and Elatostema sp. 4 with habitat disturbance and Goodyera hispida with collecting. [ABSTRACT FROM AUTHOR]

Background and Aims: Although appendicitis is rare in young infants, the reported mortality is high. Primary aim of this systematic review was to provide updated insights in the mortality and morbidity (postoperative complications, Clavien‐Dindo grades I–IV) of appendicitis in infants ≤3 months of age. Secondary aims comprised the evaluation of patient characteristics, diagnostic work‐up, treatment strategies, comorbidity, and factors associated with poor outcome. Methods: This systematic review was reported according to the PRISMA statement with a search performed in Pubmed, Embase and Web of Science (up to September 5th 2022). Original articles (published in English ≥1980) reporting on infants ≤3 months of age with appendicitis were included. Both patients with abdominal appendicitis and herniated appendicitis (such as Amyand's hernia) were considered. Data were provided descriptively. Results: In total, 131 articles were included encompassing 242 cases after identification of 4294 records. Overall, 184 (76%) of the 242 patients had abdominal and 58 (24%) had herniated appendicitis. Two‐hundred (83%) of the patients were newborns (≤28 days) and 42 (17%) were infants between 29 days and ≤3 months of age. Either immediate, or after initial conservative treatment, 236 (98%) patients underwent surgical treatment. Some 168 (69%) patients had perforated appendicitis. Mortality was reported in 20 (8%) patients and morbidity in an additional 18 (8%). All fatal cases had abdominal appendicitis and fatal outcome was relatively more often reported in newborns, term patients, patients with relevant comorbidity, nonperforated appendicitis and those presented from home. Conclusion: Mortality was reported in 20 (8%) infants ≤3 months of age and additional morbidity in 18 (8%). All patients with fatal outcome had abdominal appendicitis. Several patient characteristics were relatively more often reported in infants with poor outcome and adequate monitoring, early recognition and prompt treatment may favour the outcome. [ABSTRACT FROM AUTHOR]

We report a case of retroperitoneal hematoma during prophylactic heparin therapy for coronavirus disease 2019 (COVID-19). A 79-year-old man was diagnosed with COVID-19 pneumonia with possible exacerbation of fibrotic hypersensitivity pneumonia. He received a prophylactic dose of subcutaneous heparin therapy, methylprednisolone pulse therapy and Intravenous remdesivir but developed a spontaneous iliopsoas muscle hematoma, and transcatheter arterial embolization was performed. Even with a prophylactic dose of subcutaneous heparin therapy, the course should be carefully monitored, especially in patients with preexisting risk factors for hemorrhagic complications. Once retroperitoneal hematoma develops, aggressive procedures, such as transcatheter arterial embolization, should be considered to avoid fatal outcomes. [ABSTRACT FROM AUTHOR]

Diminished physical activity is a frequent phenomenon leading to a higher incidence of cardiovascular morbidity and mortality. Our study aimed to assess the impact of physical activity on arterial stiffness and inflammation. Classification of physical activity was performed in 1945 individuals of the cross-sectional "Corinthia" study using the International Physical Activity Questionnaire. Demographic and clinical characteristics were obtained via a standardized questionnaire. Arterial stiffness was estimated via carotid-femoral pulse wave velocity evaluation, and the inflammatory burden was assessed via high sensitivity C reactive protein (hsCRP) measurement. Participants with low physical activity had the most impaired carotid-femoral pulse wave velocity values while abnormally increased measurements—adjusted for age and blood pressure—were more frequently encountered in individuals with low physical activity. Participants characterized as having vigorous physical activity had the lowest inflammatory burden, as estimated by hsCRP levels. The results remained unaffected even after adjustment for confounders. In a subgroup analysis according to sex, increased arterial stiffness and inflammatory burden were noted similarly in female and male subjects within the lowest percentile of physical activity. In conclusion, a significant association between physical activity, arterial stiffness, and inflammation was observed, even after adjusting for known cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

A revision of Rinorea Aublet in Peninsular Malaysia with key to species and varieties is given. A total of nine species are recognized and five varieties, including three new varieties, R. bengalensis var. wallichiana (Hook. & Thoms.) Kwek & Latiff stat. nov et var. nov., R. lanceolata var. maingayi (Hook. & Thoms.) Kwek & Latiff stat. nov et var. nov., and R. cinerea ssp. cinerea var. subcordata var. nov. and their synonyms, notes on distribution, habitats, and ecology, vernacular names (if known), specimens examined and taxonomic notes given. [ABSTRACT FROM AUTHOR]

Of the 92 Codonoboea species that occur in Peninsular Malaysia, 20 are recorded from the state of Terengganu, of which 9 are endemic to Terengganu including three new species, C. norakhirrudiniana Kiew, C. rheophytica Kiew and C. sallehuddiniana C.L.Lim, that are here described and illustrated. A key and checklist to all the Terengganu species are provided. The majority of species grow in lowland rain forest, amongst which C. densifolia and C. rheophytica are rheophytic. Only four grow in montane forest. The flora of Terengganu is still incompletely known, especially in the northern part of the state and in mountainous areas and so, with botanical exploration, more new species can be expected in this speciose genus. [ABSTRACT FROM AUTHOR]

A revision of the Peninsular Malaysian species of Beilschmiedia (Lauraceae) is presented with a summary of the taxonomic history of the group, key, full descriptions, distribution maps, conservation assessments, ecological information, ethno-botanical notes and a discussion of morphology. In this treatment, 18 species are recognised; six names are lectotypified (B. insignis, B. kunstleri, B. maingayi, B. membranacea, B. roxburghiana and B. scortechinii) and five are placed into synonymy for the first time; one name is validly published for the first time (B. atra) and one species is recognised and described here as new to science (B. kochummenii). Most species are considered to be common (Least Concern), but B. atra must be considered to be extinct, two species are Critically Endangered (B. kochummenii and B. membranacea), four are Endangered (B. lumutensis, B. penangiana, B. scortechinii, B. wallichiana) and one is listed as Vulnerable (B. insignis). [ABSTRACT FROM AUTHOR]

Initiating a revision of the Malaysian Myrsinaceae for the Flora of Peninsular Malaysia project, this paper revises Ardisia subgenus Bladhia from the region. Five taxa are recognised including a new species - Ardisia subverticillata Julius & Utteridge; a key, species descriptions, conservation assessments and distribution maps are provided. In addition, Ardisia tumida Furtado, previously treated within this subgenus, is excluded and transferred to subgenus Pimelandra. [ABSTRACT FROM AUTHOR]

In the treatment of Strombosia for the Flora of Peninsular Malaysia, the doubtful taxon, Strombosia sp. A sensu Whitmore was re-examined. This taxon is recorded from Malaysia and is identified to be closely related to Strombosia ceylanica Gardner due to the presence of an obvious nectar disc in the flower buds and their similarities in fruits. However, Strombosia sp. A shows a remarkable leaf size difference from S. ceylanica. Therefore, a standard morphological taxonomic revision and morphometric analysis were carried out to assess the status of Strombosia sp. A. A total of 131 collections from India, Sri Lanka, Sumatra, Peninsular Malaysia, Singapore, Borneo and Java were studied. Of these, 12 specimens of Strombosia sp. A and 47 of S. ceylanica were selected for morphometric analysis and 14 vegetative and reproductive characters were analysed using Divisive Hierarchical Clustering and Principal Components Analysis. Results showed that Strombosia sp. A formed a distinct clade, well-separated from S. ceylanica. Description of Strombosia sp. A as a new variety is justified by the results of morphometric analysis and consistency of its larger-sized leaves, while reproductively, it is similar to S. ceylanica. This new variety is described here as Strombosia ceylanica Gardner var. macrophylla Phoon. Enumeration and illustration of this new variety are provided here. [ABSTRACT FROM AUTHOR]

A revision of the genus Microcos in Peninsular Malaysia and Singapore was conducted resulting in the recognition of twelve species. Six taxa (M. antidesmifolia var. antidesmifolia, M. fibrocarpa, M. lanceolata, M. latifolia, M. laurifolia and M. tomentosa) are common and occur more or less throughout Peninsular Malaysia. Four species (M. globulifera, M. hirsuta, M. latifolia and M. tomentosa) are recorded for Singapore. One species (M. riparia) is newly recorded for Peninsular Malaysia, and two species (M. erythrocarpa and M. malayana) are endemic to Peninsular Malaysia. A complete list of exsiccatae, key, nomenclatural typification and synonymy, descriptions and illustrations are provided for all twelve species. [ABSTRACT FROM AUTHOR]