Few data are available on the burden of malaria hospitalization in the United States. Study of malaria using hospital-based data can better define the impact of malaria and help inform prevention efforts. U.S. malaria cases identified from hospitalization discharge records in the 2000-2014 Nationwide Inpatient Sample were examined. Frequencies and population rates were reported by demographics, infecting species, clinical, financial, institutional, geographic, and seasonal characteristics, and disparities were identified. Time trends in malaria cases were assessed using negative binomial regression. From 2000 to 2014, there were an estimated 22,029 malaria-related hospitalizations (4.88 per 1 million population) in the United States, including 182 in-hospital deaths and 4,823 severe malaria cases. The rate of malaria-related hospitalizations did not change significantly over the study period. The largest number of malaria-related hospitalizations occurred in August. Malaria-related hospitalizations occurred disproportionately among patients who were male, black, or 25-44 years of age. accounted for the majority of malaria-related hospitalizations. On average, malaria patients were hospitalized for 4.36 days with charges of $25,789. Patients with a malaria diagnosis were more often hospitalized in the Middle Atlantic and South Atlantic census divisions, urban teaching, private not-for-profit, and large-bed-size hospitals. Malaria imposes a substantial disease burden in the United States. Enhanced primaryand secondary prevention measures, including strategies to increase the use of pretravel consultations and prompt diagnosis and treatment are needed.
Risks for illness and death caused by the Blastomyces dermatitidis fungus are affected by demographic, geographic, and behavioral factors.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. The University of Chicago Press is collaborating with JSTOR to digitize, preserve and extend access to International Journal of Plant Sciences.Premise of research. Tristylous populations of Oxalis alpina have three floral morphs (short-, mid-, and long-styled), and populations appear to be at different stages in the evolution of distyly via loss of the midstyled morph. In tristylous populations transitioning to distyly, asymmetrical incompatibility reactions could affect style-morph frequencies and slow the evolution of distyly. We hypothesized that greater success of pollen from long-styled relative to short-styled morphs leads to an excess of mid-styled progeny from mid-styled morphs and favors retention of tristyly despite other forms of selection acting against the mid-styled morph.Methodology. We quantified morph ratios of progeny from naturally pollinated plants. We also compared pollen tube and seed production of mid-styled plants following single-source pollinations using pollen from long-versus short-styled pollen parents, and we investigated the proportion of short-styled progeny following pollinations of mid-styled plants with mixtures of pollen from short-and long-styled plants.Pivotal results. Three lines of evidence generally support the hypothesis that reduced performance of shortstyled pollen donors may favor retention of mid-styled plants.(1) Naturally pollinated mid-styled plants exhibited reduced numbers of short-styled progeny for two years in one of two tristylous populations with modified tristylous incompatibility. (2) In populations transitioning toward distyly, mid-styled plants pollinated by short-styled plants had fewer pollen tubes and lower seed production than crosses using longstyled plants as pollen parents. (3) Hand-pollinations of mid-styled plants using mixtures of pollen from shortand long-styled plants resulted in reductions in the proportion of short-styled progeny, consistent with the differences in pollen tube numbers produced by the paternal morphs.Conclusions. Asymmetry in paternity among different pollen donors via pollen tube performance influences the evolution of the breeding system of O. alpina, by affecting the relative proportions of different floral morphs and potentially counteracting selection through inbreeding depression and differential fitness of alleles controlling floral morphs.
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