The oldest known bat skeletons and their implications for Eocene chiropteran diversification.

The Fossil Lake deposits of the Green River Formation of Wyoming, a remarkable early Eocene Lagerstätte (51.98 ±0.35 Ma), have produced nearly 30 bat fossils over the last 50 years. However, diversity has thus far been limited to only two bat species. Here, we describe a new species of Icaronycteris based on two articulated skeletons discovered in the American Fossil Quarry northwest of Kemmerer, Wyoming. The relative stratigraphic position of these fossils indicates that they are the oldest bat skeletons recovered to date anywhere in the world. Phylogenetic analysis of Eocene fossil bats and living taxa places the new species within the family Icaronycteridae as sister to Icaronycteris index, and additionally indicates that the two Green River archaic bat families (Icaronycteridae and Onychonycteridae) form a clade distinct from known Old World lineages of archaic bats. Our analyses found no evidence that Icaronycteris? menui (France) nor I. sigei (India) belong to this clade; accordingly, we therefore remove them from Icaronycteridae. Taken in sum, our results indicate that Green River bats represent a separate chiropteran radiation of basal bats, and provide additional support for the hypothesis of a rapid radiation of bats on multiple continents during the early Eocene.

Wide pulse pressure: A clinical review.

Pulse pressure naturally increases over time as individuals' age due to arteriosclerosis and diffuse vascular stiffening. However, the differential for widened pulse pressure is broad and includes causes of hyperdynamic circulation and high-output heart failure, such as aortic regurgitation and hyperthyroidism. In the absence of an underlying cause, wide pulse pressure is a sign of deteriorating cardiovascular health and carries increased risk for mortality, disease progression, and adverse clinical outcomes in chronic diseases including cardiovascular disease and chronic kidney disease. Current emphasis of antihypertensive treatment on systolic and diastolic blood pressure does not always address pulse pressure, thus subjecting many patients to an independent risk factor for poor outcomes. Pulse pressure control is more successfully achieved with thiazide diuretics and long-acting nitrates when compared to other antihypertensive agents, but further research is needed to quantify the additional benefits of pulse pressure control over conventional blood pressure therapy. This case review provides an overview of the pathogenesis, pathologic causes, and treatment of widened pulse pressure and evaluates current evidence for pulse pressure as a predictor of clinical outcomes.