Based on morphological evidence three new deciduous species of Berberis L. are proposed - Berberis pseudovirescens, Berberis orbicularis and Berberis tawangensis, the types being collected in the Tawang and West Kameng districts of Arunachal Pradesh, India. Detailed description and diagnosis, along with colour photoplate, distribution information and conservation status are provided. All these new species are provisionally evaluated as Data Deficient (DD) following IUCN guidelines.

Manuscript titleA Rare Familial Case of Harlequin Ichthyosis in Infant of a Diabetic Mother: a diagnostic and management challenge in Low middle income settings

The autonomic nervous system (ANS) plays a crucial role in maintaining homeostasis, and its dysfunction is linked to numerous clinical conditions, including chronic pain. Neuromodulatory interventions such as transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous cervical magnetic stimulation (tCMS), and intermittent theta burst stimulation (iTBS) have been investigated for their potential to modulate autonomic responses and pain perception. However, the efficacy and safety of these techniques remain unclear. This study aimed to evaluate the feasibility and safety of a single session of neuromodulatory stimulation in modulating autonomic function and pain processing in healthy individuals. A double-blind, randomized, crossover clinical trial was conducted with 22 healthy participants, each undergoing four intervention sessions (taVNS, tCMS, iTBS, and Sham-taVNS) in randomized order, with a washout period of at least 36 hours between sessions. Heart rate variability (HRV) and conditioned pain modulation (CPM) were assessed pre- and post-intervention using a Polar H10 cardiac sensor and a digital pressure algometer. Adverse effects were recorded immediately after each session. No statistically significant differences were observed in HRV or CPM outcomes across active stimulation conditions when compared to sham. Among the techniques evaluated, tCMS presented the most favorable safety profile, with fewer reported adverse effects relative to iTBS and taVNS. The absence of significant modulation effects suggests that a single session may be insufficient to induce detectable changes in autonomic or pain processing. However, the tolerability and safety of tCMS indicate its potential for future research involving repeated sessions and clinical populations.

AbstractToxic Epidermal Necrolysis (TEN) is an acute, uncommon, extensive, and life-threatening dermatological condition, which is caused by a delayed adverse response of the skin to a particular type of drug. Herein, we report a 41-year-old female with a known case of IgA nephropathy admitted for having TEN after a recent intake of Deflazacort, developed systemic candidiasis during admission, and was successfully treated with oral fluconazole. Early detection and immediate antifungal treatment of invasive candidiasis in TEN are crucial to prevent systemic complications and enhance patient outcomes.

Host density, genetic diversity and social groups are key factors influencing pathogen transmission in wildlife populations, but their interactions remain poorly understood in insects. Islands can provide natural laboratories with distinct populations that vary in density and genetic diversity, whereby dense, genetically homogenous populations are expected to facilitate pathogen transmission. We used bumble bees to test these predictions, assessing the population structure of the two common species Bombus pascuorum and B. terrestris across island and mainland sites in the British Isles and France and testing bees for five micro-parasitic and four viral pathogens. B. pascuorum formed distinct genetic clusters on islands, with varying levels of heterozygosity and only the Isle of Arran clustering with mainland populations. B. terrestris populations were less structured, but populations on the Isle of Man and the Scilly Isles were genetically separated from other island and mainland populations while showing low heterozygosity. Colony density was similar between species and not linked to genetic diversity, but had a positive effect on the prevalence of some pathogens. Contrary to expectations, there was no protective effect of high genetic diversity, suggesting that generalist bumble bee pathogens could be more affected by host species diversity and density. Yet, within B. terrestris populations, we found that nestmates showed more similar pathogen profiles than unrelated individuals, suggesting that genetic similarity and high contact rates within nests affect pathogen prevalence in wild bees.

The common crane (Grus grus), like other soaring species of birds, uses a migration strategy to minimise the risk of wind drift over open sea, resulting in aggregation of birds along migratory corridors. With the planned large-scale development of offshore wind farms there is a need for an improved understanding of the potential interactions between cranes and the wind turbines as they cross the sea during migration. By using laser rangefinder tracking and GPS-tagged crane individuals we studied the vertical flight behaviour in relation to weather conditions as they cross the Arkona Basin between Sweden and Germany. The effect of weather conditions on the vertical distribution (i.e. flight altitudes) of the cranes was modelled using generalized additive mixed models. The results show that the flight altitude of common cranes crossing the basin strongly depends on the wind and visibility conditions. Both during the spring and autumn migration the cranes utilise thermal winds at the coast to soar, and frequently reach altitudes >300 m. Despite variability in wind and visibility conditions, the model predictions showed that the flight altitude descended towards the central offshore parts of the basin with a steeper descending trend during headwind and during poor visibility. The Arkona Basin is currently the focus of large-scale offshore wind farm development activities with a full built out of the region’s capacity for offshore wind projected to cover approximately 80% of the migration corridor. Our results indicate that the overall collision risk of migrating cranes will depend on the frequency of adverse conditions which cause the birds to fly at rotor height over the wind development zone.

Fire and drought increasingly co-occur, exposing plants to greater drought stress during post-fire resprouting. Yet, the effect of this combination of disturbances on plant fitness remains poorly understood. Here, we examine how post-fire resprouting influences reproductive success under drought conditions in the Mediterranean shrub Anthyllis cytisoides. We took advantage of a natural setting where, following a high-intensity wildfire, burned (and resprouting) individuals coexisted with unburned ones. We compared flowering and fruiting performance under a postfire drought in both burned and unburned plants. Our results show that burned individuals were significantly less affected by drought: Compared to their unburned counterparts, they had a higher probability of flowering, produced more flowers, set more fruits and seeds, and produced heavier seeds. We propose that reduced competition and enhanced physiological condition following fire may temporarily boost plant fitness despite environmental stress. These findings suggest that post-fire resprouting may confer a short-term reproductive advantage during drought (“post-fire advantage window”). Understanding this dynamic is essential to predict plant responses under compound disturbance regimes in fire-prone ecosystems.

Animal-mediated seed dispersal is a key process in plant population dynamics, species distribution and ecosystem functioning. As long-distance dispersal agents, ungulates help to maintain native plant populations facing abiotic changes in their habitat and habitat fragmentation or habitat loss. However, they also contribute to the spread of exotic species. Most ungulates live in groups, whose dynamics depend on the social status, personality, sex, age and body size of its different members. But how ungulate sociality affects zoochory remains largely unknown. We designed our experiment with sheep to test the effect of age composition on epizoochorous dispersal. Ewe lambs have stronger social links and respond more strongly to stress than adult ewes, therefore showing higher group cohesion. First, we expected that the more frequent interactions among ewe-lambs would shorten diaspore retention times and dispersal distances as ewe-lamb proportion increases. Second, diaspore exchange should be higher with increasing ewe-lamb proportion. We monitored groups of six domestic sheep (Ovis aries, Romane breed) individuals with different age ratios, replicated four times: respectively, 0/6, 2/4, 4/2 and 6/0 adult ewes to ewe lambs. We attached five cocklebur (Xanthium strumarium) diaspores, colour-coded for each animal, to the fur on each individual flank, 10 in total. We traced each diaspore fate during six-hour sessions where we recorded movements, physical interactions among individuals and individual behaviour resulting in diaspore detachment or exchange. As expected, we found shorter retention times and dispersal distances and more diaspore exchanges as the proportion of ewe-lamb increases in the groups. Shaking, then scratching were the main behaviours leading to diaspore loss. Non-intentional contacts between individuals were the most frequent interactions associated with diaspore exchange. We encourage further research on the effect of group living, be it group size or composition, on the different phases of epizoochorous dispersal.

Purpose: To report the experience of the Italian Working Group on DDD (Ita-DDD-wg) in assigning DDDs to a list of antineoplastic agents. Methods: Active substances from the ATC L01 group with no assigned DDD and reimbursed at least once during 2021 by the Italian Healthcare Service were identified. A DDD-assignment reporting template was developed, including the following fields: ATC fifth-level code, active, route of administration, reference indication of use, reference posology, assignment criteria, DDD calculation formula, DDD value, and DDD unit of measure. Information from national and international Summaries of Product Characteristics of medicines containing the active substance of interest, along with evidence from literature and input from Ita-DDD-wg experts were considered. DDD assignment criteria were based on WHO guidelines and, whenever necessary, complemented by ad hoc criteria. Results: Forty-three ATC 5th-level codes were evaluated, resulting in a total of 44 DDDs assigned (2 distinct DDDs were assigned respectively to topical and oral aminolaevulinic acid formulations). For 35 out of 44 DDDs, adaptations of general WHO assignment criteria or newly defined approaches were adopted, i.e. calculations based on reference body surface area (BSA = 1.82 m 2), treatment cycle duration, and average daily amounts of topical product. Conclusion: This work demonstrated that assigning DDDs to antineoplastic agents is feasible based on few additional assumptions and criteria with respect to those from WHO guidelines. In fact, based on this work, WHO decided to establish an ad hoc working group for evaluation and assignment of DDDs to antineoplastic agents.

Purpose: This study developed and validated algorithms to identify incidence of endometrial cancer using ICD-9-CM and ICD-10-CM coding systems as part of a post-authorization safety study (EU PAS: EUPAS45602) of vaginal estrogen, estrogen and progestin combination hormone therapy (EPHT), and non-users of vaginal estrogen. Methods: Using national claims data in the HealthCare Integrated Research Database (HIRD), provisional endometrial cancer cases were identified using a screening algorithm comprising at least one endometrial cancer diagnosis code at any location and position between 1/1/2007, and 12/31/2021. One medical record per case was obtained for 700 provisional cases. Two experts in obstetrics and gynecology adjudicated the medical records classifying each patient as a confirmed case, confirmed non-case, or unknown. Positive predictive value (PPV), sensitivity, and their respective 95% confidence intervals (CI) were calculated. Algorithms were generated by choosing the codes and number of encounters to balance endometrial cancer detection and false positives. Algorithms were trained in a sample of non-users of vaginal estrogen and tested across treatment groups. Results: Among non-users, two visits with ICD-9-CM code 182.0 or 182.8 had a PPV of 91.2% (85.4%-95.2%) and sensitivity of 99.3% (95.9%-100.0%). Two visits with ICD-10-CM code C54.1, C54.8, or C54.9 had a PPV of 97.0% (93.6%-98.9%) and sensitivity of 99.5% (97.2%-100.0%). PPVs and sensitivities were over 75% across cohorts for both algorithms. Conclusion: Two visits with an endometrial cancer diagnosis code accurately identified endometrial cancer cases in both coding systems. Endometrial cancer diagnosis codes were highly specific. PPVs and sensitivities were similar in all cohorts.

Temperature is a crucial factor influencing the quality of sleep, as it directly affects thermal comfort during sleep. The present work reports the investigation of the thermal performance of high-density (HDF) and low-density (LDF) polyurethane foam mattresses impregnated with sodium-based Phase Change Materials (PCMs) and their efficacy in temperature buffering features. A controlled laboratory study comparing exposure to these mattresses was conducted by installing mattresses in an insulated wooden box and simulating body heat with incandescent light bulbs. Ten different mattress designs were tested, including variations such as the addition of PCM and perforations for maximum heat dissipation. A multichannel record system and a hygrometer were employed to constantly monitor the temperature and relative humidity, respectively. The results were both statistically significant and reliable, as confirmed by error and ANOVA tests (P < 0.0001). Among all the samples, it was found that PCM1/LDF possessed the most efficient thermal regulation capacity at a temperature difference of 6.98 °C, which is most suitable for improving sleep comfort. These results provide a way to enhance user thermal comfort by providing informative data for better mattress design.

A document by Justin L. Hay. Click on the document to view its contents.

A full-term male neonate delivered by midwife at home following an uneventful pregnancy to consanguineous union in Sudan was brought to emergency department with difficulty breathing, poor feeding, and a noticeable anterolateral neck swelling at six hours of life. The delivery was uncomplicated. On examination, the newborn was tachypneic, hypoxic and had tachycardia with weight 3.3 kg. A soft, non-tender neck mass measuring approximately 4×6 cm was noted in the anterior > right lateral region, displacing the head into extended position. The overlying skin was normal, and trachea was difficult to palpate (Image 1a). Non-invasive oxygen support initiated, and congenital neck masses like cystic hygroma or branchial cysts were considered as etiology for mass causing respiratory distress.Lateral neck radiography demonstrated tracheal deviation and narrowing. Neck ultrasound showed an enlarged, lobulated thyroid gland. Computed tomography confirmed a homogeneously enlarged thyroid with retrosternal extension compressing the upper airway. Thyroid function testing revealed markedly elevated thyroid-stimulating hormone (TSH reference: 152-292 nmol/L), consistent with congenital primary hypothyroidism. Maternal thyroid function was normal and hence, goiter is likely due to dyshormonogenesis. A case of twins with congenital goiter has been reported to require intubation and ventilation due to goiter.(1)  Oral levothyroxine (25 μg/day) was initiated. The infant’s respiratory distress improved and by day 5, oxygen was discontinued, and oral feeds resumed. Reports of successful antenatal thyroxine treatment have been reported.(2,3) At the 3-month follow-up, the neck swelling had fully regressed, and the infant demonstrated normal growth, development, and neurologic function (Image 1b). Thyroid function normalized at 3 month follow up.Key Clinical Message:Our case highlights that neonatal goiter causing airway compression is a rare but significant presentation of congenital hypothyroidism. Early recognition through imaging and thyroid function testing, followed by timely initiation of levothyroxine, can rapidly reverse respiratory distress and support normal neurodevelopment.ReferencesReynolds BC, Simpson JH, Macara L, Watt AJ, Kubba H, Donaldson MD, Pohlen J. Goitrous congenital hypothyroidism in a twin pregnancy causing respiratory obstruction at birth: implications for management. Acta Paediatr. 2006 Nov;95(11):1345-8. doi: 10.1080/08035250600711074. PMID: 17062458.Hanono A, Shah B, David R, Buterman I, Roshan D, Shah S, Lam L, Timor-Tritsch I. Antenatal treatment of fetal goiter: a therapeutic challenge. J Matern Fetal Neonatal Med. 2009 Jan;22(1):76-80. doi: 10.1080/14767050802448299. PMID: 19085636.Abuhamad AZ, Fisher DA, Warsof SL, Slotnick RN, Pyle PG, Wu SY, Evans AT. Antenatal diagnosis and treatment of fetal goitrous hypothyroidism: case report and review of the literature. Ultrasound Obstet Gynecol. 1995 Nov;6(5):368-71. doi: 10.1046/j.1469-0705.1995.06050368.x. PMID: 8590211.Figure legendsImage 1a: Visible anterior neck swelling shortly after birth.. Image 1b: Resolution of goiter after 3 months of therapy.Written informed consent was taken from the parents of the index case for publication purposes.Author contribution:Khalid Makki was the primary physician managing the case, contributed to the clinical diagnosis, coordinated imaging and treatment, and drafted the initial manuscript.Fatima Abdallah contributed to the clinical management, collected relevant patient data, reviewed the literature, and assisted in manuscript preparation.Poorvi Agrawal supervised the case report development, contributed to the interpretation of findings, critically revised the manuscript for intellectual content, and ensured compliance with reporting standards.All authors approved the final manuscript and agree to be accountable for all aspects of the work.

The sublethal effects of infection and disease on male advertisement behaviour remains poorly understood. The ‘terminal investment hypothesis’ proposes that infected organisms will increase reproductive investment when their future reproductive prospects decline. Evidence to support this hypothesis has come from reports that some anuran amphibians respond to infection with the amphibian chytrid fungus pathogen by elevating calling activity. However, the generality of this response remains unclear, justifying studies in more anuran species. The aim of the present study was to provide a preliminary examination of the terminal investment hypothesis by investigating the relationship between chytrid fungus infection status and male calling behaviour in wild Australian brown toadlets (Pseudophryne bibronii). Across four populations, we examined correlations between infection status and spectral and temporal properties of the biphasic advertisement call, whilst also accounting for interrelationships with intrinsic and extrinsic factors known to influence calling behaviour. We found that infected males produced calls with more pulses and high pulse repetition rate compared to uninfected males. The association we report supports the terminal investment hypothesis, and has the potential to impact host attractiveness, host fitness, and disease transmission. Our findings join a small yet growing body of evidence that chytrid fungus impacts frog calling behaviour, and more broadly, that pathogens modify host reproductive behaviour.

Climate change posing a serious threat to species distribution globally. Recently, climate change has substantially changed the distribution of invasive species. Coreopsis is a widely distributed invasive genus with strong adaptability, reproductive capacity and ability to growth well under wide range of conditions. The invasion of Coreopsis species has become a significant ecological issue in China. Therefore, this study, study used three climate change scenarios (SSP-126, SSP-245, SSP-585), along with MaxEnt modeling and ArcGIS, to identify the potential distribution areas and centroids of Coreopsis invasive plants in China. The results indicate temperature particularly, isotherm (BIO3) and the mean temperature of the warmest season and humidity were the major factor affecting distribution of Coreopsis. Human activities (HA) were also identified as major factor affecting the distribution of Coreopsis species. The results also indicated that suitable habitat Coreopsis drummondii has a largest area (4.138×106 km²), while Coreopsis verticillata has small suitable habitat area (9.53×105 km²). Under the current climate scenario, the six Coreopsis species are mainly distributed in southern China, but they are expected to migrate northward and to plateau regions under future climate scenarios. Moreover, the ecological and range overlap between Coreopsis grandiflora, Coreopsis lanceolata, Coreopsis grandiflora and Coreopsis tinctoria, is high. Therefore, these findings suggests that intense interspecific competition may occur between these adjacent species.

A document by Mario Rüdiger. Click on the document to view its contents.

Multi-band electrochromic (MBEC) smart windows, capable of decoupled management of solar radiation (visible and near-infrared transmittance) and thermal radiation (mid- and long-wave infrared emissivity), are crucial for zero-energy buildings and adaptive optical systems. However, they have not yet been developed due to the inherent material design challenges and kinetics-stability trade-offs. Inspired by lotus root vessels, we develop vertically aligned nano-helix tungsten oxide (NH-WO3) films with amorphous-crystalline heterophase. The multiscale microstructure provides numerous active sites, enhances local electric fields, and alleviates stress during repeated cycling. Consequently, NH-WO3 achieves unprecedented quad-band electrochromic performances with decoupled photothermal modulation across the visible to long-wave infrared spectra, featuring large optical contrast (ΔTVIS-NIR ~ 79%), significant temperature and emissivity variation (ΔT = 9.3 ℃, Δε = 0.47@5 μm), ultrafast switching (3.9/1.9 s@780 nm, 2.8/2.5 s@990 nm), and robust cyclability (10,000 cycles with only 9.1% optical-contrast loss). Furthermore, a prototype smart window based on the NH-WO3 film maintains a comfortable indoor temperature of 26 ℃ even under continuous AM 1.5G solar irradiation for 1 hour. This bio-inspired nano-helix design provides an efficient strategy for the development of advanced next-generation photothermal management smart windows towards practical energy-efficient architectures and adaptive optics.

Objective: To evaluate current clinical practices, identify perceived barriers, and explore healthcare professionals’ perspectives on the use of autologous umbilical cord blood (AUCB) in neonatal cardiac surgery across Europe. Methods: A descriptive, cross-sectional online survey was distributed to healthcare professionals involved in neonatal cardiac surgery. The questionnaire, developed ad hoc by a multidisciplinary expert team, assessed institutional AUCB use, perceived benefits and barriers, and professionals’ interest in further information. The survey was disseminated through European scientific societies and professional social media platforms. Data were collected anonymously and analyzed using descriptive statistics. Results: A total of 42 responses were analyzed. The majority of respondents were neonatologists (50%), followed by perfusionists and neonatal nurses; 78% were based in Spain. Only 10% of participants reported institutional use of AUCB, primarily for selected patients in the postoperative setting. Reported benefits included reduced transfusion requirements and decreased exposure to allogeneic blood products. Among non-users, key barriers included logistical challenges (18%), insufficient scientific evidence (15%), and limited training (10%). The most frequently cited overall obstacle was lack of education and training (78%), followed by regulatory restrictions. Only 8% considered the current evidence sufficient to support routine AUCB use. Despite limited implementation, overall interest was high (mean rating 4.6/5), with many respondents expressing interest in future collaboration. Conclusions: AUCB use in neonatal cardiac surgery remains limited and institution-dependent across Europe. Significant barriers—including insufficient training, logistical challenges, and perceived evidence gaps—hinder broader adoption. These findings highlight the need for standardized protocols, targeted educational strategies, and further clinical evidence to facilitate safe and effective integration of AUCB into neonatal cardiac care.