Characteristics of refused materials are prerequisite information required to determine the strategic reclamation of extreme land degradation in post-tin mining areas. The objective of the study was to evaluate mineralogical, chemical, and physical properties and heavy metals of spoil and tailing as the basis for reclamation measures. Seven representative soil profiles were made and sampled to a depth of 130 cm for various soil analyses. Results showed that tin mining has drastically altered the soil texture from sandy clay loam under native conditions to loamy sand and sand under post-tin mining. Mineralogical constituents of refused materials were mainly mineral resistant to chemical weathering, consisting of predominant quartz with small amounts of tourmaline, opaque, zircon and garnet. Total X-ray fluoresce elemental analysis showed extreme high SiO2 content (92-96%) associated mainly with quartz mineral, and extremely low oxides of Ca, Mg, P, K and S (< 0.2% altogether). This suggests all nutrients are severe problems for crops. Type of total heavy metals showed the Cr2O3 was high in sandy tailing (204 - 286 mg kg-1), while the SnO was low (0 -153 mg kg-1) and they were preserved in the structure of host minerals, thereby the health risk is negligible. Based on many serious constraints of soils, the strategic reclamation to recover soil productivity and ecological function was the building up soil organic matter, establishing “pot planting point” technique, complete fertilizer application, and selection of crops with an ability to fix N nutrient from the atmosphere, and adaptive to low soil nutrients.

Accepted version of this manuscript can be found here: https://doi.org/10.1111/gcb.15862The distribution of abundance and biomass within ecological communities is related to trophic transfer efficiency from prey to predators. While it is considered to be one of the few consistent patterns in ecology, spatiotemporal variation of this relationship across continental-scale environmental gradients is unknown. Using a database of stream communities collected across North America (18-68° N latitude, -4 to 25°C mean annual temperature) over 3 years, we constructed 162 mass-abundance relationships (i.e. size spectra). Size-spectra slopes declined (became steeper) with increasing temperature. However, the magnitude of change was relatively small, with median slopes changing from -1.2 to -1.3 across a 29°C range in mean annual temperature. In contrast, total community biomass increased 3-fold over the temperature gradient. Our study suggests strong conservation of abundance size-spectra in streams across broad natural environmental gradients. This supports the emerging use of size-spectra deviations as indicators of ecosystem health.

In the present study, we first introduce Generalized Bessel-Maitland function $\mathbb{J}^{\xi }_{\zeta,a}(z)$ and then derive sufficient conditions under which the Generalized Bessel-Maitland function $\mathbb{J}^{\xi}_{\zeta,a}(z)$ have geometric properties like univalency, starlikeness and convexity in the open unit disk $\mathscr{D}$.

Background: Prolonged tracheostomy bypasses the upper airways leading to absence or reduction of nasal airflow. This altered nasal physiology not only impairs olfaction but also may cause mucociliary dysfunction and consequent nasal crusting and rhinosinusitis. Objective: To objectively evaluate the extent of nasal mucociliary impairment in patients with prolonged duration of tracheostomy. Design and Setting: This is a prospective case-control study done in a tertiary care center wherein the nasal mucocilary function was assessed by saccharin test in patients who were tracheostomized for a period of more than 4 weeks and the saccharin transit time (time taken to appreciate the sweet taste after endoscopic insertion of saccharin pellet on anterior end of inferior turbinate) was compared by the same test in age and sex matched healthy individuals. Main outcome measures: Clinical data, indication of tracheostomy and duration of tracheostomy were assessed for their impact on the nasal mucociliary clearance using saccharin transit time in the two groups which was then statistically analyzed using student t-test. Results: Mean saccharin transit time in 30 patients with prolonged tracheostomy was 934.97 seconds with a standard deviation of 75.95 seconds whereas in 30 controls, the meantime was 447.4 seconds with a standard deviation of 63.22 seconds, which was statistically significant (p<0.001) Conclusion: Prolonged duration of tracheostomy leads to impaired nasal mucociliary clearance, which in turn could cause chronic rhinosinusitis.

Introduction: Extensive ossification over the semicircular canal is not common in the surgery of otitis media. This study aimed to reduce intraoperative and postoperative complications among patients with extensive ossification over the lateral semicircular canal and concomitant otitis media. Methods: The patients’ clinical data were retrospectively reviewed to determine the preoperative imaging characteristics of perilabyrinthine ossificans and key points of surgical operation. The data of 156 patients who underwent radical mastoidectomy or tympanoplasty between January 2016 and December 2018 due to chronic otitis media or cholesteatoma were reviewed. Seven patients with extensive ossification over the lateral semicircular canal were identified, and their preoperative imaging results, intraoperative procedures, and postoperative symptoms were evaluated. Results: The incidence of extensive ossification over the lateral semicircular canal among patients with chronic otitis media was 4.5% (7/156). Ossification occurred in the periphery of the lateral semicircular canal; the osseous tissue frequently fused with the osseous lateral semicircular canal, obscuring the boundaries between the two structures. A semicircular canal fistula was observed in two of the seven patients with extensive ossification over the lateral semicircular canal. The two patients underwent surgical patching or filling and symptomatic hormone treatment. Postoperative vertigo occurred in both patients and subsided within 1–3 months. There was no significant difference between preoperative and postoperative hearing thresholds. Conclusion: Extensive ossification over the lateral semicircular canal has a low incidence and may be discovered through preoperative imaging evaluation, enabling medical personnel to engage in adequate preoperative preparations. During the surgical procedure, navigational landmarks are required to determine the anatomical structures. The management of semicircular canal fistulas is essential to the reduction of intraoperative and postoperative complications.

Cesaro polynomials were introduced and investigated in 1978, and then have been cited in several articles [1, 2]. In this sequel, by modifying Lin at el. show how to generalize the Cesaro polynomials in one variables to present two generating functions of the generalized Cesaro polynomials g_{n}^{(s)}(λ,x) [6]. Very recently, M. A. Malik introduced and investigated Cesaro polynomials in two and three variables to give their generating functions [3]. Subsequently, N. Özmen investigated the generating functions for the q analogue of generalized Cesaro polynomials [7]. In this paper, new multivariate generalized Cesaro polynomials will be obtained. Two new generating functions will be given and some special properties of this polynomial will be examined.

Objective: Cardiac tumors are rare conditions. The vast majority of them are benign yet they may lead to serious complications. Complete surgical resection is the gold standard treatment and should be performed as soon as the diagnosis is made. Median sternotomy (MS) is the standard approach and provides excellent early outcomes and durable results at follow-up. However, minimally invasive (MI) is gaining popularity and its role in the treatment of cardiac tumors needs further clarification. Methods: A systematic literature review identified 12 candidate studies; of these, 11 met the meta-analysis criteria. We analyzed outcomes of 653 subjects (294 MI and 359 MS) with random effects modeling. Each study was assessed for heterogeneity. The primary endpoints were mortality at follow-up and tumor relapse. Secondary endpoints included relevant intra- and post-operative outcomes; tumor size was also considered. Results: There were no significant between-group differences in terms of late mortality (incidence rate ratio (IRR): MI vs. MS, 0.98 [95% CI: 0.25¬–3.82], p = 0.98). Few relapses and redo surgery were observed in both groups (IRR: 1.13[0.26-4.88], p=0.87);( IRR: 1.92 [95% CI: 0.39-9.53], p=0.42); MI was associated to prolonged operation time yet with no effects on clinical outcomes. Tumor size did not significantly differ between groups. Conclusions: Both MI and MS are associated with excellent early and late outcomes with acceptable survival rate and low incidence of recurrences. This study confirms that cardiac tumor may be approached safely and radically with a MI approach.

Background: Vascular endothelial dysfunction, arteriosclerosis and atherosclerotic plaque are well-known risk factors for cardiovascular disease (CVD). Studies on vascular health markers have been well-established, however, there is still a lack of related research on combined vascular structure and function indicators. A variety of CVD prediction models are proposed, all of which are aimed at the traditional risk factors. Beijing vascular health stratification (BVHS) aiming at vascular health, combined the endothelial function, arteriosclerosis, atherosclerotic plaque and vascular lumen stenosis to comprehensively assess the vascular health and grade it. This study will take the BVHS as the guiding ideology to explore the predictive value of the combined evaluation of vascular structure and function for cardiovascular events and assess the predictive value of BVHS and compare it with the existing risk assessment systems. Methods: A total of 1,500 subjects will be enrolled into the prospective cohort study from a community and will be followed up for 3 years from July 1, 2020 to June 30, 2023. Subjects aged 40 or above, without coronary heart disease, stroke or peripheral artery disease, with written informed consent will be included; subjects with end-stage hepatorenal diseases (uremia, renal failure, cirrhosis, liver failure), mental disorders or cognitive disorders, with any other factors that the researcher thinks are not suitable for the study will be excluded. Conclusions: The study will be the first to grade vascular health by combing various vascular indicators and explore the prediction value and compare with other risk prediction system in general Chinese population.

Background More evidence has shown FDG PET/CT parameters might be associated with survival of patients with locally advanced cervical cancer (LACC) treated with concurrent chemo-radiotherapy (CCRT). Objectives To perform this meta-analysis to investigate the prognostic value of pretreatment FDG PET/CT parameters. Search strategy PubMed and Embase. Selection criteria Studies that met the following criteria were enrolled: patients treated with CCRT for LACC; FDG PET/CT scans performed before or during treatment; and relationship between the parameters of FDG PET/CT and the prognosis of patients were investigated. Data collection and analysis Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate overall survival (OS) or event-free survival (EFS). Main results Higher primary tumor TLG (HR = 1.843, 95% CI = 1.100–3.086, P = 0.02) and MTV (HR = 2.06, 95% CI, 1.21–3.51, P = 0.007) were significantly associated with shorter EFS. Patients with high SUVmax have a shouter OS than those with low SUVmax (HR = 2.582, 95% CI 1.936–3.443, P <0.001). Primary tumor SUVmax (HR = 1.938, 95% CI, 1.203–3.054, P = 0.004) and nodal SUVmax (HR = 3.478, 95% CI = 2.006-6.029, P <0.001) were significantly correlated with EFS with relatively high heterogeneity (I2 = 84%, I2 = 69.4%, respectively). Nodal SUVmax (HR = 2.095, 95% CI = 2.027–2.166, P <0.001) were significantly correlated with OS with relatively high heterogeneity (I2 = 54.1%, P = 0.140). Other parameters had no detected association with survival. Conclusions Pretreatment FDG PET/CT parameters serve as a prognostic predictor.

Objective: To investigate the effects of 3-month supplementation with oral probiotics on quality of life in young women with primary dysmenorrhoea Design Randomized, double blind, placebo-controlled trial Setting A tertiary university hospital in Malaysia Population Women aged 18 to 45 years old suffering from primary dysmenorrhoea Methods: 72 patients were randomized to receive either oral sachets containing Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus lactis, Bifidobacterium bifidum, Bifidobacterium longum, and Bifidobacterium infantis 107 mg each or placebo twice daily for three months. Main outcome measures Visual Analog Score (VAS) of pain, Verbal Rating Scale (VRS) of severity, frequency of non-steroidal anti-inflammatory drugs (NSAIDs) use, and quality of life (QoL) scores derived from Short Form 12 item version 2 (SF12v2) questionnaire Results Both groups showed improvement in quality of life scores. There was a non-statistically significant lower NSAIDs use in probiotic group compared to placebo group (median 1 vs 2, p-value = 0.26). Placebo group showed better severity score (VRS) on day 2 of menses compared to probiotic group (median 0 vs 1, p-value <0.05). No difference in other quality of life scores was noted. In subgroup of non-NSAIDs users, the pain score (VAS) was lower in the probiotic group compared to placebo, which was not statistically significant (p-value = 0.59) Conclusion Probiotic supplement may reduce NSAIDs use in women with primary dysmenorrhoea Funding This study receives supply of the oral probiotic sachets and placebo from the manufacturing company Hexbio Sdn Bhd Keywords Primary dysmenorrhea, probiotics, quality of life, menstrual disorders

Objective: To investigate whether the COVID-19 pandemic would significantly affect pregnancy-associated factors in uninfected pregnant women in China. Design: A combined cohort study Setting: Six sites in China Population: Uninfected pregnant women participating in the programs with a singleton birth and delivery or termination from January 1 to May 31 2019 (pre-pandemic period, P-2019) and from January 1 to May 31 2020 (pandemic period, P-2020) (n = 32,277). Methods: The associations of pregnancy-associated outcomes and the COVID-19 were assessed by poisson regression, linear regression or log-binomial regression. Main Outcomes Measures: The number of prenatal examinations (NPE), delivery gestational week (DGW), caesarean section (CS), preterm birth, macrosomia. Results: For Hubei, the NPE and DGW were negatively associated with the COVID-19 pandemic, whereas the CS and preterm birth rates were positively associated with the COVID-19, with adjusted relative risks (aRRs) of 1.11 [95% confidence interval (CI) 1.06–1.17] and 1.37 (95% CI: 1.02–1.84) respectively. For Guangdong, the associations of CS and preterm birth with the COVID-19 were similar in Hubei. Limited associations were evident in other areas while a positive association with macrosomia was observed in Beijing [aRR = 1.26 (95% CI: 1.03–1.55)]. Conclusions: The CS and preterm birth rates increased slightly in areas that were more affected by the pandemic than other areas. NPEs were not significantly interrupted and most maternal and neonatal clinical characteristics were within the normal ranges. Appropriate interventions should be considered to protect pregnant women. Keywords: COVID-19, pregnancy outcome, neonatal outcome, uninfected pregnant women

Objective: To describe the measurement of uterine cavity shape on coronal section by three-dimensional ultrasound in Chinese adult female population. Methods: A cross-sectional observational study including 172 adult females with normal uterine cavity was performed and all participants underwent transvaginal two-dimensional and three-dimensional ultrasonography. Seven measurements (uterine cavity width, uterine cavity length, internal os width, lateral indentation depth, lateral indentation angle, cornual angle, uterine cavity area ) were determined and evaluated on coronal plane of uterus. Results: The mean age of the participants included was 29.8±5.4 years. 95% reference range of uterine cavity length, uterine cavity width, internal os width, cornual angle, lateral indentation angle and lateral indentation depth were estimated as 26-38 mm, 25-40 mm, 4-11mm, 39-88°, 131-171° and 0.8-6.4 mm, respectively. The mean uterine cavity area was 5.5±1.3 cm² and the range of 95% reference value was 3.0-8.0 cm2. Conclusion: Our research showed that a normal uterine cavity in adult women of childbearing age had lateral indentation depth ≤7mm, lateral indentation angle ≥130° and cornual angle ≥40°. The width of the uterine cavity measured on the coronal plane less than 22mm and the uterine cavity area less than 3cm2 can be considered smaller than normal.

Soil and nutrient loss play a vital role in eutrophication of water bodies. Several simulated rainfall experiments have been conducted to investigate the effects of a single controlling factor on soil and nutrient loss. However, the role of precipitation and vegetation coverage in quantifying soil and nutrient loss is still unclear. We monitored runoff, soil loss, and soil nutrient loss under natural rainfall conditions from 2004 to 2015 for 50-100 m2 runoff plots around Beijing. Soil erosion was significantly reduced when vegetation coverage reached 20 and 60%. At levels below 30%, nutrient loss did not differ among different vegetation cover levels. Minimum soil N and P losses were observed at cover levels above 60%. Irrespective of the management measure, soil nutrient losses were higher at high-intensity rainfall (Imax30>15 mm/h) events compared to low-intensity events (p < 0.05). We applied structural equation modelling (SEM) to systematically analyze the relative effects of rainfall characteristics and environmental factors on runoff, soil loss, and soil nutrient loss. At high-intensity rainfall events, neither vegetation cover nor antecedent soil moisture content (ASMC) affected runoff and soil loss. After log-transformation, soil nutrient loss was significantly linearly correlated with runoff and soil loss (p < 0.01). In addition, we identified the direct and indirect relationships among the influencing factors of soil nutrient loss on runoff plots and constructed a structural diagram of these relationships. The factors positively impacting soil nutrient loss were runoff (44-48%), maximum rainfall intensity over a 30-min period (18-29%), rainfall depth (20-27%), and soil loss (10-14%). Studying the effects of rainfall and vegetation coverage factors on runoff, soil loss, and nutrient loss can improve our understanding of the underlying mechanism of slope non-point source pollution.

The aim of this paper is to give an alternative technique for the derivation of a prior energy estimate. Consequently, this allows to define a natural energy norm of the long-term well-posedness result established by S. Israwi in [2] but for the original system, in which the partial operator ∇× is not involved.

The real estate sector is evolving and changing rapidly with the increase in housing demand, and new luxury housing projects appear every day. The reliability of housing market investments is largely dependent on accurate pricing. The aim of this study is to introduce a dynamic pricing procedure that estimates housing prices using the most important attributes of a house. To this end, a hybrid modeling system is proposed employing linear regression, clustering analysis, nearest neighborhood classification, and the Support Vector Regression (SVR) method. The housing data of the Kadikoy area in Istanbul, collected via manual web scraping, was used for the raining and validation of the proposed algorithm. The results of the hybrid model were compared using multiple linear regression, ridge regression, and Support Vector Machines (SVMs). The experimental results show that the proposed model is superior, both in terms of Residual Mean Square Error (RMSE) and Mean Absolute Percentage Error (MAPE) measures. Therefore, the proposed dynamic hybrid modelling structure can be successfully used for predicting house pricing.

We are presenting a case of Necrobiosis Lipodica disease in a 55 year lady whose diabetes status was not known at the time of presentation in dermatology OPD. Traditionally, the diagnosis is confirmed by histopathological examination (HPE). Dermoscopy can also be used as a noninvasive tool to confirm the diagnosis.

Cysteine (Cys) is the most reactive amino acid participating in a wide range of biological functions. In-silico predictions complement the experiments to meet the need of functional characterization. Multiple Cys function prediction algorithm is scarce, in contrast to specific function prediction algorithms. Here we present a deep neural network-based multiple Cys function prediction, available on web-server (DeepCys) (https://deepcys.herokuapp.com/). DeepCys model was trained and tested on two independent datasets curated from protein crystal structures. This prediction method requires three inputs, namely, PDB identifier (ID), chain ID and residue ID for a given Cys and outputs the probabilities of four cysteine functions, namely, disulphide, metal-binding, thioether and sulphenylation and predicts the most probable Cys function. The algorithm exploits the local and global protein properties, like, sequence and secondary structure motifs, buried fractions, microenvironments and protein/enzyme class. DeepCys outperformed most of the multiple and specific Cys function algorithms. This method can predict maximum number of cysteine functions. Moreover, for the first time, explicitly predicts thioether function. This tool was used to elucidate the cysteine functions on domains of unknown functions (DUFs) belonging to cytochrome C oxidase subunit-II (COX2) like transmembrane domains. Apart from the web-server, a standalone program is also available on GitHub (https://github.com/vam-sin/deepcys)

Heterocephalus glaber or the naked mole rats(NMRs) belongs to the genus nude moles of the Bathyergidae family, which is the only kind of temperature changing mammal with true sociality in the world and shares 93% genetic homology with humans. Long-term subterranean burrowing living has led to NMRs gradually evolved a series of physiological characteristics that are significantly different from mammals living on the ground, such as vitamin D deficiency, sensory organs degeneration and extreme hypoxia tolerance. Despite the harsh living environment, NMRs are extremely long-lived. Their average lifespan is 5-7 times that of laboratorial mice of the same size, up to 30 years. These physiological characteristics of NMRs giving them a good applicable prospect when studying neurological related diseases such as pain, ischemic stroke, and Alzheimer’s disease(AD). Here, we have reviewed the studies published on the neurophysiological characteristics of NMRs to provide reference for future research.

Data on the prevalence and outcomes of coronavirus disease (COVID-19) in children with cancer is limited, more so from developing countries. We aimed to evaluate the prevalence, severity and outcome of COVID-19 in pediatric oncology patients by implementing a screening and testing plan. Among 104 children tested, the rate of COVID-19 positivity was 15% and 3% in symptomatic and asymptomatic respectively. Majority had mild illness with uneventful recovery, whereas neutropenia increased the risk of serious illness. Prolonged virus shedding with a median time to negativity of 21 days was observed.

BRAFV600E inhibitor therapy, either alone or in combination with a MEK inhibitor, demonstrates positive responses in pediatric patients with gliomas harboring the BRAFV600E mutation. However, rare but life-threatening hypersensitivity reactions to BRAFV600E inhibitors may result in abrupt and permanent discontinuation of therapy. We report successful desensitization, tolerance, and continued response to an alternative BRAFV600E inhibitor plus the addition of a MEK inhibitor in a 7-year-old girl with bilateral optic pathway glioma who experienced a severe hypersensitivity reaction to vemurafenib. This strategy thereby avoided the systemic late effects of chemotherapy and radiation therapy.

The emergent of the new coronavirus (SARS-CoV-2) and consequently the viral infection that spread widely affecting hundreds of thousands across the entire world has developed a global health concern. Coronaviruses infect humans causing highly prevalent diseases. The current work is an effort to examine commercially available drugs in order to repurpose them against SARS-CoV-2 by the means of structure-based in-silico screening. The present study focusses on testing the repurposing efficacy of the currently used drugs against SARS-CoV-2 main protease. The main proteases from the coronavirus are essential for the viral replication and are involved in the polyprotein cleavage and immune regulation, making them attractive and effective targets for the development of antiviral drugs. Number of approved anti-viral drugs were tested as potential SARS-CoV-2 virus inhibitors using molecular docking analysis by examining the free natural affinity of the binding ligand to the active-site pocket and catalytic residues without forcing the docking of ligand to active site. SARS-CoV-2 protease solved structure (6LU7) is targeted by repurposed drugs. The molecular docking analysis results have shown that the binding of Remdesivir and Mycophenolic acid acyl glucuronide with the protein drug target has optimal binding features suggesting further experimental consideration for their treatment effectiveness.

Predictors of Paediatric Influenza-like-Illness Severity During the COVID-19 Pandemic*George James Porter1 and Stephen Owens2,3Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom.Department of Paediatric Immunology and Infectious Diseases, Great North Children’s Hospital, Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom.*Indicates the corresponding author, correspondence to: g.porter2@newcastle.ac.ukWord Count: 807Respiratory viral illness is a common cause of paediatric admission in the UK. It is estimated that In an average winter in the UK, 2.4% of children under five will have a respiratory illness attributable to Influenza A alone.(1) Despite the importance of viral respiratory infection, the predictive value of symptoms, co-morbidities and viral isolation are debated.(2) For example, in an American study of 241 children presenting to hospital with influenza-like-illness (ILI) the risk of severe complications was only increased by neurological/neuromuscular disease.(3) Meanwhile, a similar British study analysing 265 paediatric H1N1-positive ILI patients each with 2 virus-negative ILI controls found that chronic lung disease, cerebral palsy, chest retractions, tachycardia, dehydration and oxygen requirement predicted adverse outcome across the two groups.(4)The ongoing COVID-19 pandemic has shown that surges of acute respiratory infections must be planned for by the health service. Therefore, clearer definition of the early indicators of high-risk patients could be of considerable benefit regarding resource allocation and risk stratification. Equally, few studies have taken into account demographic data (including age and ethnicity), co-morbidities and symptoms and signs at presentation simultaneously.(5) We therefore conducted a retrospective study to help identify the predictors of severity of ILI in the North East of England during the height of the coronavirus pandemic.We defined ILI as the presence of fever ≥37.8oC and one other upper respiratory symptom. A cohort of children hospitalised with ILI in Newcastle-Upon-Tyne hospitals between 01/03/2020 and 05/05/2020 was identified from trust records. Information on symptoms at presentation, past medical history, demographics and outcomes was extracted. Disease severity was approximated by admission length, oxygen usage and intensive care unit (ITU) admission. Regression modelling identified variables which impacted these outcomes.

Thrombocytosis is common in children with sickle cell disease (SCD). Reactive thrombocytosis must be distinguished from myeloproliferative disorder or inherited thrombocytosis syndrome. We present an adolescent with hemoglobin SS and thrombocytosis associated with increased frequency of pain, priapism, and acquired von Willebrand disease.

Endemics co-occur because they evolved in situ and persist regionally or because they evolved ex situ and later dispersed to shared habitats, generating evolutionary or ecological endemicity centres, respectively. We investigate whether different endemicity centres can intertwine in the region ranging from Alps to Sicily, by studying their butterfly fauna. We gathered an extensive occurrence dataset for butterflies of the study area (27,123 records, 269 species, in cells of 0.5x0.5 degrees of latitude-longitude). We applied molecular-based delimitation methods (GMYC model) to 26,557 COI sequences of Western Palearctic butterflies. We identified entities based on molecular delimitations and the most recent checklist of European butterflies and objectively attributed occurrences to their most probable entity. We obtained a zoogeographic regionalisation based on the 69 endemics of the area. Using phylogenetic ANOVA we tested if endemics from different centres differ from each other and from non-endemics for key ecological traits and divergence time. Endemicity showed high incidence in the Alps and Southern Italy. The regionalisation separated the Alps from the Italian Peninsula and Sicily. The endemics of different centres showed a high turnover and differed in phenology and distribution traits. Endemics are on average younger than non-endemics and the Peninsula-Sicily endemics also have lower variance in divergence than those from the Alps. The observed variation identifies Alpine endemics as paleoendemics, now occupying an ecological centre, and the Peninsula-Sicily ones as neoendemics, that diverged in the region since the Pleistocene. The results challenge the common view of the Alpine-Apennine area as a single “Italian refugium”.