Sickness sleep and rebound following sleep deprivation share humoral signals including the rise of cytokines, in particular interleukins. Nevertheless, they represent unique physiological states with unique brain firing patterns and involvement of specific circuitry. Here we performed untargeted metabolomics of mouse cortex and hippocampus to uncover acute changes with sickness and rebound sleep as compared to normal daily sleep. We found that the three states are biochemically unique with larger differences in the cortex than in the hippocampus. Both sickness and rebound sleep shared an increase in tryptophan, with the highest levels during sickness. Surprisingly these two sleep states showed stark differences in terms of the energetic signature, with sickness impinging on glycolysis intermediates whilst rebound increased the triphosphorylated form of nucleotides. These findings indicate that rebound following sleep deprivation stimulates an energy rich state in the brain that is devoid during sickness sleep in line with the energy conservation hypothesis of sickness behavior.

IntroductionMotivation is directly correlated with employee retention. Leaders should prioritize understanding what motivates an employee to ensure the sustainability of the organization. By understanding the needs, drive and goals of an employee, managers can invest in the professional development of the employee to ensure satisfaction in the workplace. In addition, organizational culture can be developed through shifting leadership styles to shape the culture in favor of the team. This paper explores the various motivational factors that drive employees in organizations.Leadership Styles and MotivationA strong leader can motivate employees to go above and beyond in terms of assigned tasks. In contrast, a poor leader will instill dissatisfaction which results in turnover and missed deadlines. Chen and Cuervo (2022) surveyed 443 full-time employees in Guangdong–Hong Kong–Macao Great Bay Area China. They found that if employees have a positive perception of their leadership, through a transformational leadership style they perform their assigned tasks beyond expectation, partially because of employee motivation. Conversely, employee motivation can be negatively affected by dissatisfaction in leadership style. Bhana and Bayat (2020) focused on ethical leadership in their study. They found a linear relationship between employee items and line management leadership of 74.7 percent, which suggested significant correlation. They also found that line management leadership directly affects behavior and employees’ performance in a South African Higher Education Institution in KwaZulu-Natal. Further investigation revealed that 46.8 percent of participants disagreed with the assertion that their line management leadership is dedicated and passionate. Finally, they found that their participants felt that line management leadership did not respect the needs, abilities, and aspirations of employees. These findings express the importance of effective leadership strategies for the motivation of employees. Leaders need to be present and empathetic towards the needs of stakeholders at all levels of the organization to ensure productivity. Leaders who are not invested in their employees cause them to feel unvalued, which results in a decrease of productivity that can affect long-term sustainability and the reputation of the organization. Employee development combined with modernized workplaces and workplace flexibility can elevate job performance as well as job satisfaction. Leaders should invest in providing these needs within the organization to help ensure employees are motivated in an effort to improve retention.Firzly et al. (2020) expressed the importance of autonomous motivation over controlled motivation to develop interpersonal behavior. Since employees are aware of supportive and thwarting behaviors, they will react accordingly. Thus, it is important to provide them with organized leadership that guides and assists them. Leaders need to provide clear directions about what is critical to the organization and maintain consistency in responsibilities and duties. By maintaining this example, employees have a standard set of expectations and are set up to achieve success. (Bahan and Bayat, 2020) In addition, flexibility permits employees a sense of control which can also act as a motivating factor. Davidescu et al. (2020) found workspace flexibility and functional flexibility can act as motivators as they increase the level of job satisfaction. Job satisfaction positively correlates with motivation at work. If an employee is satisfied by the work that they perform, then they are likely to want to complete tasks to help sustain the organization.It is critical that leaders facilitate an environment that provides opportunities for development. Luhgiatno and Dwiatmadaja (2020) explained the importance of investing in resources to allow innovative employees to flourish. They stated that emphasis should be placed on learning in an open context. This means that leaders should provide the team with opportunities to learn new skills and provide them with the necessary resources to complete the tasks involved in self-development. Supervisors need to listen to middle management when they request these needs be met for their employees. Managers should be given the opportunity by organizations to rework environments and cultures to provide opportunities for meaningful work. (Yilmaz and Kaya, 2022) The breakdown between one level of management to another can result in a lack of morale in front line workers who feel their voices are not heard. In turn, middle management will feel discouraged as they demonstrate drive but lack support to implement ideas and strategies that can better optimize the overall success of the organization.Behavior and MotivationHuman behaviors are instinctive, and leadership needs to be aware of how their behaviors affect employees, as well as if the intrinsic desires of employees are met. Firzly et al. (2022) examined how the interpersonal behavior of a mentor affects the motivation of a mentee at work by studying 368 undergraduate students from a Canadian University. Findings suggested needs-thwarting behavior led to a decrease in well-being, work engagement, and controlled motivation. In direct contrast, there was a positive correlation between needs-supporting behavior and greater autonomous motivation, well-being, and work engagement. Also, needs-supporting behavior negatively correlated with turnover intention of employees in the workplace. Creativity is another behavior that shows positive motivation in employees. In a separate study, Kim et al. (2021) paired 382 Chinese employee-supervisors with 106 teams to study how creativity affects motivation. Cognitive diversity and creativity led to intrinsic motivation in teams and individuals. Learning goals reflected this correlation. The stronger the perception of cognitive diversity, the higher the intrinsic motivation increased to meet the learning objectives. There was also a positive relationship between cognitive diversity and creativity in which learning goals enhanced through intrinsic motivation. Therefore, this evidence suggests that organizations should invest in initiatives that provide leaders with a chance to work with their team in creative and cognitive challenges that promote a desire to learn. This will result in self-motivation among employees. In addition, leaders need to be mindful of the perceptions they create within the workplace. By being actively engaged with their team or those they supervise, leaders can develop relationships with their employees and better understand what drives their efforts for success.A leader can develop a lasting relationship with their mentee by acknowledging their contribution to the success of the organization. Motivation from satisfaction can result from work being perceived as meaningful. To achieve this, transpersonal relationships must be developed and maintained at work. (Yilmaz & Kaya, 2022) Firzly et al. (2022) explained that while colleagues, managers and supervisors all support the employees needs the direct mentor assigned to the employee has a unique relationship that builds a distinct rapport. Thus, this form of motivation is critical to ensure employee performance and organizational success.Health and MotivationA healthy lifestyle is desirable for mental and emotional benefits. People naturally desire the opportunity to live an active and healthy lifestyle. Work environments that provide unhealthy habits can exhibit high turnover because of being in an undesirable place for emotional and physical well-being. Studies also show a connection between health opportunities and motivation in the workplace. This is in support of the health self-empowerment theory. This theory explains the positive relationship between an increase in motivation and other modifiable behaviors with an increase in the desired behavior. Meaning that if one is motivated to be healthy, they will be more likely to achieve healthy habits than someone who is not motivated. Theoretical framework can be used to implement workplace health promotion programs to increase such motivators and remove barriers that would prevent healthy behaviors. (Williams et al., 2020) Knippen et al. (2018) surveyed 816 members of an urban academic-medical institution. They found that less than 10 percent of participants reported their health as excellent status and that 20 percent of participants had life challenges that prevented them from seeing a primary care provider. This evidence supports the need for health programs that focus on perception of positive norms and accountability. Accountability and positive self-identity are also behaviors that can translate into other beneficial aspects of employee success. It is beneficial to the organization to invest in developing these habits while also ensuring the well-being of employees.Diversity, Inclusion, Value and MotivationPeople want to feel like they belong and provide value to the organization they work for. There is a desire to feel important and needed. By providing them with this, leaders can ensure that employees participate and are involved in organizational implementation strategies. (Pleasant, 2017) Explored the relationship between inclusion and diversity in the workplace and employee engagement. They found that performance within the organization is a shared outcome resulting from employees’ desires for inclusion and diversity. They concluded that performance could be leveraged to understand the desires of employees regarding diversity and engagement. This directly applies to implementation strategies and can be utilized to increase their success rates. Yilmaz and Kaya (2022) found that teacher contributions have a connection to value and organizational identity of self. However, there is a lack of literature on this subject. They sampled 330 teachers in Kahramanmaras and found that there is a positive relationship between meaningful work and organizational identity. When describing meaningful work, they included concepts of work relationships, meaning at work, leadership at work, humility at work and transcendence at work. These findings directly support the idea that inclusion results in increased engagement. These behaviors are desirable in a motivated employee.Tertiary institutions are businesses at heart, which sell higher education and science services. Thus, successful management often focuses on industrial management and professionalism in practice. (Luhgiatno & Dwiatmadaja, 2020). However, educators do not come from this background and are not motivated by traditional industrial practices. Instead, concepts such as dignity of profession drive educators through concepts of meaningful work and organizational identity. (Yilmaz & Kaya, 2022) Leaders who guide educators must understand that they have a deeper sense of meaning and belonging in their profession than a typical business employee. By ensuring that educators feel valued and that they make a difference in the lives of those they teach, all while living a healthy lifestyle, university leaders can decrease turnover and improve employee satisfaction in their institution.

Mitral valve prolapse is a common valve disorder that usually has a benign prognosis unless there is significant regurgitation or left ventricular impairment. However, a subset of patients are at an increased risk of ventricular arrhythmias and sudden cardiac death, which has led to the recognition of ‘arrhythmic mitral valve prolapse’ as a clinical entity. Emerging risk factors include mitral annular disjunction and myocardial fibrosis. While echocardiography remains the primary method of evaluation, cardiac magnetic resonance has become crucial in managing this condition. Cine-MR sequences provide accurate characterization of prolapse and annular disjunction, assessment of ventricular volumes and function, identification of early dysfunction and remodeling, and quantitative assessment of mitral regurgitation when integrated with flow imaging. However, the unique strength of magnetic resonance lies in its ability to identify tissue changes. T1 mapping sequences identify diffuse fibrosis, in turn related to early ventricular dysfunction and remodeling. Late gadolinium enhancement sequences detect replacement fibrosis, an independent risk factor for ventricular arrhythmias and sudden cardiac death. There are consensus documents and reviews on the use of cardiac magnetic resonance specifically in arrhythmic mitral valve prolapse. However, in this article, we propose an algorithm for the broader use of cardiac magnetic resonance in managing this condition in various scenarios. Future advancements may involve implementing techniques for tissue characterization and flow analysis, such as 4D flow imaging, to identify patients with ventricular dysfunction and remodeling, increased arrhythmic risk, and more accurate grading of mitral regurgitation, ultimately benefiting patient selection for surgical therapy.

Soil microorganisms, including prokaryotes and eukaryotes, represent a large fraction of global terrestrial biodiversity. These organisms and their microbiomes play critical roles in ecosystem functioning and services and are essential to soil health. Soil biodiversity is governed by above-ground and below-ground factors, which create specific habitat conditions that structure soil communities. However, the compounded effects of such environmental drivers are often understudied, thus limiting our understanding of processes governing soil biodiversity, especially in desert habitats. Here we show that above- and below-ground factors shape prokaryotic and microeukaryotic communities, but these environmental factors do not appear to structure invertebrate-associated microbiomes. By integrating metabarcoding and morphological datasets, we found that soil compactness is a major factor structuring prokaryote and microeukaryote assemblages and influences the abundance of genes involved in nutrient cycling and organic matter decomposition. Despite having lower nitrogen levels, compacted soils displayed significantly higher alpha-diversity than uncompacted habitats across datasets. Different bacterial clades were enriched within specific nematode lineages (Plectids and Tylenchids) highlighting potentially new species-specific nematode-associated taxa. The data suggests that nematode microbiomes are less impacted by the same environmental drivers of the soil bacterial community and respond to microscale variations among sampling sites. The prevalence of functionally diverse invertebrate-associated bacteria (Mycobacterium) in the nematode microbiome suggests that these microbial communities benefit the host. Our findings highlight the importance of assessing above- and below-ground effects to elucidate patterns of microbial community assembly in terrestrial habitats, and how fine-scale analyses are critical for understanding patterns of host-associated microbiomes.

A document by Michael Robert Filoramo. Click on the document to view its contents.

Systemic sclerosis (SSc) is an autoimmune rheumatic disorder distinguished with fibrosis and vascular injury and structural alteration, coexisting with Reynaud’s phenomenon. The crosstalk between activated fibroblasts, immune effectors, and endothelial cells are the primary culprits in disease process. Fractalkine (FKN) or CX3CL1 is an unremarkable membrane-bound soluble chemokine and an adhesion molecule expressed on pro-inflammatory cytokine. In this systematic review, FKN and its receptor’s (CX3CR1) role in mediating inflammatory processes focusing on the pathogenesis of SSc is investigated. FKN is one of the most influential molecules which monitors the trafficking of inflammatory cells through the endothelium and has been observed to have pronounced expression in inflammation. The correlation between increased CX3CL1 levels in SSc and interstitial lung disease was established, and it was noted that CX3CL1 is predominantly co-localized with infiltrating mononuclear cells and epithelia within the lungs. The interstitial lung disease prediction and its progression may be available through augmented concentrations in SSc patients. Conclusively, Emerging evidence claims that FKN could be expressed in numerous tissues, taking part in the CX3CR1 positive cell accumulation at sites of inflammation and, as a result, involved in countless rheumatic diseases such as rheumatoid arthritis, Systemic lupus erythematosus, and scleroderma. Besides, it may play a prominent part in the SSc pathogenesis, involving vascular injury and tissue inflammation. Its estimation could be used as a serological marker for the recognition and follow-up of skin and pulmonary complications.

This article proposes a high step-up, low switching voltage stress DC-DC converter based on the traditional Boost circuit, incorporating switched-capacitor (SC) and coupled-inductor (CL) techniques. The design approach of this converter involves replacing the single switch in a single-switch DC-DC converter with SC, combining CL together, and integrating the resonant boost circuit with the Boost circuit. Compared to other traditional DC-DC converters, the improved topology of the power switches in this design exhibits lower voltage stress, lower diode current stress, fewer total components, and a common ground. The working mode and steady-state analysis of the converter are provided, and the stress derivation of the components and theoretical efficiency analysis are conducted. A comparison with other DC-DC converters is also performed. Finally, experiments are conducted on a 200W DC-DC converter prototype to verify the reliability of this converter.

This article develops a variational formulation for the modeling of a chemical reaction suitable to represent a combustion process. The results are obtained through standard tools of calculus of variations and optimization theory in function spaces. We assume such a chemical reaction develops in a volume control which allows the entering and leaving of the concerned reacting chemical substances. Finally, we highlight the related fluid motion is addressed in an Eulerian context.

Automatic animal identification through image analysis holds immense value across various fields. This study evaluates the effectiveness of the Vision Transformer (ViT) model for this task. We trained a ViT model on a dataset of animal images and assessed its performance. The model achieved an accuracy of 89%, demonstrating robust classification capabilities for most animal classes. Notably, several species were classified perfectly, highlighting ViT's potential for accurate animal identification. However, the performance varied across classes, with some requiring further exploration for improvement. These findings suggest that ViT is a promising approach for animal image classification, offering a powerful tool for various applications in ecology, conservation, and beyond.

Williams-Campbell Syndrome: An unusual case presentation.  Corresponding author :1. Bikram Yadav, bikramyadav123@gmail.com, Dhulikhel Hospital, Dhulikhel, NepalORCiD ID: 0009-0008-0667-7502

A document by Elena Esina. Click on the document to view its contents.

Andrographis saxatilis (Acanthaceae) new species is described and illustrated from the rocky plateau of the Owk Dam area, Andhra Pradesh. It is a perennial, woody undershrub. Unique characters are hispid hairy, obovate, elliptic-oblong and oblanceolate leaves; lanceolate glandular hairy sepals; empty (without flowers) bract and calyx towards base of rachis. Andrographis saxatilis allied A. glandulosa Nees by its perennial habit, woody rootstock in between rocks, glaucous green leaves, hairy stem, attenuate and glandular hairs on sepals and corolla tube outside. But it distinguished from the later by its hispid texture (versus densely pubescent), obovate, elliptic-oblong, and oblanceolate leaves (versus ovate-oblong), obtusely 4-angled stem (versus acutely 4-angled), hispid and glandular hairy sepals (versus villous with long glandular hairs), boat-shaped upper lip of corolla (versus ligulate), pubescent fruit (versus glabrous at base and glandular hairy towards the tip). IUCN threat status of the species is assessed as ‘Data Deficient’ (DD) in this article.

This paper aims to present a previously published study [1] in an errorless form to make readers understand the work better. The study presents a 3D electromagnetic cloak which has arbitrary structure; which is undoubtedly an attractive work in the field of electromagnetic cloaking. Unfortunately, there are some errors in the paper which make confusions for the readers, so they cannot understand the value of the study. Meanwhile, the figures of the paper are not trustworthy, because the formulation is not correct.

Aim: This study aims to enhance our understanding of the temporal and spatial proceses scales governing the taxonomic diversification of Neotropical birds with Trans- and Cis-Andean populations. Location: Central America and South America. Taxon: Attila spadiceus (Bright-rumped Attila). Methods: Through a multilocus analysis of the mitochondrial (CytB and ND2) and nuclear genes (I7BF, I5BF, and G3PDH) of 41 samples representing six subspecies, we describe the existing molecular lineages of A. spadiceus, and estimate their demographic dynamics. We also modeled the climatic niche of the species. Results: The analysis confirms a relatively recent divergence of the Trans- and Cis-Andean lineages, at approximately 0.25 million years ago (Ma). The niche modeling supports the existence of a dynamic scenario of the expansion and retraction of forest corridors in northwestern South America during the last glaciation. This suggests that the earlier orogenesis of the Andes was not a primary determinant of this dichotomy. Additionally, the analysis of population dynamics indicated a trend of increasing population size starting at 0.05 Ma for both lineages. Main Conclusions: Our findings highlight the significance of Pleistocene Forest corridors north of the Andes as the key factor maintaining communication before the separation of the lineages, likely associated with the retraction of this forest. We highlight the absence of any significant differentiation between the disjunct Amazonian and Atlantic Forest populations, both part of the Cis-Andean lineage. The phylogeographic profile of A. spadiceus diverges from the patterns observed in other Neotropical birds, which emphasizes the need for further research on the role of the forest corridors of the northern Andes as drivers of diversification, to provide comprehensive insights into the processes that led to the formation of the region’s present-day avian diversity.

IntroductionObesity is a complex disease defined as abnormal or excessive fat tissue accumulation that presents a risk to health. 1According to the World Health Organization (WHO), obesity is a latent disease declared as a non-infectious and noncommunicable pandemic.1,2 Indeed, obesity is linked to more deaths worldwide than being underweight, being a risk factor for cardiovascular diseases, diabetes, musculoskeletal disorders, and some cancers.1,2 In particular, obesity is associated with 13 different cancers, among them: breast, endometrial, ovarian, prostate, liver, gallbladder, kidney, and colon and rectum3,4Most frequently, obesity is a primary condition, while differential diagnosis of secondary obesity includes: Hypothyroidism, Hypercortisolism, Hyperinsulinism (type 2 diabetes), Polycystic Ovary Syndrome, and drugs.Obesity stigma refers to social devaluation and denigration due to excess body weight. 5 Several large-scale studies across various countries showed that a high percentage of patients suffered from obesity stigma also from healthcare professionals.6,7 In particular, primary care physicians spend less time during office visits with patients with obesity as they consider them as noncompliant patients. 8 Therefore, experiences of and expectations for poor treatment may cause avoidance of care, mistrust of doctors, and poor adherence among patients with obesity. 8,9 Obesity stigma can reduce the patient’s quality of care, including preventive and screening care, despite the best intentions of healthcare professionals to provide high-quality care. 8–10The patient was sent to a referral center by the primary care provider for surgical evaluation for long-standing severe obesity (BMI 59). This case report is unique because of its clinical relevance to obesity differential diagnosis.

The genotoxic and clastogenic/aneugeneic potentials of four α, ß-unsaturated aldehydes, 2-phenyl-2-butenal, nona-2-trans-6-cis-dienal, 2-methyl-2-pentenal and p-methoxy cinnamaldehyde, which are used as fragrance materials, were assessed in avian fetal livers using the Chicken Egg Genotoxicity Assay (CEGA) and the Hen’s egg micronucleus (HET-MN) assay, respectively. Selection of materials was based on their chemical structures and the results of their assessment in the regulatory in vitro and/or in vivo genotoxicity test battery. Three tested materials, 2-phenyl-2-butenal, nona-2-trans-6-cis-dienal and 2-methyl-2-pentenal, were negative in both, CEGA and HET-MN assays. These findings were congruent with the results of regulatory in vivo genotoxicity assays. In contrast, p-methoxy cinnamaldehyde, which was also negative in the in vivo genotoxicity assays, produced evidence of DNA damage, including DNA strand breaks and DNA adducts in CEGA, however, no increase in the micronucleus formation in blood was reported in the HET-MN study. Pretreatment with a glutathione precursor, N-acetyl cysteine, negated positive outcomes produced by p-methoxy cinnamaldehyde in CEGA, indicating that difference in response observed in the egg and rodent models can be attributed to rapid glutathione depletion. Additionally, the dosing protocols for both HET-MN and CEGA assays are different, which can also be an important contributing factor. Overall, our findings support the conclusion that CEGA and/or HET-MN can be considered as a potential alternative to animal testing as follow-up strategies for assessment of genotoxic potential of fragrance materials with evidence of genotoxicity in vitro.

Note: In this technique, a thin plate with designed apertures, called a stencil mask, is placed adjacent to the substrate and used in combination with material evaporation. be. Evaporated material stops at the upper surface of the stencil mask, except in the openings. So the material grows with specific patterns determined by the stencil mask.Using appropriate stencil masks, nanopatterned materials can be grown at wafer scale in one shot. Resolution down to 20 nm has been achieved and can be used on non-conventional substrates such as rope , but this technique suffers from some problems related to deposition. Shade under the stencil mask tolerates lifetime issues due to stencil mask deterioration caused by material depositing at the edge of the holes, eventually blocking them (occlusion effect). Advances such as the use of dynamic stencil masks have increased the range of applications of this technique.

Note:  In nanoscience and nanoelectronics, the structure of materials calculations, fracture toughness or fracture toughness is a property that describes the resistance that objects with cracks show against fracture  . This parameter is important for all solids design applications and is represented by KIc. Fracture toughness  is a calculation method for brittle failure when cracks are present in the material. If the fracture toughness of a material is low, that material will break brittle, and  the higher the fracture toughness, the higher the probability of soft fracture.Temperature is the most important difference between gas and solid source based methods. In CCVD, low temperature is usually used and nanotubes  are grown at a temperature below 0111 degrees. More than one mechanism can be involved in the growth of carbon nanotubes depending on the type of gaseous precursor, the catalyst used and the operating parameters  . The mechanism of dissolution-infiltration-precipitation is one of the most common, which mostly prevails in low temperature methods. In this  mechanism, catalytic nanoparticles of metal alloys or transition metals (such as nickel, iron and cobalt) are considered spherical or floating on the surface of the substrate  . Hydrocarbon vapor (such as CO, CH4, C2H2, C2H4 and C2H6) (when It makes contact with the hot particles of the catalyst,  decomposes into carbon and hydrogen, and the carbon penetrates into the substrate metal.

Pharmacoepidemiological studies provide important information on the safety and effectiveness of medications, but the validity of study findings can be threatened by residual bias. Ideally, biases would be minimised through appropriate study design and statistical analysis methods. However, residual biases can remain, for example due to unmeasured confounders, measurement error, or selection into the study. A group of sensitivity analysis methods, termed quantitative bias analyses, are available to assess, quantitatively and transparently, the robustness of study results to these residual biases. These approaches include methods to quantify how the estimated effect would be altered under specified assumptions about the potential bias, and methods to calculate bounds on effect estimates. This article introduces quantitative bias analyses for unmeasured confounding, misclassification, and selection bias, with a focus on their relevance and application to pharmacoepidemiological studies.

Cold environments, such as polar systems, are highly vulnerable to global change drivers such as climate change and invasive species. Therefore, it is essential to assess what drives the diversity of native and invasive species in these systems. We investigated what drives native and alien plant species richness on sub-Antarctic Marion Island and determined the scale-dependence of these drivers. Native and alien plant species richness was surveyed at “small” (1 m2) and “large” (9 m2) sampling grains. Difference in richness between the two sampling grains was calculated to assess how local turnover contributes to species assemblage. The factors driving richness at both grains, and the differences in richness between the two grains, were analysed using simultaneous auto-regressive models. Drivers related to energy and environmental heterogeneity were correlated with native richness, whilst drivers related to productivity were related to alien richness. Biotic interactions with a cushion plant facilitated native richness, but restricted alien richness at low elevations. Further, some drivers of richness depended on spatial grain. Native richness was positively related to northness at large, but not small grain size, suggesting that higher northness increases local turnover at a grain size > 1 m2. On the other hand, topographical wetness index (TWI) boosted native richness at small but not large grains, implying that competition for water limits coexistence at low TWI (i.e., low moisture availability) only at small grain. Differences in native species richness between large and small grain sizes were more pronounced at low elevations, suggesting higher compositional heterogeneity at low altitudes. Our study highlights that drivers of plant species richness in a polar ecosystem differ between native and alien plant species. Additionally, the effects of some drivers on richness differ between sampling grains, and considering these differences provides insight into drivers of local patterns of species assemblage.

AIM: Chagas disease (ChD) is a neglected disease affecting approximately 7 million individuals in Latin America. Benznidazole (BZ) is the most commonly used treatment. Therefore, understanding the adverse effects of BZ is crucial for devising targeted monitoring and interventions to enhance patient management. METHODS: A retrospective cohort study of patients with ChD treated with BZ to identify and characterize BZ adverse drug reactions (ADRs). RESULTS: 518 patients were enrolled: 449 children (median age: 4yrs, range 1mo-17.75yrs) and 69 adults (median age: 25yrs, range 18-59). A 75% of pediatric patients received a median dose of BZ of 6.6 mg/kg/day (IQR25–75 = 5.7-7.3) for at least 60 days. Adult patients received a median BZ dose of 5.6 mg/kg/day (IQR25–75 = 5.2-6.1) for a median duration of 31 days (IQR25–75 = 30-60). Overall, 152/518 (29.34%) patients developed BZ-related ADRs, with an incidence of 116/449 (25.83%) in children and 36/69 (52.17%) in adults (OR = 0.32, CI95 = 0.19 to 0.54, p < 0.001). The study identified 240 ADRs, primarily mild to moderate, but severe ADRs occurred in 1.11% of children and 1.45% of adults. The skin was the most affected system in both groups. A 10.23% of patients abandoned treatment (53/518). Adults discontinued treatment more frequently than children (OR = 3.36 CI95 = 1.7 to 6.4, p < 0.001). CONCLUSION: Our study supports the safety of BZ for ChD in children and adults. Avoiding BZ treatment due to safety concerns does not seem to be supported by the evidence.

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Clinical Case Reports

A document by Yasmine Elsherif. Click on the document to view its contents.