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The debate over medical residents' commitment highlights the evolution of the healthcare profession. Moving beyond the rhetoric of "vocation" or initiatory suffering, a new professionalism is emerging. This must integrate scientific expertise with Medical Humanities, be supported by legal and organizational safeguards, and foster a therapeutic relationship built on trust and collaboration among colleagues.
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Nirsevimab is a long-acting monoclonal antibody designed to prevent infections due to respiratory syncytial virus (RSV). Here we report on a retrospective, multicenter study encompassing a total of 19 Italian neonatal and pediatric centers evaluating the epidemiology of lower respiratory tract infection (LRTI)-related hospitalizations in infants younger than 2 years during the first RSV season following the introduction of nirsevimab prophylaxis. A total of 401 hospitalizations were reported, with 40.4% being in children with previous prophylaxis with nirsevimab. Respiratory syncytial virus was the most frequently identified pathogen (47.5%), followed by rhinovirus/enterovirus (20.2%) and human metapneumovirus (hMPV; 6.9%). In multivariable analyses adjusted for age, sex, and month of diagnosis, prior nirsevimab immunization was associated with a significantly reduced likelihood of RSV-related hospitalization (adjusted odds ratio [aOR], 0.259; 95% CI, 0.157-0.427), corresponding to an estimated effectiveness of 74.1% (95% CI, 57.3-84.3). Conversely, nirsevimab-immunized infants showed increased odds of hospitalization due to hMPV (aOR, 2.490; 95% CI, 1.019-6.085) and rhinovirus/enterovirus (aOR, 2.573; 95% CI, 1.424-4.650). Lower respiratory tract infections associated with hMPV predominantly occurred outside the typical RSV season, being associated with moderate-to-severe clinical presentations. These findings confirm the real-world effectiveness of nirsevimab against RSV hospitalizations, also highlighting the need for the continued surveillance of non-RSV respiratory pathogens in the context of universal RSV immunoprophylaxis.
Alcohol consumption is an important occupational risk factor, especially in safety-sensitive sectors such as construction. Alcohol-related psychomotor impairment may increase the risk of workplace injuries and may also affect the safety of third parties. However, data on alcohol-related behaviors, workers' risk perception, and alcohol-focused health surveillance among Italian construction workers are still limited.  Methods: We conducted a cross-sectional survey between September 2023 and June 2024 in 315 construction workers employed in small Italian companies. All participants performed work activities for which local legislation mandates alcohol-use and alcohol-dependence checks as part of occupational health surveillance. Data were collected through an anonymous 27-item questionnaire exploring sociodemographic characteristics, alcohol consumption (AUDIT-C; cut-off ≥5 for men and ≥4 for women), alcohol use at work, knowledge of national regulations, alcohol-related risk perception, and accident/injury indicators. Nonparametric tests and multivariable linear regression were used to identify factors associated with AUDIT-C scores. Logistic regression analyses examined associations between perceived alcohol-related risks and awareness of, and exposure to, alcohol-dependence checks during health surveillance. The sample was predominantly male (274/315; 86.98%), and 26.03% of workers were aged 46-55 years. The mean AUDIT-C score was 2.85±2.49 (3.13±2.47 in men; 0.95±1.75 in women); 32.7% of workers screened positive, mainly men. Alcohol consumption during the work shift was reported by 1.9% of participants (7.94% occasionally), and during breaks by 5.08% (19.37% occasionally). Most workers were aware of the workplace alcohol ban (90.48%), and 83.49% reported having undergone alcohol-related checks. Higher AUDIT-C scores were associated with alcohol consumption during the work shift and occasional drinking during breaks. Although average AUDIT-C scores were not high, a relevant subgroup of workers showed risky drinking patterns and some alcohol consumption at work.  These findings highlight the need to strengthen prevention strategies and ensure consistent alcohol-related health surveillance in construction settings.
Neuroinflammation, oxidative stress and metabolic dysfunction are co-dependent drivers of neuropathic pain, jointly sustaining reactive gliosis and spinal sensitization. The interplay among neuroinflammation, redox imbalance, and metabolic reprogramming in glial cells represents a crucial process in this context, but the integrative mechanisms involved remain elusive. Poly(ADP-ribose) polymerase 1 (PARP1), a nuclear enzyme activated by genotoxic stress, has emerged as a key regulator of neuroinflammatory-associated diseases. The aim of the present study was to investigate the role of PARP1 in the pathophysiology of neuropathic pain and to evaluate the neuroglia phenotype and metabolism. Using a combination of in vitro glial cell cultures and an in vivo model of peripheral nerve injury, we demonstrated that sustained PARP1 activation triggers parthanatos, apoptosis signalling, and reactive gliosis, promoting neuroinflammation and maladaptive redox-inflammatory coupling in the spinal cord. At the behavioural level, PARP1 inhibition attenuated mechanical allodynia and improved motor coordination in rats with chronic constriction injury (CCI) of the sciatic nerve. Multi-omics profiling revealed a broad restoration of injury-altered proteomic and metabolic signatures, converging on restoring redox imbalance and related metabolic pathways, including glutathione and amino acid metabolic processing. Cell-type-specific knockdown of PARP1 established a causal link between redox balance, mitochondrial metabolism, and intercellular crosstalk during microglia inflammatory priming. Taken together, these findings highlight PARP1 as a functional regulator of the glial cell reactive phenotype in neuropathic pain and support its inhibition as a strategy to modulate central sensitization mechanisms.
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The alpine biome, located at higher elevations of mountains worldwide, supports unique biodiversity and provides important ecosystem contributions to people. Despite the growing recognition of mountain biodiversity in international policy frameworks, substantial gaps remain in our understanding of how alpine biodiversity varies across mountain systems, undermining estimates of its conservation value and consequently effective conservation strategies. Here, we curate a dataset on alpine biodiversity, incorporating expert-validated data on species' elevational ranges for vascular plants, mammals, birds, and reptiles across 32 mountain ranges worldwide. We show that alpine biodiversity hotspots are concentrated in Neotropical regions, while most temperate regions represent coldspots with lower species richness. These patterns persist whether considering species with broad elevational ranges or only those strictly confined to the alpine zone. Unlike the classical latitudinal gradient of biodiversity, alpine richness patterns show no consistent relationship with latitude, highlighting the importance of regional history, landscape structure, and biogeographical processes.
Erythrocyte glutathione transferase (e-GST) and oxidized human serum albumin (HSAox) were used as biomarkers to assess the environmental health of a foundry and a ceramics factory located in the Umbria region (Italy). While HSAox level indicates that no relevant oxidative stress is present in workers of either company, a distinct overexpression of e-GST, also present in non-workers residents, suggests exposure to broad environmental stressors that may be attributed to common sources. A more careful analysis of different job sectors and the effect of filtering facepieces indicates that the workers exposed to solvents show the highest e-GST expression, while different pollutants (possibly dust and/or metal fumes) seem to be present in other areas of the foundry as well as in external areas. In the ceramic company, the high e-GST activity reveals the presence of other contaminants which can be efficiently blocked by filtering facepieces and gloves together. Intriguingly, a cohort of monks (n = 14) residing in a monastery adjacent to the foundry exhibited e-GST activities significantly lower than those observed in non-worker residents, suggesting that specific lifestyle or localized environmental factors may influence exposure levels, a finding that warrants further targeted research.
In recent years, the widespread availability of wearable devices and smartphones has enabled the large-scale collection of human activity data, fostering new opportunities for automatic workout recognition and personalized fitness monitoring. However, the centralized storage of video recordings raises critical privacy concerns, particularly when raw data contain identifiable individuals. Federated Machine Learning provides a paradigm designed with the aim of reducing privacy risks; here, models are collaboratively trained across distributed clients without sharing their sensitive data. In this paper, we propose an approach for workout video classification with Federated Machine Learning, enhanced by explainability through Gradient-weighted Class-Activation Mapping. The proposed method is evaluated on a real-world multi-class exercise video dataset, organized into eight biomechanically coherent macro-classes. In the experimental analysis, we consider several federated configurations in terms of the number of clients, the chosen aggregation strategy, and global communication rounds. The obtained results demonstrate that different aggregation strategies achieve comparable overall accuracy, while explainability effectively highlights the discriminative regions associated with exercise execution, revealing meaningful differences in model behavior between aggregation strategies and uncovering misclassifications driven by contextual biases, demonstrating the trustworthiness of the proposed approach for explainable workout video classification.
to evaluate the preventability of workplace fatalities that occurred in Piedmont Region (Northern Italy) through inspections by Occupational Safety and Health (OSH) inspectors. It was examined whether an inspection carried out the day before the event could have avoided the injury, and also differences in its impact across various sectors were investigated. descriptive study. workplace injury investigations conducted by OSH inspectors on fatalities that occurred in Piedmont from 2002 to 2022, classified according to the InforMo method. using a group of validated criteria of preventability, fatalities were divided into three categories: probably preventable, probably not preventable, and uncertain. two-thirds of the 786 workers who died were employed in construction and agriculture, while the remaining third worked in manufacturing and other sectors. The analysis on the preventability of fatalities indicates that, in at least half and up to two thirds of the cases, an inspection carried out the previous day probably could not have prevented the fatality. Interviews with OSH inspectors confirmed the validity of the criteria adopted to classify the preventability of injuries. the results suggest that, although inspections can play a significant role in preventing workplace fatalities, a considerable portion of them probably could not have been avoided with a hypothetical inspection the day before the event. To corroborate this result, it is necessary to extend the analysis to fatalities occurring in other Regions. Nevertheless, it is necessary to strengthen the contribution of the various actors envisaged by Legislative Decree 81/2008 and Legislative Decree 626/1994 (RSPP, RLS, etc.) to improve significantly the workplace safety.
The aim of this study is to verify if outdoor workers' exposure to low dose of benzene in urban air may affect thyroid hormone levels. The study was conducted on a total sample of 334 subjects. Benzene's environmental monitoring has been performed through personal dosimeters, whereas, for the biological monitoring, we have measured the concentration of blood benzene, trans,trans-muconic acid (t,t-MA) urinary, and S-phenylmercapturic acid (S-PMA) urinary on thyroid hormones. The statistical analysis was performed. Statistic test shows that there is a negative correlation between blood benzene levels, t,t-MA urinary, FT3, and FT4; there is a positive correlation between blood benzene, t,t-MA urinary, and TSH. Occupational exposure to low dose of benzene in urban pollution can affect thyroid hormone levels in occupationally exposed workers.
In 2012, the 'Workplace Injury Stories' project was developed. Within this project, professionals from the Occupational Health and Safety Prevention Services of Local Health Authorities in Piedmont and Lombardy Regions (Northern Italy) and in Marche Region (Central Italy) transformed occupational injury investigation reports into narrative stories. This study aimed to explore the contexts in which injury stories are used, their application in training settings, and their contribution to preventive activities.An online survey was administered to 225 professionals involved in the project, and three focus groups were conducted. Among 135 respondents (60%), 25 participated in the focus groups. Injury stories were mainly used for training purposes, most commonly through lectures combined with group work using innovative approaches such as role play and theatrical performances, and as case studies in peer discussions and during inspection activities also emerged. In training settings, injury stories promoted identification and empathy, supporting reflection on preventive actions. These findings support the use of narrative-based training for the continuing education of workers and prevention professionals.
Firefighters are potentially exposed to multiple harmful substances, and their activities are classified as carcinogenic to humans. This case study assessed early genotoxic damage (fpg-comet and BMCyt assays) and epigenetic alterations (seven circulating miRNAs) in 35 firefighters compared to 45 non-exposed workers. Occupational exposure to fire smoke was self-reported via questionnaire. Firefighters showed higher median genotoxic DNA damage with respect to the non-exposed group (%DNA tail Buff 19.4 vs. 16.8; %DNA tail Enz 22.2 vs. 19.3; Tail moment 5.5 vs. 4.5; % of apoptotic cells 1.13 vs. 0.97). miRNAs related to air pollution, oxidative stress, tumor suppression, and immune responses, like mir-16, mir-15a, mir-29a, mir-125b, and mir-142, showed significant downregulation (p < 0.001) in the exposed group. Mean percentages of early apoptosis biomarkers and composite DNA damage indices among FF also differed significantly from the other participants (‱Condensed chromatin 0.46 vs. 0.06; ‱Tot anomalies 5.15 vs. 3.82). Multiple correlations emerged, particularly between miRNAs and comet assay parameters, and between comet assay and BMCyt indicators. The implemented integrated approach provides information about the existence of a relationship between genotoxic and epigenetic effects in firefighters, also influenced by time since exposure. Future studies with bigger sample sizes are required.
Urban environments are increasingly recognized as important settings for biodiversity monitoring, yet empirical knowledge of insect fauna in cities remains limited. Ants are key components of urban ecosystems and useful model organisms to study the ecological effects of urbanization. Urban ant assemblages include invasive alien species, climate-sensitive taxa, and species associated with both ecosystem functioning and human environments, making them relevant to questions of biodiversity loss, sustainable urban development, and human well-being. Here we describe a nationwide dataset on urban ants in Italy, compiled through the community science project School of Ants. The dataset, accessible through GBIF, contains 4,698 occurrence records collected between 2011 and 2024 using a standardized baiting protocol (cookie-crumb-filled tubes left open for one hour). It documents 66 species and four species complexes, belonging to 21 genera and three subfamilies of the family Formicidae, and represents approximately one-fourth of the known Italian ant fauna. Data were generated through the participation of more than 6,000 volunteers and subsequently validated by taxonomic experts. Records were harmonized according to Darwin Core standards to facilitate integration with global biodiversity infrastructures. This dataset provides a spatially and temporally structured resource to investigate the effects of urbanization on ant assemblages, track dominant and non-native species. Although coverage is concentrated in Northern Italy, the standardized and accessible protocol provides a scalable framework that can be readily adopted to generate comparable urban ant datasets in other geographic contexts.
Migratory birds crossing large ecological barriers can exhibit significant plasticity in their circadian movement patterns, e.g., shifting from nocturnal to continuous flight over seas. But substantial plasticity in the circadian patterns of active migration has also been reported in other birds, such as most intra-Palearctic dabbling ducks, that do not face major ecological barriers en route. Yet, the factors driving such behavioural variation in these species remain poorly understood. We investigated how biotic and abiotic factors influenced circadian movement patterns and seasonal migratory schedules during pre-breeding migration of GPS-tracked Northern pintails (Anas acuta) tagged in late winter in northern Adriatic wetlands (Italy) and migrating across Eurasia towards their breeding areas. We classified behaviours from GPS data and estimated the probability of being in active migration as a function of biome, altitude of the sun above the horizon, average ground temperature, and orthodromic distance from the breeding site. While showing a consistent preference for conditions of low (and decreasing) sun altitude throughout migration (n = 22 pintails, n = 25 complete migration events), we observed a gradual shift towards diurnal flight along the movement path, with the level of diurnality varying according to the specific biome encountered and, likely, to the potential exposure to predators in forested areas, across latitudes. Stopovers were longer in the first half of migration and shorter and more frequent as pintails neared the breeding grounds (located mainly in the Russian Arctic). Although active migration segments were covered at very high speeds, the overall migration pace was consistently slow, suggesting a tendency to follow seasonal cues en route. Our study provided evidence that circadian migration patterns and seasonal migratory schedules in pintails were continuously adjusted in response to the environmental conditions encountered during migration. This variation was not solely due to the steep reduction in dark hours as individuals migrated northeast, nor to the increasing urgency to reach the breeding grounds. Rather, it likely resulted from an adaptation to ecological contexts favouring daytime migration, counteracted by the necessity of waiting for environmental conditions to become suitable for breeding.
The hemodynamic management of acute spinal cord injury (SCI) aims to improve perfusion and mitigate ischemic secondary injury to the injured spinal cord, traditionally through the augmentation of mean arterial pressure (MAP). Recently, there has been interest in managing spinal cord perfusion pressure (SCPP)-the difference between MAP and intrathecal pressure (ITP) -after acute SCI. SCPP may be more physiologically relevant than MAP for neurologic recovery after traumatic SCI. Drainage of cerebrospinal fluid (CSF) through a lumbar intrathecal catheter to reduce ITP and increase SCPP is commonly performed to reduce the risk of ischemic paralysis in thoracoabdominal aortic aneurysm (TAAA) surgery. We investigated a protocol for CSF drainage through intrathecal catheters to maintain SCPP ≥65 mmHg in participants with acute traumatic SCI. We sought to determine if managing SCPP was associated with better neurologic recovery compared to traditional MAP targets. Fifty-eight participants with acute SCI (51 ± 19 years, 46M/12F) were enrolled across eight North American sites between August 2019 and May 2024 into this prospective single-arm multi-center clinical trial of CSF drainage for SCPP management (NCT03911492). Data were compared to data from a historical cohort of 86 participants (44 ± 19 years, 72M/14F) who had intrathecal catheters inserted for SCPP measurement only; these participants were managed according to conventional MAP guidelines with a target MAP of 85-90 mmHg (NCT01279811). MAP, ITP, SCPP, intrathecal waveform morphology, vasopressor use, and CSF drainage volume were reported for up to 7 days following SCI. Fifteen participants in the intervention group were lost to follow-up. Neurological assessments at enrollment and 6-months post-SCI were compared. The investigator team ended the trial when it was clear that adherence to the protocol was inconsistent across study sites. Participants managed according to the SCPP management protocol had an intrathecal catheter in place 138 hours (95% CI [129,147]) and 495cc (95% CI [350,641]) of CSF drained. No CSF was drained from seven participants. There were no significant differences in hemodynamic measures such as ITP and SCPP between groups, indicating that the SCPP management protocol did not alter the hemodynamic management. Subsequently, there were no differences in measures of neurological recovery between participants managed according to SCPP management protocol and conventional MAP guidelines (p = 0.897). Participants managed according to an SCPP target had more ITP waveform recordings noted as dampened or fully pulsatile suggesting a patent subarachnoid space (p = 0.006) and were administered vasopressors on fewer hourly observations (p = 0.004). Six reported adverse events were probably related to the intervention. Adherence to a protocol for managing SCPP through CSF drainage across multiple sites was challenging. Ultimately, our protocol resulted in little CSF being drained, limited modification of ITP and SCPP, and no effect on neurological recovery. The relationship between CSF drainage volume and change in ITP was surprisingly unclear. This study revealed that draining CSF is more complex in traumatic SCI than in TAAA surgery patients. Future efforts to reduce ITP through CSF drainage likely need to address the occlusion of the subarachnoid space at the injury site through aggressive surgical decompression techniques.
Rosehip-based products are rich in polyphenols with recognized health benefits, making accurate characterization essential for quality control and functional evaluation. Conventional analytical approaches for polyphenol determination are often time-consuming, costly, and environmentally demanding. In this study, a sustainable analytical method based on capillary zone electrophoresis coupled with diode array detection (CE-DAD) was developed as a green and accessible screening method for polyphenol analysis in rosehip-based products. Twelve polyphenolic compounds belonging to different classes (stilbenes, flavonols, flavanols, flavanones, and flavones) were used to optimize the electrophoretic conditions, including the buffer pH, voltage, and electrolyte concentration. Herbal tea and supplement samples were analyzed before and after a simple cartridge-based clean-up step to reduce matrix interferences. The method enabled simultaneous profiling of multiple polyphenol classes in a single CE-DAD run, showing excellent linearity (R2 > 0.99), run to run reproducibility (RSD 0.8-1.6%), and sensitivity (LOD 0.4-1.4 μg/mL; LOQ 0.9-4.7 μg/mL). Eight target polyphenols were identified and quantified in real samples. Polyphenol profiling was complemented by DPPH and ABTS antioxidant assays, allowing a functional interpretation of compositional data and a case-based comparison between different product formulations. Specifically, the herbal tea showed the values of a 13.8 mg Trolox/g sample (80.5% DPPH inhibition) and 15.3 mg Trolox/g sample (98.5% ABTS inhibition), whereas the food supplement presented a 7.4 mg Trolox/g sample (34.2% DPPH inhibition) and 7.4 mg Trolox/g sample (54.1% ABTS inhibition). Method sustainability and applicability were also evaluated using the Blue Applicability Grade Index (BAGI), confirming a low environmental footprint.
Occupational exposure to chromium trioxide (CAS number: 1333-82-0) remains a major concern in the electroplating sector. Risk assessment is regulated under both the REACH Regulation, which focuses on substance-related risks across the supply chain, and Occupational Safety and Health (OSH), which emphasizes workplace-specific exposure. The two regulatory frameworks adopt different approaches, particularly regarding the role of exposure models and monitoring for workplace risk assessment. This study investigated the outcomes of exposure assessment under REACH and OSH, comparing modeled exposure estimates with measured workplace data for occupational exposure to hexavalent chromium, in order to analyze differences in the exposure assessment process and the risk characterization under both approaches. The study focuses on four Italian companies involved in metal products manufacturing, which applied to ECHA for authorization to use chromium trioxide. Worker contributing scenarios were defined from Chemical Safety Reports. Exposure estimates were derived using the Advanced REACH Tool, while additionally measured data came from workplace monitoring campaigns, evaluated according to EN 689:2019. Comparisons between exposure estimates and measured data were made following the criteria of level of consistency and level of conservatism. Considerations on risk as risk characterization ratio (RCR) under OSH and excess risk under REACH were also made due to the different regulatory approach. Model estimates from ART frequently have allow level of consistency with measured workplace concentrations, in some cases by up to two orders of magnitude. RCR values calculated from each exposure measured and estimated data were always <1, although EN 689 testing revealed cases of noncompliance. Excess risk under REACH remained below the tolerable level defined but was closer to it than to the acceptable level. The analysis highlighted fundamental differences between REACH and OSH: REACH relies mostly on exposure models for registration. For Application for Authorizations, monitoring is more frequently applied. On the other hand, OSH prioritizes monitoring of carcinogenic agents by workplace measurements in any case. Models are useful tools, but their reliability depends amongst others on assessor expertise and contextualization with workplace data. Integrating REACH authorization conditions with OSH monitoring obligations can create a more consistent and effective strategy to protect workers from Cr(VI) exposure. As the concept of risk is framed differently in REACH and OSH, this study highlights how the exposure tools may be used at different levels, leading to mutual benefits for both approaches.
BACKGROUND: Preclinical studies suggest that initiating activity-based therapy (ABT) within days of an acute spinal cord injury (SCI) best enhances recovery, but may also increase the risk of inducing spinal cord damage. This study assesses the effects of early ABT initiated within 48 h of spinal surgery (or 3 days of the SCI), while patients are in the intensive care unit (ICU) for hemodynamic management. METHODS: This single-arm proof-of-concept trial included 45 adults with a severe traumatic SCI receiving daily 30-minute sessions of in-bed leg cycling for 14 consecutive days, in comparison to a matched historical control cohort that did not undergo ABT. Cycling was initiated in the ICU within 48 h of spinal surgery. The main patient outcome was the recovery of independent walking 6 months post-SCI. Secondary outcomes included the rates of complications and other neurofunctional assessments. RESULTS: Recovery of independent walking occurred in 31% of PROMPT-SCI participants and 36% of controls (p = 0.3). Neurological recovery was similar between the two cohorts. The PROMPT-SCI cohort had decreased spontaneous spams (9% vs. 40%, p<10− 3) and co-occurrence of pneumonia, pressure injury and urinary tract infection (P/UTI/PI) (2% vs. 13%, p = 0.03). Readiness for rehabilitation transfer was decreased by 7 days in the PROMPT-SCI cohort, approaching statistical significance (p = 0.051). When adjusting for baseline motor score, spontaneous spasms remained decreased with ABT (p = 0.001; odds ratio = 0.14 [95%CI: 0.04–0.45]), and rehabilitation transfer readiness was shorter (p = 0.03; β=-0.22 [95%CI: -0.41 – -0.04]). However, there was no significant association between concomitant P/UTI/PI and ABT (p = 0.08; Odds ratio = 0.14 [95%CI: 0.02–1.24]). CONCLUSIONS: Early acute ABT did not increase the risk for neurological deterioration when initiated in the ICU for patients requiring hemodynamic management. It can decrease the early occurrence of spontaneous spasms, and may potentially reduce the co-occurrence of P/UTI/PI and accelerate rehabilitation transfer readiness. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04699474 (Registration Date: January 5th 2021).
Afzelia corallina A.Bianchi, S.Orsenigo & Baldesi (Fabaceae: Detarioideae) is described from the coral rag forests of the Tondooni Peninsula in the Ngezi-Vumawimbi Forest Reserve on Pemba Island, Zanzibar, Tanzania. Morphologically distinct from all known members of the genus, this large, emergent tree shows the closest affinities to Afzelia quanzensis but differs in several vegetative and floral characters, including its falcate leaflets, highly branched terminal inflorescences, petal colour, the colour of stamens, and the number of extra staminodes. The species is currently known only from a restricted coastal limestone habitat, indicating a micro-endemic distribution. An updated diagnostic key to East African Afzelia species is provided. This discovery highlights the botanical uniqueness and conservation importance of Pemba's remaining forest ecosystems.