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Air ions are the key components for a series of atmospheric physicochemical interactions, such as ion-catalyzed reactions, ion-molecule reactions, and ion-induced new particle formation (NPF). They also control atmospheric electrical properties with effects on global climate. We performed molecular-level measurements of cluster ions at the high-altitude research station Chacaltaya (CHC; 5240 m a.s.l.), located in the Bolivian Andes, from January to May 2018 using an atmospheric-pressure-interface time-of-flight mass spectrometer. The negative ions mainly consisted of (H2SO4)0–3⚫HSO4-, (HNO3)0–2⚫NO3-, SO5-, (NH3)1–6⚫(H2SO4)3–7⚫HSO4-, malonic-acid-derived, and CHO / CHON⚫(HSO4- / NO3-) cluster ions. Their temporal variability exhibited distinct diurnal and seasonal patterns due to the changes in the corresponding neutral species' molecular properties (such as electron affinity and proton affinity) and concentrations resulting from the air masses arriving at CHC from different source regions. The positive ions were mainly composed of protonated amines and organic cluster ions but exhibited no clear diurnal variation. H2SO4–NH3 cluster ions likely contributed to the NPF process, particularly during the wet-to-dry transition period and the dry season, when CHC was more impacted by air masses originating from source regions with elevated SO2 emissions. Our study provides new insights into the chemical composition of atmospheric cluster ions and their role in new particle formation in the high-altitude mountain environment of the Bolivian Andes.

Background Laminotomy has been introduced in surgical practice to reduce complications of laminectomy after surgery of tumors in the spinal canal. However, the posterior ligament complex, which is routinely interrupted to remove the laminoplasty segment and gain access to the spinal canal, has a tendency not to heal and can lead to progressive kyphosis and collapse. Case presentation A 5-month-old boy affected by a thoracolumbar extradural tumor extending along seven spinal levels was operated on. The tumor was exposed and completely resected by a one-piece laminotomy with preservation of the integrity of the posterior tension band at both extremities. After 1-year radiological examination ruled out spinal deformity. Conclusion The technique herein presented, which we named in situ laminotomy, allows to fully preserve the posterior tension band without reducing the exposure of the spinal canal in multilevel tumors. Additionally, the technique makes also the reconstruction of the spine elements very easy and rapid. However, longer follow-up is necessary to prove the effectiveness of this procedure in preventing long-term deformity and instability.

Artificial Intelligence (AI) is at a crucial point in its development: stable enough to be used in production systems, and increasingly pervasive in our lives. What does that mean for its safety? In his book Normal Accidents, the sociologist Charles Perrow proposed a framework to analyze new technologies and the risks they entail. He showed that major accidents are nearly unavoidable in complex systems with tightly coupled components if they are run long enough. In this essay, we apply and extend Perrow’s framework to AI to assess its potential risks. Today’s AI systems are already highly complex, and their complexity is steadily increasing. As they become more ubiquitous, different algorithms will interact directly, leading to tightly coupled systems whose capacity to cause harm we will be unable to predict. We argue that under the current paradigm, Perrow’s normal accidents apply to AI systems and it is only a matter of time before one occurs. This article appears in the AI & Society track.

Introduction: Luminal tumors show molecular differences and different behavior. The antigen Ki67 is one of the factors that differentiate between luminal A and B. Genomic platforms can identify which patients will benefit from chemotherapy. Objectives: To establish if there is an association between ki67 and Oncotype Dx Score (RS). To assess the influence of ki67 and RS on the therapeutic decision, to evaluate the association between clinical risk and RS, between lymphovascular invasion (LVI) and RS, and between positive axillar nodes (up to 1 node) and RS. Materials and methods: Retrospective, observational, descriptive study. We included 68 patients with negative Her2Neu luminal tumors, T1-T2, negative or positive axillary up to 1 node, who performed Oncotype DX between 2009 and 2020 at Hospital Alemán. They were classified into RS less than or equal to 25 and greater than 25 based on the TAILORx study, where it was shown that overall there is no benefit from chemotherapy between 0-25. Results: An association was observed between ki67 and RS in 44 (64.7%) patients and it was greater between low ki67 and RS less than or equal to 25 (77.3%). The treatment was based on RS. An association between clinical risk and RS was observed in 43 (63.2%) patients, and it was greater between low clinical risk and RS less than or equal to 25 (87.5%). In 88.8% there was no association between LVI and RS, as well as between positive axillary up to 1 node and RS in 85.7%. Conclusion: It is necessary to offer every patient with a luminal tumor a genomic platform since both ki67 and other pathological clinical factors alone did not prove to be superior or sufficient.

Introduction: Numerous publications have individually evaluated the expression of the p53 protein, the presence of androgen receptors and the magnitude of the lymphocyte infiltrate TILs in triple negative tumors. The presence or absence of these variables could help identify subgroups in triple negative breast cancer (TNBC). Objectives: The objective of this study is to evaluate in triple negative tumors feasibility of using lymphocyte infiltration, the expression of p53 protein and androgen receptors as prognostic markers (overall survival and disease-free) .and collaborate in the identification of biomarkers for the development of specific target treatments. Material and Methods: We intend to analyze those patients diagnosed with TNBC treated at the German Hospital of Buenos Aires and at the Mater Dei Sanatorium from December 2002 to December 2014. Results: Thirty-five patients with TNBC were analyzed. The prevalence in the p53 mutation was 57% in the general population, 64,7% in relapses and 69% in deceased patients. 22.8% of the patients studied showed expression of androgenic receptors. The average lymphocytic tumor infiltration (TILs) was 20.6% (5%-70%), being lower when the population of patients who relapsed was only evaluated (19.6%) and even lower when evaluating the population of deceased patients (17.1%). Discussion: The mutation in p53 in our population has a RR of 1.6 for survival with a p = 0.596. The presence of ILV together with the mutation in p53 constitutes a mortality risk factor with p = 0.0147. The expression of androgenic receptors has a RR of 1.5 as a mortality risk factor and a p: 0.974. The presence of TILS greater than 20% is predictive of mortality and recurrence with a p: 0.0269. This is maintained with values of TILs of 18% and 15% with p = 0.0131 and p = 0.0032 respectively. Conclusion: The determination of the TILs together with the evaluation of the mutation of the p53, and its evaluation in combination with other prognostic factors (ILV and Ki67) is useful for predicting prognosis in the TNBC. We think that the presence of mutation of p53 and the degree of TILs are determinations whose evaluation should be standardized in patients with TNBC and be duly recorded in the pathology report.

Dimethyl sulfide (DMS) influences climate via cloud condensation nuclei (CCN) formation resulting from its oxidation products (mainly methanesulfonic acid, MSA, and sulfuric acid, H2SO4). Despite their importance, accurate prediction of MSA and H2SO4from DMS oxidation remains challenging. With comprehensive experiments carried out in the Cosmics Leaving Outdoor Droplets (CLOUD) chamber at CERN, we show that decreasing the temperature from +25 to -10 °C enhances the gas-phase MSA production by an order of magnitude from OH-initiated DMS oxidation, while H2SO4production is modestly affected. This leads to a gas-phase H2SO4-to-MSA ratio (H2SO4/MSA) smaller than one at low temperatures, consistent with field observations in polar regions. With an updated DMS oxidation mechanism, we find that methanesulfinic acid, CH3S(O)OH, MSIA, forms large amounts of MSA. Overall, our results reveal that MSA yields are a factor of 2-10 higher than those predicted by the widely used Master Chemical Mechanism (MCMv3.3.1), and the NOxeffect is less significant than that of temperature. Our updated mechanism explains the high MSA production rates observed in field observations, especially at low temperatures, thus, substantiating the greater importance of MSA in the natural sulfur cycle and natural CCN formation. Our mechanism will improve the interpretation of present-day and historical gas-phase H2SO4/MSA measurements. publishedVersion

I disturbi dello spettro autistico sono caratterizzati da difficoltà nell'interazione socio-comunicativa, dalla presenza di comportamenti e interessi ristretti e ripetitivi. In determinate circostanze, ad esempio durante un periodo di lockdown, quando l'isolamento sociale e il distanziamento diventano obbligatori per tutti, in particolare per le famiglie con un bambino con disturbo dello spettro l'interruzione delle routine quotidiane (scuola, terapia, tempo libero) rischia di minare il lavoro terapeutico e i progressi che faticosamente le famiglie avevano raggiunto fino a quel momento. In questo studio abbiamo monitorato 81 famiglie di bambini con disturbo dello spettro, valutandole prima dell'inizio della pandemia e circa 4 mesi dopo, per verificare quali comportamenti dei bambini fossero peggiorati e quali invece fossero rimasti stabili o anche migliorati. Le famiglie sono state intervistate, a febbraio e luglio 2020, attraverso rating scale standardizzate e i risultati hanno evidenziato un intensificarsi nei bambini di irrequietezza motoria, difficoltà nella regolazione del sonno, mentre non sono emersi peggioramenti nelle condotte autolesive o etero-aggressive, né nelle autonomie personali. Va considerato che tutte le famiglie coinvolte nella presente ricerca erano inserite in percorsi terapeutici e non hanno interrotto il percorso di supporto psicologico (online), con lo specifico obiettivo di sostenerli nel loro ruolo genitoriale nelle fasi più critiche vissute dai bambini, e nel renderli sempre più attivi nei processi di consolidamento delle competenze acquisite dai bambini.

The architecture for transportation and mobility had, between the sixties and seventies, an intensive period of execution in Argentina, driven by a political context that advocated for development in all its forms. Innovative programs and technologies were used in a typology that posed challenges in resolution terms for the professionals of the time. Among the numerous works that were built in the country, this article highlights the Mendoza Bus Terminal project, one of the first built in a provincial capital that, planned in 1964, was inaugurated in 1972, after a short construction period. From the review of technical publications of the time, graphic documentation of the project, press clippings, government work, and an interview with the site’s main designer, this text, in historical terms, seeks to delve into the particular aspects of the ideation and execution of this urban landmark, a local reflection of the degree of progress in terms of technology and construction techniques, and the executive capacity of the provincial State.

Atmospheric new particle formation significantly affects global climate and air quality after newly formed particles grow above ∼50 nm. In polluted urban atmospheres with 1-3 orders of magnitude higher new particle formation rates than those in clean atmospheres, particle growth rates are comparable or even lower for reasons that were previously unclear. Here, we address the slow growth in urban Beijing with advanced measurements of the size-resolved molecular composition of nanoparticles using the thermal desorption chemical ionization mass spectrometer and the gas precursors using the nitrate CI-APi-ToF. A particle growth model combining condensational growth and particle-phase acid-base chemistry was developed to explore the growth mechanisms. The composition of 8-40 nm particles during new particle formation events in urban Beijing is dominated by organics (∼80%) and sulfate (∼13%), and the remainder is from base compounds, nitrate, and chloride. With the increase in particle sizes, the fraction of sulfate decreases, while that of the slow-desorbed organics, organic acids, and nitrate increases. The simulated size-resolved composition and growth rates are consistent with the measured results in most cases, and they both indicate that the condensational growth of organic vapors and H

New particle formation (NPF) in the tropical free troposphere (FT) is a globally important source of cloud condensation nuclei, affecting cloud properties and climate. Oxidized organic molecules (OOMs) produced from biogenic volatile organic compounds are believed to contribute to aerosol formation in the tropical FT, but without direct chemical observations. We performed in-situ molecular-level OOMs measurements at the Bolivian station Chacaltaya at 5240 meters above sea level, on the western edge of Amazonia. For the first time, we demonstrate the presence of OOMs, mainly with 4-5 carbon atoms, in both gas-phase and particle-phase (in terms of mass contribution) measurements in tropical FT air from Amazonia. These observations, combined with air mass history analyses, indicate that the observed OOMs are linked to isoprene emitted from the rainforests hundreds of kilometers away. Based on particle-phase measurements, we find that these compounds can contribute to NPF, at least the growth of newly formed nanoparticles, in the tropical FT on a continental scale. Thus, our study is a fundamental and significant step in understanding the aerosol formation process in the tropical FT.

Early growth of atmospheric particles is essential for their survival and ability to participate in cloud formation. Many different atmospheric vapors contribute to the growth, but even the main contributors still remain poorly identified in many environments, such as high-altitude sites. Based on measured organic vapor and sulfuric acid concentrations under ambient conditions, particle growth during new particle formation events was simulated and compared with the measured particle size distribution at Chacaltaya Global Atmosphere Watch station in Bolivia (5240 m a.s.l.) during April and May 2018, as a part of the SALTENA (Southern Hemisphere high-ALTitude Experiment on particle Nucleation and growth) campaign . The simulations showed that the detected vapors were sufficient to explain the observed particle growth, although some discrepancies were found between modelled and measured particle growth rates. This study gives an insight on the key factors affecting the particle growth on the site. Low volatile organic compounds were found to be the main contributor to the particle growth, covering on average 65 % of simulated particle mass in particle with diameter of 40 nm In addition, sulfuric acid had a major contribution to the particle growth, covering at maximum 39 % of simulated particle mass in 40 nm particle during periods when volcanic activity was detected on the area, suggesting that volcanic emissions can greatly enhance the particle growth.

Highly oxygenated organic molecules (HOMs) are a major source of new particles affecting Earth’s climate1,2. HOM production from the oxidation of volatile organic compounds (VOCs) occurs during both day and night, and can lead to new particle formation (NPF)3,4. However, NPF involving organic vapors has been reported much more often during daytime3-6 than during nighttime7,8. Here, we show that the nitrate radicals (NO3) - which arise predominantly at night – inhibit NPF during the oxidation of monoterpenes based on three lines of observational evidence: NPF experiments in the CLOUD chamber at CERN; radical chemistry experiments using an oxidation flow reactor; and field observations in a wetland that occasionally exhibits nocturnal NPF. Nitrooxy-peroxy radicals formed from NO3 chemistry suppress the production of ultra-low volatility organic compounds (ULVOCs) responsible for biogenic NPF, which are covalently bound RO2 dimer association products. The ULVOC yield of α-pinene in the presence of NO3 is one-fifth of that resulting from ozone chemistry alone. Even trace amounts of NO3 radicals, at sub parts per trillion level, suppress the NPF rate by a factor of 4. Ambient observations further confirm that when NO3 chemistry is involved, monoterpene NPF is completely turned off. Our results explain the frequent absence of nocturnal biogenic NPF in monoterpene-rich environments.

The lack of annotated publicly available medical images is a major barrier for innovations. At the same time, many de-identified images and much knowledge are shared by clinicians on public forums such as medical Twitter. Here we harness these crowd platforms to curate OpenPath, a large dataset of 208,414 pathology images paired with natural language descriptions. This is the largest public dataset for pathology images annotated with natural text. We demonstrate the value of this resource by developing PLIP, a multimodal AI with both image and text understanding, which is trained on OpenPath. PLIP achieves state-of-the-art zero-shot and transfer learning performances for classifying new pathology images across diverse tasks. Moreover, PLIP enables users to retrieve similar cases by either image or natural language search, greatly facilitating knowledge sharing. Our approach demonstrates that publicly shared medical information is a tremendous resource that can be harnessed to advance biomedical AI.

New particle formation processes contribute significantly to the number concentration of ultrafine particles (UFP), and have great impacts on human health and global climate. Iodine oxoacids (HIOx, including iodic acid, HIO3 and iodous acid, HIO2) have been observed in pristine regions and proved to dominate NPF events at some sites. However, the knowledge of HIOx in polluted urban areas is rather limited. Here, we conducted a long-term comprehensive observation of gaseous iodine oxoacids and sulfuric acid in Beijing from January 2019 to October 2021 and also in Nanjing from March 2019 to February 2020, and investigated the contribution of HIOx to UFP number concentration in urban environments. HIO3 concentration is highest in summer, up to 2.85×106 cm-3 and 2.78×106 cm-3 in Beijing and Nanjing, respectively, and is lowest in winter, with a more prominent seasonal variation than H2SO4. HIO3 concentration shows a clear diurnal pattern at both sites with a daily maximum at around noontime, similar to the atmospheric temperature, radiation and ozone (O3) levels. HIO2 concentration has the same diurnal and seasonal trend as HIO3 but is overall about one order of magnitude lower than HIO3 concentration. Back trajectory analysis suggests that the sources for inland iodine species could be a mix of marine and terrestrial origins, both having peak iodine emission in warm seasons. While the contribution of HIO2 to particle growth is marginal in Beijing and Nanjing, our results demonstrate that HIO3 enhances the particle survival probability of sub-3 nm particles by about 40 % (median) and occasionally by more than 100 % in NPF events, suggesting HIOx are non-negligible contributor to UFPs in polluted urban areas. As the growth contribution from HIO3 and H2SO4 is similar on a per-molecule basis, we propose that the sum of HIO3 and H2SO4 could be used to estimate sub-3 nm particle growth of inorganic acid origin, in the polluted atmospheres with a significant amount of HIOx.

Background: Near-infrared fluorescence-based sentinel lymph node (SLN) mapping technique with indocyanine green (ICG) has been found a useful surgical modality for sentinel node detection and disease staging in endometrial cancer (EC) worldwide. Objective: We aimed to introduce the SNL mapping technology using ICG and Near Infrared (NIR) fluorescence in Argentina. We aimed to assess the overall and bilateral detection rate of ICG based SNL mapping along with verifying its feasibility and effectiveness in surgical staging. We also aimed to discover the perceptions of surgeons regarding the use of ICG as a tracer and NIR as light-medium in SNL mapping. Method: ICG SLNs identification was evaluated retrospectively. This study was performed at the Hospital Aleman de Buenos Aires in September, 2017The detection rates were calculated along with the analysis of the number of SNL observed and operative time, and time taken by overall surgery. Subsequently, the surgeons were interviewed to ascertain their opinion of using ICG SNL mapping in endometrial cancer staging. Results: Four patients with endometrial cancer were included for analysis. The overall and bilateral detection rates have been 100% and 75%, respectively. While, under white light, no SLNs were identified. The average operative time of nodes resection was estimated 2.15 minutes. The fluorescence has been used for 2.2 minutes and overall time taken by surgery was estimated 71.5 minutes. The estimated blood loss (EBL) has been lower than 50 ml. The responses of surgeons’ from the interview have been 100% positive. The cost of the procedure based on the amount of dye used was 25 dollars per patient. Conclusion: Laparoscopic ICG SLN resulted to be feasible, practical and no expensive surgical modality for uterine cancer triage.

Dimethyl sulfide (DMS) is the primary natural contributor to the atmospheric sulfur burden. Observations concerning the fate of DMS oxidation products after long-range transport in the remote free troposphere are, however, sparse. Here we present quantitative chemical ionization mass spectrometric measurements of DMS and its oxidation products sulfuric acid (H2SO4), methanesulfonic acid (MSA), dimethylsulfoxide (DMSO), dimethylsulfone (DMSO2), methanesulfinic acid (MSIA), methyl thioformate (MTF), methanesulfenic acid (MSEA, CH3SOH), and a compound of the likely structure CH3S(O)2OOH in the gas phase, as well as measurements of the sulfate and methanesulfonate aerosol mass fractions. The measurements were performed at the Global Atmosphere Watch (GAW) station Chacaltaya in the Bolivian Andes located at 5240 m above sea level (a.s.l.). DMS and DMS oxidation products are brought to the Andean high-altitude station by Pacific air masses during the dry season after convective lifting over the remote Pacific ocean to 6000–8000 m a.s.l. and subsequent long-range transport in the free troposphere (FT). Most of the DMS reaching the station is already converted to the rather unreactive sulfur reservoirs DMSO2 in the gas phase and methanesulfonate (MS−) in the particle phase, which carried nearly equal amounts of sulfur to the station. The particulate sulfate at Chacaltaya is however dominated by regional volcanic emissions during the time of the measurement and not significantly affected by the marine air masses. In one of the FT events, even some DMS was observed next to reactive intermediates such as methyl thioformate, dimethylsulfoxide, and methanesulfinic acid. Also for this event, back trajectory calculations show that the air masses came from above the ocean (distance >330 km) with no local surface contacts. This study demonstrates the potential impact of marine DMS emissions on the availability of sulfur-containing vapors in the remote free troposphere far away from the ocean.

Agent-Based Modeling (ABM) is a computational method used to examine social outcomes emerging from interaction between heterogeneous agents by computer simulation. It can be used to understand the effect of initial conditions on complex outcomes by exploring fine-grained (multiple-scale, spatial/temporal) observations on the aggregate consequences of agent interaction. By performing in silico experimental tests on policy interventions where ex ante predictions of outcomes are difficult, it can also reduce costs, explore assumptions and boundary conditions, as well as overcome ethical constraints associated with the use of randomized controlled trials in behavioral policy. Here, we introduce the essential elements of ABM and present two simple examples where we assess the hypothetical impact of certain policy interventions while considering different possible reactions of individuals involved in the context. Although highly abstract, these examples suggest that ABM can be either a complement or an alternative to behavioral policy methods, especially when understanding social processes and exploring direct and indirect effects of interventions are important. Prospects and critical problems of these in silico policy experiments are then discussed.

BACKGROUND Grape pomace (GP), a wine-making by-product rich in dietary fiber (DF) and total phenolic compounds (TPC), is a potential functional ingredient in the fortification of baked goods. RESULTS In the present study, fortified breadsticks samples were obtained by replacing wheat flour with 0, 5 and 10 g 100 g-1 of powdered GP (GPP). The GPP inclusion affected the rheological properties of the doughs by increasing the water absorption and tenacity (P) at the same time as reducing the extensibility (L), with a significant increase in the P/L value and a decrease in the swelling index (G) value and deformation energy (W). Textural characteristics of breadsticks were influenced by the GPP addition, showing a reduction in hardness and fracturability as the amount of GPP increased in the recipe. The GPP fortified breadsticks exhibited decreased pH, volume and specific volume values compared to the control. The TPC and the antioxidant capacity increased in GPP fortified breadsticks, whereas the increased amount of DF allowed the products to benefit from the claim 'high fiber content' at the highest level of GPP inclusion. The sensory evaluation revealed that GPP addition increased wine odor, acidity, bitterness, astringency and hardness, and decreased the regularity of alveolation and friability. Finally, the GPP fortified products achieved good sensorial acceptability. CONCLUSION GPP improved the nutritional values of fortified breadsticks and changed the rheology of dough and breadsticks' technological properties without affecting sensory acceptability. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Biogenic volatile organic compounds (BVOCs) are known to strongly influence the global climate by affecting various atmospheric constituents such as oxidants and aerosols. Among the several BVOCs that are emitted continuously into the atmosphere, studies have shown that up to 96% of the emissions have been missed out by current analytical techniques. In this study, we used a Vocus proton-transfer-reaction time-of-flight mass spectrometer (Vocus) to characterize and quantify emissions from a branch of a downy birch tree at a boreal forest site in Hyytiälä, Finland in August 2019. During the measurement period, we were able to observe real-time emissions of hydrocarbons with up to 20 carbon atoms and oxygenated compounds (OVOCs) with up to 4 oxygen atoms. OVOCs accounted for around 90% of the total observed emissions with the largest contribution from C8H8O3 (0.37 μgg–1h–1; ∼60% of total). For the first time, emissions of diterpenes (C20H32, C20H36, and C20H38) were observed from downy birch tree, although in minor quantities (0.1% of total emissions). During this late growing season, C10H16 and C10H14 contributed ∼7% in total emissions, while the sum of C5H8, C15H22, and C15H24 contributed around ∼3%. The branch experienced abiotic stress during the measurement period, which might explain the unusually high emissions of C8H8O3. Standardized emission potentials are reported for all compounds using two Guenther algorithms. While emissions of most compounds fit well with either of the two algorithms, emissions of certain compounds like C8H8O3 could not be explained by either suggesting the influence of other factors besides temperature and light. Vocus PTR-TOF-MS can help identify a diverse range of molecules even if emitted in minute quantities. The BVOCs detected from birch emissions may be important in the formation of secondary organic aerosols but their implications in the atmosphere need to be verified with further studies.

Liu et al. found that the formation rate of particulate ammonium is slower in the atmosphere than that observed in the laboratory, while it is sped up due to an increase in aerosol acidity driven by an emission reduction of dust in North China Plain.Ammonium salt is an important component of particulate matter with aerodynamic diameter less than 2.5 mu m (PM2.5) and has significant impacts on air quality, climate, and natural ecosystems. However, a fundamental understanding of the conversion kinetics from ammonia to ammonium in unique environments of high aerosol loading is lacking. Here, we report the uptake coefficient of ammonia (gamma(NH3)) on ambient PM2.5 varying from 2.2 x 10(-4) to 6.0 x 10(-4) in the North China Plain. It is significantly lower than those on the model particles under simple conditions reported in the literature. The probability-weighted gamma(NH3) increases obviously, which is well explained by the annual decrease in aerosol pH due to the significant decline in alkali and alkali earth metal contents from the emission source of dust. Our results elaborate on the complex interactions between primary emissions and the secondary formation of aerosols and the important role of dust in atmospheric chemistry.

Atmospheric cluster ions are important constituents in the atmosphere, and their concentrations and compositions govern their role in atmospheric chemistry. However, there is currently limited quantitative research on atmospheric ion compositions, sources, and sinks, especially in the urban atmosphere where pollution levels and human populations are intense. In this study, we measured the compositions of negative cluster ions and neutral molecules using an atmospheric pressure interface high-resolution time-of-flight mass spectrometer (APi-TOF) and a chemical ionization mass spectrometer in urban Beijing. Quantitative analysis of cluster ions was performed by their comparison with condensation sink (CS), reagent ions, and neutral molecules. We demonstrate the feasibility of quantifying cluster ions with different compositions using in situ-measured ion mobility distributions from a neutral cluster and air ion spectrometer (NAIS). The median concentration of negative cluster ions was 85 (61–112 for 25 %–75 %) cm−3 during the measurement period, which was negatively correlated with CS. The negative cluster ions mainly consisted of inorganic nitrogen-containing ions, inorganic sulfur-containing ions, and organic ions in the form of adducts with NO3- or HSO4-. The CHON-related organic ions accounted for over 70 % of the total organic ions. Although the molecules clustered with NO3- and HSO4- had similar compositions, we found that HSO4- clustered more efficiently with CHO and CHONnonNPs species (CHON excluding nitrated phenols), while NO3- clustered more efficiently with nitrated phenols (CHONNPs). Additionally, most organic ions were positively correlated with neutral molecules, resulting in similar diurnal cycles of organic ions and neutral molecules. However, an exception was found for CHONNPs, the concentration of which is also significantly influenced by the reagent ions NO3-. The charge fractions are generally higher for molecules with higher molecular weight and a higher oxidation state, and the opposite diurnal variations in charging fractions between H2SO4 and organic species indicate a charging competition between them. Finally, we choose HSO4- and C3H3O4- as representatives to calculate the contribution of different formation and loss pathways. We found their losses are condensational loss onto aerosol particles (73 %–75 %), ion–molecule reaction losses (19 %), and ion–ion recombination losses (6 %–8 %).

Background The enlargement of the posterior cranial fossa volume is considered one of the main steps of the surgical management of children with multiple sutures craniosynostosis. Different management options have been proposed including fixed expansive craniotomy, free bone flap craniotomy, and distraction osteogenesis. Objectives To review indications to “free bone flap” craniotomy for the posterior fossa expansion, detailing advantages, disadvantages, and complications related to the technique. Results and conclusions A review of the literature shows that “free bone flap” posterior expansion cranioplasty still has a role, particularly in infants with thin and “honeycomb” structure of the bone, allowing to gain adequate intracranial volume increases and to postpone to a more adequate time surgery aimed at anterior cranial fossa expansion.

Raising a child with autism spectrum disorder (ASD) can be a very stressful experience, impacting parents and their ability to take care of their child. We examined the relationship between parenting stress and child, and parent and contextual factors in a sample of 61 families of children with ASD recruited in a centre for ASD assessment and treatment. Results showed that mothers had a higher level of stress related to their parental role when compared to fathers. Data also showed the importance of considering the specific role of parental emotion regulation, family functioning and educational level in influencing maternal stress and the specific role of couple adjustment in influencing fathers’ parental distress. This study pointed out the importance of employing a vision that embraces different domains of family life in cases of children with ASD and in parents’ intervention programmes because these factors may contribute to parental stress.

Malformations of the craniovertebral junction (CVJ) range from mild, asymptomatic conditions to severe forms of instability with basilar invagination. Rarely, there have been accounts of forms of so-called paramedian basilar invagination, with abnormal bone masses invading the lateral portion of the foramen magnum. All these entities have been comprehensively classified both from an anatomical and embryological standpoint.Here, we report a case of a unique CVJ malformation which is not included in any existing classification framework and could represent a novel pathologic entity. We also provide an overview of the pertinent literature.The patient was a 14-year-old boy with a recent onset of spastic tetraparesis. Radiological studies documented a malformation of the atlas which invaginated through the foramen magnum, causing anterolateral medullary incarceration. Surgical treatment involved posterior decompression with resection of the abnormal bone and occipito-cervical fusion.Our report enriches the panorama of CVJ malformations, showing how anatomical knowledge and embryological insights constitute the basis for the correct assessment and treatment of these complex entities.

In spite of the significant technical and technological progress in neurosurgery and the continuous discoveries by the basic research, adamantinomatous craniopharyngioma remains a significant clinical challenge. Actually, the huge size of the tumor, its multiple cystic components, the encasement of Willis' circle and optic pathways, and the invasion of the hypothalamus often prevent its safe surgical resection. Moreover, the local aggressiveness of the tumor accounts for a high risk of recurrence even after a gross total resection. For these reasons, more and more efforts are being dedicated to enhance the knowledge about AC and improve the tools for its treatment.This paper is dedicated to the most recent advances concerning the AC management. Promising, new insights come for the basic research, thanks to the updates on the role of the WNT-β-catenin pathway (important for the tumor genesis and progression, not yet developed enough for a safe target therapy in children but useful for determining the prognosis) and the inflammatory mediators (widely overexpressed, especially by the cyst of the tumor, and for which target therapies are being developed). Moreover, further factors and pathways are under investigation.Also the development of new treatment strategies accounts for the improvement of the prognosis and the quality of life of AC patients. The enhancement of the experience with the endoscopic techniques (both transsphenoidal and transventricular approaches) actually allows to perform a less invasive but effective surgery that can be coupled with new modalities of radiation therapy aiming at obtaining a reliable control of the disease and protecting the endocrinological, ophthalmological, and neurological functions. A special mention is finally deserved by the techniques specifically designed for the intracystic therapy (as cyst fenestration alone or in combination with administration of radionuclides or bleomycin or interferon-α) that are here analyzed together with the aforementioned advances.

Covid lockdown presented an important opportunity to study relatively cleaner conditions in India. The complex factors of power production, industry, and transportation could be more carefully dissected because of the extreme reduction in the influence of the latter two emission sources. Measurements of cloud condensation nuclei (CCN) activity and other chemical properties of atmospheric aerosols showed that newly formed aerosol particles were produced in the SO2 plume from a large coal-fired power plant, contrary to normal conditions of heavy pollution. The sulfate-rich particles had high CCN activity and number concentration, indicating high cloud-forming potential. Examining the sensitivity of CCN properties under relatively clean conditions over India provides important new constraints on the perturbations of past and future climate forcing by anthropogenic emissions. Because most sensitive regime of aerosol climate forcing on cloud development is the midpoint of relatively clean conditions afforded by the Covid lockdown between background and polluted conditions.

To investigate the current practice of neurosurgeons and their perception of complications related to the securement of external drainage (ED) to the skin.We created a 24-points English language questionnaire on Google Forms covering the five main domains of care. The survey was distributed among members of the European Society for Pediatric Neurosurgery (ESPN) in April 2020.The results were entirely self-reported, without any independent validation. Fifty-one neurosurgeons practising in different centres worldwide participated in this survey. Despite well-known complications and drawbacks, sutures are still the most commonly used method to secure cerebrospinal fluid (CSF) ventricular ED (49 out of 51 respondents) and spinal ED (37 out of 51) to the skin. Perception of the risk of pullout is estimated as1% by 25.5% of the respondents, 1-5% by 39.2%, 5-10% by 17.6% and 10% by 11.8%. Twenty out of fifty-one respondents acknowledge that their method of securement has drawbacks, and 49% believe that it may also affect the risk of infection. Factors eventually affecting the risk of pullout are young age (62.7%), aetiology (25.5%), neurological status (90.2%), occipital exit site (37.3%), inadequate length of the subcutaneous tunnel (58%), the duration of ED (70.6%), and hospital stay in service (84.3%). 39.2% of respondents agree that the paediatric population deserves a different device or technique to secure ED to the skin. 21.6% of respondents underestimate the risk of accidental pullout. 86.3% of respondents have never read about the 'sutureless subcutaneous anchoring device'.Complications associated with the securement method, such as the risk of pullout and infection, are most likely underestimated. More research is needed to implement effective guidelines in this field.

Along-valley winds in four major valleys in the southern slope of Nepal Himalayas are studied by means of a 5-day long high-resolution Weather Research and Forecasting model simulation. Model evaluation against observations from three automatic weather stations in the Khumbu valley showed a good agreement in the simulated diurnal cycle of wind direction and strength. The characteristics of the daytime up-valley winds are identified in the four valleys and compared to each other. Since all four valleys are under similar large-scale forcing, the differences in the along-valley winds are assumed to be mainly due to differences in the valley topographies. These valleys are separated by their topographic characteristics in two groups: the valleys in the west have a continuous inclination (2–5 degrees) in the valley floor and there is an 1-km high perpendicular mountain barrier between the valleys and the plain. The two valleys in the east have a 40 km portion with a nearly flat valley floor (Daytime up-valley winds develop in all of the four valleys and they vary between the valleys and their parts in strength (2–10 m/s) and flow depth (600–1500 m). The night-time along-valley winds are weak and flow mostly in the up-valley direction. During large-scale northerlies, the daily cycle of the along-valley winds is interrupted more compared to the days with large-scale westerlies especially in the heads of the valleys that reach up to 4000 masl. The night-time down-valley winds are found more during the large-scale northerlies, which is most likely due to channelling of above-valley winds into the valley atmosphere.The daytime up-valley winds are shallower and weaker in the parts of the valleys where the floor inclination exceeds 2 degrees compared to the parts where the valley floor is almost flat. The depth of the surface-based heated layer within the valleys is correlated with the flow depth and is lower in the steeply inclined parts of the valleys. The steep inclination of the valley floor and ridges in along-valley direction may shift the dominant driving mechanism of the along-valley winds from the valley volume effect to the buoyancy mechanism which would explain the shallower and weaker along-valley winds.The winds at the valley entrances are weaker in the two valleys with the 1-km high barrier between the valleys and the plain, compared to the valleys with open valley entrances. A shallow layer with strong along-valley winds is found on the lee-side slope of the barrier and 20 km after this (i.e. towards the head of the valley), weaker winds are evident. This spatial distribution of the along-valley wind speed resembles the typical structure of a hydraulic jump related to down-slope windstorms.

Local along-valley winds in four major valleys on the southern slope of the Nepal Himalayas are studied by means of high-resolution meteorological modelling. The Weather Research and Forecasting model is run with a 1 km horizontal grid spacing covering a 4 d period in December 2014. Model evaluation against meteorological observations from three automatic weather stations in the Khumbu Valley (one of the four valleys) shows a good agreement between the modelled and observed daily cycle of the near-surface wind speed and direction. Well-defined daytime up-valley winds are found in all of the four valleys during this 4 d period. The night-time along-valley winds are weak in magnitude and flow mostly in the up-valley direction. Differences in the daytime up-valley winds are found between the valleys and their parts. As the valleys are under similar large-scale forcing, the differences are assumed to be due to differences in the valley topographies. Parts of the valleys with a steep valley floor inclination (2–5∘) are associated with weaker and shallower daytime up-valley winds compared with the parts that have nearly flat valley floors (∘). In the four valleys, the ridge heights also increase along the valley, meaning that the valley floor inclination does not necessarily lead to a reduction in the volume of the valley atmosphere. This way, the dominant driving mechanism of the along-valley winds, within the valleys, could shift from the valley volume effect to buoyant forcing due to the inclination. Two of the valleys have a 1 km high barrier in their entrances between the valley and the plain. Winds at the valley entrances of these two valleys are weaker compared with the open valley entrances. Strong and shallow winds, resembling down-slope winds, are found on the leeward slope of the barrier followed by weaker and deeper winds at the valley entrance, 20 km towards the valley from the barrier. Although the large-scale flow during the 4 d period was similar to the long-term climatology, the impact of different large-scale flows on the thermally driven winds was not considered. This topic could be addressed in the future by performing a longer simulation.

Symbolic knowledge representation and reasoning and deep learning are fundamentally different approaches to artificial intelligence with complementary capabilities. The former are transparent and data-efficient, but they are sensitive to noise and cannot be applied to non-symbolic domains where the data is ambiguous. The latter can learn complex tasks from examples, are robust to noise, but are black boxes; require large amounts of –not necessarily easily obtained– data, and are slow to learn and prone to adversarial examples. Either paradigm excels at certain types of problems where the other paradigm performs poorly. In order to develop stronger AI systems, integrated neuro-symbolic systems that combine artificial neural networks and symbolic reasoning are being sought. In this context, one of the fundamental open problems is how to perform logic-based deductive reasoning over knowledge bases by means of trainable artificial neural networks. This paper provides a brief summary of the authors’ recent efforts to bridge the neural and symbolic divide in the context of deep deductive reasoners. Throughout the paper we will discuss strengths and limitations of models in term of accuracy, scalability, transferability, generalizabiliy, speed, and interpretability, and finally, will talk about possible modifications to enhance desirable capabilities. More specifically, in terms of architectures, we are looking at Memory-augmented networks, Logic Tensor Networks, and compositions of LSTM models to explore their capabilities and limitations in conducting deductive reasoning. We are applying these models on Resource Description Framework (RDF), first-order logic, and the description logic $\mathcal {E}{\mathscr{L}}^{+}$ respectively.

Pediatric hospitalization is a common experience that may increase children’s sense of isolation and impinge on their social-emotional wellbeing. Educators and medical practitioners could minimize these negative effects of hospitalization if they were able to listen to the voices of the children and, therefore, better meet their needs. This qualitative study provides an overview of how children with a medical condition actively construct and organize their thoughts and feelings about illness, life in hospital, and relationships. We extrapolated from a collection of children’s narratives from a previous more comprehensive study (consisting of 379 narratives from children in 29 public hospitals across Italy, age range 3–14 years). Narratives grouped under the headings “Me and my illness” or “Me and the others” were selected and analyzed using interpretative phenomenological analysis (IPA) to identify the richness and complexity of children’s experience. Results showed that children’s description of their illness was affected both by cognitive and social factors. For children, the concept of feeling ill or well is not linked only to the fact that they are in hospital for a medical condition; rather, it is influenced by their ability to form relationships with others, play, be active, and feel alive within the hospital environment. Listening to narratives can deepen our understanding of children’s illness-related experiences and how they make sense of their situation. A set of practice implications are presented to help health professionals and educators to improve their listening capabilities and better prevent adverse pediatric hospitalization outcomes.

Background Gelfoam is a simple and effective hemostatic agent, which is utilized to seal brain corticotomies or skull burr holes too. Thanks also to its cheap costs, it is one of the most widely used tool in the neurosurgical daily practice. However, the migration of Gelfoam fragments can account for the occlusion of endoscopic third ventriculostomy (ETV) or shunt, leading to hydrocephalus recurrence. Case description The authors report on two cases of Galfoam migration causing recurrent hydrocephalus: a young girl, operated on by posterior fossa tumor removal and ETV for associated hydrocephalus, where part of the Gelfoam (used to seal the burr hole) migrated up to close the ETV; and a preterm boy, treated by endoscopic brain wash and, afterwards, by ventriculo-peritoneal shunt for post-hemorrhagic hydrocephalus, where all the Gelfoam used to close the corticotomy migrated into the lateral ventricle, thus reopening the corticotomy and releasing small fragments which finally obstructed the shunt. Both patients needed a new endoscopic procedure (the second one also a shunt revision). Conclusions The reviewed pertinent literature discloses other complications of Gelfoam migration (mass effect, granulomatous reaction) as well as other causes of uncommon ETV/shunt obstruction. Anyway, Gelfoam will remain an irreplaceable tool for neurosurgeons. The present paper just emphasizes the need of its correct use to avoid complications.

Ultrafine particles (UFPs) usually explosive growth during new particle formation (NPF) events. However, the risk of exposure to UFPs on NPF days has been ignored due to the prevalence of mass-based air quality standards. In this study, the daily deposited doses, i.e., the daily deposited particle number dose (D-PNd), mass dose (D-PMd), and surface area dose (D-PSd), of ambient particles in the human respiratory tract in Beijing were evaluated based on the particle number size distribution (3 nm-10 mu m) from June 2018 to May 2019 utilizing a Multiple-Path Particle Dosimetry Model (MPPD) after the hygroscopic growth of particles in the respiratory tract had been accounted for. Our observations showed a high frequency (72.6%) of NPF on excellent air quality days, with daily mean PM2.5 concentrations less than 35 mu g m(-3). The daily D-PNd on excellent air quality days was com-parable with that on polluted days, although the D-PMd on excellent air quality days was as low as 15.6% of that on polluted days. The D-PNd on NPF days was similar to 1.3 times that on non-NPF days. The D-PNd in respiratory tract regions decreased in the order: tracheobronchial (TB) > pulmonary (PUL) > extrathoracic (ET) on NPF days, while it was PUL > TB > ET on non-NPF days. The number of deposited nucleation mode particles, which were deposited mainly in the TB region (45%), was 2 times higher on NPF days than that on non-NPF days. Our results demonstrated that the deposition potential due to UFPs in terms of particle number concentrations is high in Beijing regardless of the aerosol mass concentration. More toxicological studies related to UFPs on NPF days, especially those targeting tracheobronchial and pulmonary impairment, are required in the future.

Background A comparison of clinical and radiological outcomes after two different variants of open door laminoplasty for cervical spondylotic myelopathy (CSM) is described. Methods Fifty-five patients underwent cervical laminoplasty for CSM. Between 2005 to 2009, 32 patients underwent open-door laminoplasty (Group A) performed with a monolateral exposure with contralateral "green stick" laminar fracture. A technical variant consisting in bilateral exposure, spinous process removal and symmetrical muscular closure was applied in the other 23 (Group B), from 2009 to 2016. A retrospective analysis of surgical results between the two groups was performed. Results In group B, the mean operative time was longer and the mean volume of intraoperative blood loss was much higher than in group A. Both differences were not significant (p=0.1601 and p=0.0884, respectively). The average hospitalization was nonsignificantly longer in group B (7.3±1.8 vs. 6.5±1.6 d; p= 0.0947). Postoperatively, axial neck pain was more severe in group A at last follow-up than preoperatively (P>0.05). mJOA scores and Nurick grades improved significantly in both groups at last follow-up; in group A, the mean recovery rates were 41.5 % by mJOA scores and 29.4 % by Nurick grades, whereas in group B they were 52.7 % and 36.8 %, respectively. Conclusions Applying some few variations to a standard monolateral approach, although slightly more time and blood consuming, could reduce the incidence of long term axial symptoms and, in our experience, are not burdened by worsening of outcomes. A prospective, multicentric study with a longer follow-up should be conducted in order to confirm our findings.

G-quadruplexes (G4s) are noncanonical forms of DNA involved in many key genome functions. Here, we exploited UV Resonance Raman scattering to simultaneously explore the vibrational behavior of a human telomeric G4 (Tel22) and its aqueous solvent as the biomolecule underwent thermal melting. We found that the OH stretching band, related to the local hydrogen-bonded network of a water molecule, was in strict relation with the vibrational features of the G4 structure as a function of temperature. In particular, the modifications to the tetrahedral ordering of the water network were strongly coupled to the DNA rearrangements, showing changes in temperature that mirrored the multi-step melting process of Tel22. The comparison between circular dichroism and Raman results supported this view. The present findings provide novel insights into the impact of the molecular environment on G4 conformation. Improving current knowledge on the solvent structural properties will also contribute to a better understanding of the role played by water arrangement in the complexation of G4s with ligands.