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Airborne and ground-based measurements of aerosol concentrations, chemical composition, and gas-phase precursors were obtained in three valleys in northern Utah (USA). The measurements were part of the Utah Winter Fine Particulate Study (UWFPS) that took place in January–February 2017. Total aerosol mass concentrations of PM1 were measured from a Twin Otter aircraft, with an aerosol mass spectrometer (AMS). PM1 concentrations ranged from less than 2 µg m−3 during clean periods to over 100 µg m−3 during the most polluted episodes, consistent with PM2.5 total mass concentrations measured concurrently at ground sites. Across the entire region, increases in total aerosol mass above ∼2 µg m−3 were associated with increases in the ammonium nitrate mass fraction, clearly indicating that the highest aerosol mass loadings in the region were predominantly attributable to an increase in ammonium nitrate. The chemical composition was regionally homogenous for total aerosol mass concentrations above 17.5 µg m−3, with 74±5 % (average ± standard deviation) ammonium nitrate, 18±3 % organic material, 6±3 % ammonium sulfate, and 2±2 % ammonium chloride. Vertical profiles of aerosol mass and volume in the region showed variable concentrations with height in the polluted boundary layer. Higher average mass concentrations were observed within the first few hundred meters above ground level in all three valleys during pollution episodes. Gas-phase measurements of nitric acid (HNO3) and ammonia (NH3) during the pollution episodes revealed that in the Cache and Utah valleys, partitioning of inorganic semi-volatiles to the aerosol phase was usually limited by the amount of gas-phase nitric acid, with NH3 being in excess. The inorganic species were compared with the ISORROPIA thermodynamic model. Total inorganic aerosol mass concentrations were calculated for various decreases in total nitrate and total ammonium. For pollution episodes, our simulations of a 50 % decrease in total nitrate lead to a 46±3 % decrease in total PM1 mass. A simulated 50 % decrease in total ammonium leads to a 36±17 % µg m−3 decrease in total PM1 mass, over the entire area of the study. Despite some differences among locations, our results showed a higher sensitivity to decreasing nitric acid concentrations and the importance of ammonia at the lowest total nitrate conditions. In the Salt Lake Valley, both HNO3 and NH3 concentrations controlled aerosol formation.

Nighttime vegetative uptake of carbonyl sulfide (COS) can exist due to the incomplete closure of stomata and the light independence of the enzyme carbonic anhydrase, which complicates the use of COS as a tracer for gross primary productivity (GPP). In this study we derived nighttime COS fluxes in a boreal forest (the SMEAR II station in Hyytiälä, Finland; 61°51′ N, 24°17′ E; 181 m a.s.l.) from June to November 2015 using two different methods: eddy-covariance (EC) measurements (FCOS-EC) and the radon-tracer method (FCOS-Rn). The total nighttime COS fluxes averaged over the whole measurement period were −6.8 ± 2.2 and −7.9 ± 3.8 pmol m−2 s−1 for FCOS-Rn and FCOS-EC, respectively, which is 33–38 % of the average daytime fluxes and 21 % of the total daily COS uptake. The correlation of 222Rn (of which the source is the soil) with COS (average R2  =  0.58) was lower than with CO2 (0.70), suggesting that the main sink of COS is not located at the ground. These observations are supported by soil chamber measurements that show that soil contributes to only 34–40 % of the total nighttime COS uptake. We found a decrease in COS uptake with decreasing nighttime stomatal conductance and increasing vapor-pressure deficit and air temperature, driven by stomatal closure in response to a warm and dry period in August. We also discuss the effect that canopy layer mixing can have on the radon-tracer method and the sensitivity of (FCOS-EC) to atmospheric turbulence. Our results suggest that the nighttime uptake of COS is mainly driven by the tree foliage and is significant in a boreal forest, such that it needs to be taken into account when using COS as a tracer for GPP.

Orthostatic hypotension (OH) and blood pressure circadian dysfunctions are common in older adults and may be related to aging-related autonomic nervous system deficits. This study aimed to evaluate the relationship between orthostatic and nocturnal blood pressure changes in geriatric outpatients. This cross-sectional study was carried out with 425 Italian individuals aged ≥65 years (mean age 75.8 ± 7.1 years) who attended a hypertension outpatient clinic from January 2013 to January 2020. Each patient underwent orthostatic testing and noninvasive 24-h blood pressure monitoring (ABPM). OH was detected in 38.1% of patients, and these individuals were more likely to have abnormal circadian blood pressure patterns (reverse and nondipper) than those without OH (61.7% vs. 51.7%; p = 0.045). In linear regression, after adjusting for potential confounders, orthostatic and nocturnal changes in systolic blood pressure were inversely associated (β = -0.63, 95% CI [-0.95; -0.32]; p < 0.001). This association was stronger in patients ≥80 years. OH is highly prevalent in older patients and is associated with altered nocturnal blood pressure profiles, especially in the oldest old. Because both OH and altered blood pressure patterns are associated with elevated cardiovascular risk and mortality, our study suggests that elderly patients with OH should undergo noninvasive 24-h blood pressure monitoring.

Biomass burning aerosol is a major source of PM2.5, and significantly affects Earth's radiative budget. The magnitude of its radiative effect is poorly quantified due to uncertainty in the optical properties of aerosol formed from biomass burning. Using a broadband cavity-enhanced spectrometer with a recently increased spectral range (360–720 nm) coupled to a size-selecting aerosol inlet, we retrieve complex refractive indices of aerosol throughout the near-ultraviolet and visible spectral region. We demonstrate refractive index retrievals for two standard aerosol samples: polystyrene latex spheres and ammonium sulfate. We then retrieve refractive indices for biomass burning aerosol from 13 controlled fires during the 2016 Missoula Fire Science Laboratory Study. We demonstrate that the technique is highly sensitive to the accuracy of the aerosol size distribution method and find that while we can constrain the optical properties of brown carbon aerosol for many fires, fresh smoke dominated by fractal-like black carbon aerosol presents unique challenges and is not well-represented by Mie theory. For the 13 fires, we show that the accuracy of Mie theory retrievals decreases as the fraction of black carbon mass increases. At 475 nm, the average refractive index is 1.635 (±0.056) +0.06 (±0.12)i, and at 365 nm, the average refractive index is 1.605 (±0.041) +0.038 (±0.074)i.

Particle morphology is an important parameter affecting aerosol optical properties that are relevant to climate and air quality, yet it is poorly constrained due to sparse in situ measurements. Biomass burning is a large source of aerosol that generates particles with different morphologies. Quantifying the optical contributions of non-spherical aerosol populations is critical for accurate radiative transfer models, and for correctly interpreting remote sensing data. We deployed a laser imaging nephelometer at the Missoula Fire Sciences Laboratory to sample biomass burning aerosol from controlled fires during the FIREX intensive laboratory study. The laser imaging nephelometer measures the unpolarized scattering phase function of an aerosol ensemble using diode lasers at 375 and 405 nm. Scattered light from the bulk aerosol in the instrument is imaged onto a charge-coupled device (CCD) using a wide-angle field-of-view lens, which allows for measurements at 4–175∘ scattering angle with ∼ 0.5∘ angular resolution. Along with a suite of other instruments, the laser imaging nephelometer sampled fresh smoke emissions both directly and after removal of volatile components with a thermodenuder at 250 ∘C. The total integrated aerosol scattering signal agreed with both a cavity ring-down photoacoustic spectrometer system and a traditional integrating nephelometer within instrumental uncertainties. We compare the measured scattering phase functions at 405 nm to theoretical models for spherical (Mie) and fractal (Rayleigh–Debye–Gans) particle morphologies based on the size distribution reported by an optical particle counter. Results from representative fires demonstrate that particle morphology can vary dramatically for different fuel types. In some cases, the measured phase function cannot be described using Mie theory. This study demonstrates the capabilities of the laser imaging nephelometer instrument to provide realtime, in situ information about dominant particle morphology, which is vital for understanding remote sensing data and accurately describing the aerosol population in radiative transfer calculations.

Backgrounds In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. Aim To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. Methods Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied. 88 patients matched the inclusion criteria: type 2 diabetes or hospital-related hyperglycemia, ≥65 years, regular measurements of capillary glycemia, and basal-bolus subcutaneous insulin regimen managed by “GesTIO protocol” for five consecutive days. Main outcome measures: ratio of patients with blood glucose (BG) <3.9 mmol/l; number of BG per patient in target range (5–11.1 mmol/l); daily mean BG; and calls to physicians for adjusting insulin therapy. Results Mean age was 82 ± 7 years. 9.1% patients experienced mild hypoglycaemia, and no severe hypoglycaemia was reported. The median number of BG per patients in target range increased from 2.0 ± 2 to 3.0 ± 2 ( p  < 0.001). The daily mean BG decreased from 11.06 ± 3.03 to 9.64 ± 2.58 mmol/l (−12.8%, p  < 0.005). The mean number of calls to physicians per patient decreased from 0.83 to 0.45 ( p  < 0.05). Conclusions Treatment with GesTIO protocol allows a safe and effective treatment even in very old and vulnerable inpatients with a faster management insulin therapy.

Field data from an iodine-rich, coastal environment point to the molecular steps involved in the formation of new aerosol particles from iodine vapours over coastal regions. Aerosol particle formation in coastal regions Sulfuric acid and organic vapours are thought to be involved in the formation of new aerosol particles in the atmosphere over continental regions, whereas iodine oxide vapours have been implicated in particle formation in coastal regions. But direct molecular-level observations of nucleation under atmospheric field conditions are lacking. Mikko Sipilä et al . report field data from Mace Head, Ireland, and supporting data from northern Greenland and Queen Maud Land, Antarctica, that allow for the identification of the molecular steps involved in new particle formation from iodine vapours in an iodine-rich, coastal atmospheric environment. Initial particle formation occurs primarily by uptake and sequential addition of iodic acid, followed by restructuring of molecules in clusters and subsequent evaporation of water. Homogeneous nucleation and subsequent cluster growth leads to the formation of new aerosol particles in the atmosphere 1 . The nucleation of sulfuric acid and organic vapours is thought to be responsible for the formation of new particles over continents 1 , 2 , whereas iodine oxide vapours have been implicated in particle formation over coastal regions 3 , 4 , 5 , 6 , 7 . The molecular clustering pathways that are involved in atmospheric particle formation have been elucidated in controlled laboratory studies of chemically simple systems 2 , 8 , 9 , 10 , but direct molecular-level observations of nucleation in atmospheric field conditions that involve sulfuric acid, organic or iodine oxide vapours have yet to be reported 11 . Here we present field data from Mace Head, Ireland, and supporting data from northern Greenland and Queen Maud Land, Antarctica, that enable us to identify the molecular steps involved in new particle formation in an iodine-rich, coastal atmospheric environment. We find that the formation and initial growth process is almost exclusively driven by iodine oxoacids and iodine oxide vapours, with average oxygen-to-iodine ratios of 2.4 found in the clusters. On the basis of this high ratio, together with the high concentrations of iodic acid (HIO 3 ) observed, we suggest that cluster formation primarily proceeds by sequential addition of HIO 3 , followed by intracluster restructuring to I 2 O 5 and recycling of water either in the atmosphere or on dehydration. Our study provides ambient atmospheric molecular-level observations of nucleation, supporting the previously suggested role of iodine-containing species in the formation of new aerosol particles 3 , 4 , 5 , 6 , 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , and identifies the key nucleating compound.

IntroductionDirect oral anticoagulants (DOACs) are underused in the elderly, regardless the evidence in their favour in this population.MethodsWe prospectively enrolled anticoagulant-naïve patients aged ≥ 75 years who started treatment with DOACs for atrial fibrillation (AF) and stratified them in older adults (aged 75–84 years) and extremely older adults (≥ 85 years). Thrombotic and hemorrhagic events were evaluated for 12 months follow-up.ResultsWe enrolled 518 consecutive patients. They were mostly aged 75–84 years (299 patients; 57.7%) vs. ≥ 85 years (219 patients; 42.3%). Extremely older adults showed higher incidence of all the endpoints (systemic cardioembolism [HR 3.25 (95% CI 1.71–6.18)], major bleeding [HR 2.75 (95% CI 1.77–4.27)], and clinically relevant non-major bleeding [HR 2.13 (95% CI 1.17–3.92)]) vs. older adults during the first year after starting anticoagulation. In patients aged ≥ 85 years, no difference in the aforementioned endpoints was found between those receiving on-label vs. off-label DOACs. In the extremely older adults, chronic kidney disease, polypharmacy, use of antipsychotics, and DOAC discontinuation correlated with higher rates of thrombotic events, whereas a history of bleeding, Charlson Index ≥ 6, use of reduced DOAC dose, absence of a caregiver, use of non-steroidal anti-inflammatory drugs (NSAIDs), and HAS-BLED score ≥ 3 were associated with major bleedings.ConclusionsNaïve patients aged ≥ 85 who started a DOAC for AF are at higher risk of thrombotic and bleeding events compared to those aged 75–84 years in the first year of therapy. History of bleeding, HAS-BLED score ≥ 3 and use of NSAIDs are associated with higher rates of major bleeding.

The air–sea exchange of ozone (O3) is controlled by chemistry involving halogens, dissolved organic carbon, and sulfur in the sea surface microlayer. Calculations also indicate faster ozone photolysis at aqueous surfaces, but the role of clouds as an ozone sink is currently not well established. Fast-response ozone sensors offer opportunities to measure eddy covariance (EC) ozone fluxes in the marine boundary layer. However, intercomparisons of fast airborne O3 sensors and EC O3 fluxes measured on aircraft have not been conducted before. In April 2022, the Technological Innovation Into Iodine and GV Environmental Research (TI3GER) field campaign deployed three fast ozone sensors (gas chemiluminescence and a combination of UV absorption with coumarin chemiluminescence detection, CID) together with a fast water vapor sensor and anemometer to study iodine chemistry in the troposphere and stratosphere over Colorado and over the Pacific Ocean near Hawaii and Alaska. Here, we present an instrument comparison between the NCAR Fast O3 instrument (FO3, gas-phase CID) and two KIT Fast AIRborne Ozone instruments (FAIRO, UV absorption and coumarin CID). The sensors have comparable precision < 0.4 % Hz−0.5 (0.15 ppbv Hz−0.5), and ozone volume mixing ratios (VMRs) generally agreed within 2 % over a wide range of environmental conditions: 10 < O3 < 1000 ppbv, below detection < NOx < 7 ppbv, and 2 ppmv < H2O < 4 % VMR. Both instrument designs are demonstrated to be suitable for EC flux measurements and were able to detect O3 fluxes with exchange velocities (defined as positive for upward) as slow as −0.010 ± 0.004 cm s−1, which is in the lower range of previously reported measurements. Additionally, we present two case studies. In one, the direction of ozone and water vapor fluxes was reversed (vO3 = +0.134 ± 0.005 cm s−1), suggesting that overhead evaporating clouds could be a strong ozone sink. Further work is needed to better understand the role of clouds as a possibly widespread sink of ozone in the remote marine boundary layer. In the second case study, vO3 values are negative (varying by a factor of 6–10 from −0.036 ± 0.006 to −0.003 ± 0.004 cm s−1), while the water vapor fluxes are consistently positive due to evaporation from the ocean surface and spatially homogeneous. This case study demonstrates that the processes governing ozone and water vapor fluxes can become decoupled and illustrates the need to elucidate possible drivers (physical, chemical, or biological) of the variability in ozone exchange velocities on fine spatial scales (∼ 20 km) over remote oceans.

For atmospheric sulfuric acid (SA) concentrations the presence of dimethylamine (DMA) at mixing ratios of several parts per trillion by volume can explain observed boundary layer new particle formation rates. However, the concentration and molecular composition of the neutral (uncharged) clusters have not been reported so far due to the lack of suitable instrumentation. Here we report on experiments from the Cosmics Leaving Outdoor Droplets chamber at the European Organization for Nuclear Research revealing the formation of neutral particles containing up to 14 SA and 16 DMA molecules, corresponding to a mobility diameter of about 2 nm, under atmospherically relevant conditions. These measurements bridge the gap between the molecular and particle perspectives of nucleation, revealing the fundamental processes involved in particle formation and growth. The neutral clusters are found to form at or close to the kinetic limit where particle formation is limited only by the collision rate of SA molecules. Even though the neutral particles are stable against evaporation from the SA dimer onward, the formation rates of particles at 1.7-nm size, which contain about 10 SA molecules, are up to 4 orders of magnitude smaller compared with those of the dimer due to coagulation and wall loss of particles before they reach 1.7 nm in diameter. This demonstrates that neither the atmospheric particle formation rate nor its dependence on SA can simply be interpreted in terms of cluster evaporation or the molecular composition of a critical nucleus. Significance A significant fraction of atmospheric aerosols is formed from the condensation of low-volatility vapors. These newly formed particles can grow, become seeds for cloud particles, and influence climate. New particle formation in the planetary boundary layer generally proceeds via the neutral channel. However, unambiguous identification of neutral nucleating clusters has so far not been possible under atmospherically relevant conditions. We explored the system of sulfuric acid, water, and dimethylamine in a well-controlled laboratory experiment and measured the time-resolved concentrations of neutral clusters. Clusters containing up to 14 sulfuric acid and 16 dimethylamine molecules were observed. Our results demonstrate that a cluster containing as few as two sulfuric acid and one or two dimethylamine molecules is already stable against evaporation.