Background: Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) is a well-established tool for improving tumor visualization in glioma surgery. However, its applications in non-glioma pathologies remain underexplored and require further investigation. Methods: A retrospective review of patients who underwent FGS with 5-ALA between January 2022 and September 2024 was conducted to assess its utility in non-glioma tumors. Results: Among 232 FGS procedures, 13 (5.6%) involved non-glioma pathologies. We categorized our patients into three different levels: high, moderate, and no response based on intra-operative 5-ALA fluorescence visualization. Our patients showed a high 5-ALA fluorescence in 10 cases (77%), mainly in the following tumors: choroid plexus papilloma, atypical teratoid rhabdoid tumor, metastatic adenocarcinoma as well as atypical meningiomas. Moderate 5-ALA fluorescence was seen in 2 cases (15%). While no 5-ALA fluorescence was seen in one case of CNS lymphoma. 90% of procedures with high response had total resection. Conclusions: Fluorescence-guided surgery (FGS) using 5-ALA has demonstrated effectiveness in enhancing tumor visualization beyond gliomas. This retrospective review highlights the potential applications of 5-ALA in various non-glioma pathologies. These findings emphasize the need for further research to refine the use of 5-ALA FGS in diverse pathologies, optimize patient selection, and expand its utility in neurosurgical oncology.

Background: Surgical access to the clival region is challenging, but advanced endoscopic endonasal approaches (EEA) provide a minimally invasive corridor. This study aimed to review the clinical outcomes of patients who underwent EEA for skull base lesions involving the clivus and to analyze prognostic factors. Methods: A retrospective review was conducted of patients who underwent EEA for resection of clival lesions between October 2001 and October 2023. Data on demographics, approach type, reconstruction technique, tumor pathology and outcomes were collected. Results: Forty-six patients underwent transclival EEA. The majority had ASA scores II and III (71.7%), with clival chordomas being the most common pathology (37%). Cranial nerve impairment was present in 65% of patients, and 80% showed improvement post-surgery. The mean procedure duration was 308 minutes, with a mean blood loss of 424 mL. A lumbar drain was used in 10.9%, and 76.1% received a pedicled nasoseptal flap for reconstruction. Complete tumor resection was achieved in 74% of malignant cases. Postoperative CSF leaks occurred in 4.3%, and the mean length of stay was 12.2 days. Higher readmission rates were associated with ASA IV classification (p=0.006). Conclusions: EEA to the clival region is safe and effective, with low perioperative complications and high rates of postoperative improvement.

Background: This study aims to review the clinical outcomes, extent of resection, complications, and prognostic factors in patients undergoing endonasal endoscopic resection (EEA) of anterior cranial base meningiomas. Methods: We conducted a retrospective review of 25 patients who underwent EEA resection of these lesions between 2001 and 2023. We assessed the extent of resection, complications, postoperative outcomes, and key technical aspects of the procedure. Results: 84% of patients were classified as ASA class III. Additionally, 64% of patients presented with visual disturbances. The mean blood loss was 472 ml. Intraoperative lumbar drains were used in 40% of cases, and dural sealants in 56%. A pedicled nasal flap was employed for reconstruction in 92% of cases. One vascular injury was documented, and 16% of patients developed a cerebrospinal fluid (CSF) leak in the postoperative period The degree of resection varied according to tumor location. Prognostic factors for achieving gross total resection, functional improvement, and key factors for reconstruction are discussed. The rate of CSF leaks decreased dramatically in the later years of the series Conclusions: Cranial base meningiomas can be successfully managed via a purely endoscopic endonasal approach, with acceptable morbidity and mortality rates.

Background: Endonasal endoscopic odontoidectomy (EEO) is a well-established method for treating symptomatic ventral compression at the cranio-cervical junction (CCJ). This study aims to review the clinical outcomes of patients undergoing EEO, focusing on clinical presentation, progression, and prognostic factors. Methods: We retrospectively analyzed data from patients who underwent EEO between October 2001 and October 2023. Information was collected on demographics, indications, reconstruction techniques, complications, fusion requirements, readmission rates, and outcomes. Results: Fifteen patients were included, with 60% classified as ASA class III. The majority presented with myelopathy (80%). Indications for surgery included basilar invagination, Chiari malformation, and rheumatoid arthritis. The mean blood loss was 317 ml. No perioperative lumbar drains were used, and 26.7% of patients had intraoperative CSF leaks, though no postoperative leaks were noted. A pedicled nasal flap was required in 66.7% of cases. Fourteen patients needed occipitocervical fusion, and six were readmitted within 30 days due to bulbar deficits. At the last follow-up, 86.6% of patients experienced symptom improvement. A significant association was found between decompression extent and symptomatic improvement (p=0.003). Conclusions: EEO is a safe and effective method for CCJ decompression, often accompanied by posterior cervical stabilization, with most patients showing symptomatic improvement and a low complication rate.

Background: This study aimed to identify risk factors for postoperative cerebrospinal fluid (CSF) leaks and assess their outcomes following endoscopic endonasal approach (EEA) for resection of skull base tumors. Methods: A retrospective review was conducted of patients who underwent EEA for resection of intradural pathology between October 2001 and October 2023. Data on demographics, approach type, reconstruction technique, tumor pathology, complications and outcomes were analyzed. Results: A total of 542 patients were included, with 80.1% undergoing surgery for sellar or suprasellar pathology. Lumbar drains were used in 14.9%, and dural sealants in 57.7%. Forty patients (7.3%) developed postoperative CSF leaks, with the highest rate in sellar or suprasellar lesions (5.9%). CSF leaks were associated with longer hospital stays (p < 0.001), higher 30-day readmission rates (p < 0.001), increased sepsis risk (p = 0.021), and higher rates of diabetes insipidus (p < 0.001). Lumbar drains increased the incidence of CSF leaks (p = 0.021), while nasoseptal flap reconstruction reduced leak rates (p = 0.0015). Higher BMI and intraoperative CSF leaks were also significant risk factors (p = 0.001) Conclusions: CSF leaks are associated with increased complications and extended hospital stays, highlighting the need for vigilant intraoperative monitoring and targeted strategies.

Background: Postoperative visual deterioration following endoscopic endonasal surgery for pituitary adenoma is very rare yet significant morbidity. Visual deficit can arise from iatrogenic injury, compression or ischemic insults. The specific predictors of visual decline and their correlation with the effectiveness of various interventions remain poorly understood. Methods: We retrospectively reviewed data from790 patients who underwent endoscopic endonasal surgery for pituitary adenoma between 2014-2024. We included all the patients who had New Postoperative visual deterioration. Demographic, preoperative, intraoperative, postoperative data were collected and analyzed. Results: Nine patients (1.13%) experienced early postoperative visual deterioration. None of the patient has intraoperative report of direct injury to the optic apparatus, ischemic etiology was seen in five patients. Four patients underwent early reoperation to explore and decompress the optic apparatus. Vision was restored to baseline after reoperation in all 4 compressive cases. In the ischemic group (n=5), three patients improved with supplemental oxygen and hypervolemic-hypertensive therapy (p=0.03). Conclusions: Prognosis and outcome of Postoperative visual deterioration depends on the underlying cause and the effectiveness of intervention. Compressive etiology has a favorable prognosis when identified and managed with reoperation and decompression. Ischemic etiology potentially treatable with supplemental oxygen hypervolemic-hypertensive and high mean arterial pressure in more than half of cases.

Background: Biochemical cure in functional pituitary adenomas (FPA) is crucial for reducing patient morbidity and improving quality of life following endoscopic endonasal procedures (EEA). The extent of resection plays a key role in achieving these outcomes. However, even with the aid of intraoperative navigation, complete resection of tumor components can be challenging due to the difficulty in distinguishing them from normal pituitary tissue. Indocyanine green (ICG) fluorescence has been used effectively in various cranial and spinal procedures, but its role in endoscopic skull base surgery has not yet been routinely established Methods: In this study, we describe our experience using ICG during EEA for the resection of FPA. Results: We discuss the fluorescence profiles of both adenomas and normal gland tissue. ICG helped identify additional tumor tissue that was not initially detected after macroscopic adenoma resection. It also allowed for perfusion assessment of the pituitary gland and nasoseptal flaps. No complications were observed following the ICG injection, and biochemical cure was achieved in more than 90% of cases. Conclusions: Our experience suggests that ICG is a safe and promising tool, improving both the extent of resection and endocrinologic outcomes in patients undergoing EEA for FPA.

Recent observations have shown a fast decrease in thickness and area of Pyrenean glaciers in some cases leading to a stagnation of ice flow. However, their transition to a new paraglacial stage is not well understood. Through the combination of uncrewed aerial vehicles imagery, airborne LiDAR, ground-penetrating radar and ground temperature observations, we characterized the recent evolution of Infiernos Glacier. In 2021, this glacier had small sectors thicker than 25 m, but most of area did not exceed 10 m. The thickness losses from 2011 to 2023 reached 9 m in average, of which 5 m occurring during the period 2020–23. This trend demonstrates the significant ice melt under current climatic conditions. In the last years, the glacier has also shown a remarkable increase of debris cover extent. In these areas, the ice loss was reduced by half when compared to the thickness decrease in the entire glacier. Sub-freezing ground temperatures evidence the highly probable presence of permafrost or buried ice in the surroundings of the glacier. The clear signs of ice stagnation and the magnitude of area and thickness decrease support the main hypothesis of this work: After 2023, the Infiernos Glacier can no longer be considered a glacier and has become an ice patch.

We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.

The selection, design and optimization of a suitable blanket configuration for an advanced high-field stellarator concept is seen as a key feasibility issue and has been incorporated as a vital and necessary part of the Infinity Two fusion pilot plant physics basis. The focus of this work was to identify a baseline blanket which can be rapidly deployed for Infinity Two while also maintaining flexibility and opportunities for higher performing concepts later in development. Results from this analysis indicate that gas-cooled solid breeder designs such as the helium-cooled pebble bed (HCPB) are the most promising concepts, primarily motivated by the neutronics performance at applicable blanket build depths, and the relatively mature technology basis. The lithium lead (PbLi) family of concepts, particularly the dual-cooled lithium lead, offer a compelling alternative to solid blanket concepts as they have synergistic developmental pathways while simultaneously mitigating much of the technical risk of those designs. Homogenized three-dimensional neutronics analysis of the Infinity Two configuration indicates that the HCPB achieves an adequate tritium breeding ratio (TBR) (1.30 which enables sufficient margin at low engineering fidelity), and near appropriate shielding of the magnets (average fast fluence of 1.3 ${\times}$ 10$^{18}$ n cm$^{-2}$ per full-power year). The thermal analysis indicates that reasonably high thermal efficiencies (greater than 30 %) are readily achievable with the HCPB paired with a simple Rankine cycle using reheat. Finally, the tritium fuel cycle analysis for Infinity Two shows viability, with anticipated operational inventories of less than one kilogram (approximately 675 g) and a required TBR (TBR$_{\textrm {req}}$) of less than 1.05 to maintain fuel self-sufficiency (approximately 1.023 for a driver blanket with no inventory doubling). Although further optimization and engineering design are still required, at the physics basis stage all initial targets have been met for the Infinity Two configuration.

Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16–26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.

Knowledge of Ascophyllum nodosum extracts (ANEs) is still limited to avocado ‘Hass’ in the tropics. The objective of this study was to evaluate the effects of two ANEs application methods (foliar v. drench) at four different doses (0, 2.5, 5 and 7.5 ml/l) on the physiological response of three different avocado stages (seedlings and young and adult trees). Foliar or drench ANEs applications were performed monthly for all plants for 16 weeks. The evaluated variables were recorded at 4 and 20 weeks after the start of treatment (WAT). The results showed that ANEs can be applied to the drench or foliar method at doses ≥5 ml/l in the different growth stages evaluated. In seedlings, foliar or drench ANEs applications increased total dry weight (34.5 and 57.9 g for 0 and ≥5 ml/l, respectively) and stomatal conductance (gs) (380 and 205 mmol/m2s for 0 and ≥5 ml/l, respectively) at 20 WAT. In young trees, both application methods also improved growing index (88.6 and 102 cm for 0 and ≥5 ml/l, respectively) and gs (516 and 636 mmol/m2s for 0 and ≥5 ml/l, respectively) at the last sampling point. Adult trees showed that foliar or drench applications at higher doses also caused an increase in fruit yield (3.4 and 8.7 kg/tree for 0 and ≥5 ml/l, respectively) at 20 WAT. In conclusion, the use of foliar and soil ANEs applications at higher doses (≥5 ml/l) can be considered for integrated crop management of ‘Hass’ avocado.

Until a few years ago, it was assumed that oocyte renewal did not take place in the ovary of adult organisms; however, the existence of germline progenitor cells (GPCs), which renew the ovarian follicular reserve, has now been documented in mammals. Specifically, in the adult ovary of bats, the presence of cells located in the cortical region with characteristics similar to GPCs, called adult cortical germ cells (ACGC), has been observed. One of the requirements that a GPC must fulfil is to be able to proliferate mitotically, so the evaluation of cell proliferation in ACGC is of utmost importance in order to be able to relate them to a parental lineage. Currently, there are several methods to determine cell proliferation, including BrdU labelling or the use of endogenous proliferation markers. Thus, the aim of this work was to evaluate the proliferative activity of ACGC in the adult ovary of the bat Artibeus jamaicensis, using different proliferation markers and correlating these with the protein expression of the transcription factor Oct4 and the germ line marker Ddx4. We found that the expression pattern of the proliferation markers BrdU, PCNA, Ki-67 and pH3 occurs at different times of the cell cycle, so co-localization of two or more of these markers allows us to identify proliferating cells. This allowed us to identify ACGC with proliferative capacity in the adult ovary of A. jamaicensis, suggesting that GPCs renew the follicle reserve during the adult life of the organism.