Electromagnetic ion cyclotron (EMIC) waves potentially cause precipitation loss of relativistic electrons from the outer radiation belt to the atmosphere through pitch angle scattering. However, the ...direct evidence of each EMIC wave element and burst of precipitation has not yet been reported. Here we show the temporal and spatial correspondence of the EMIC waves with relativistic electron precipitation (REP) during the geomagnetic storm of 27 March 2017. EMIC waves were observed at several stations in North America. REP was detected as a decrease of subionospheric radio amplitudes observed at Athabasca, Canada. When isolated proton aurora, observed at Athabasca, appeared on the radio propagation path, we found a good correspondence between the temporal variations of REP and EMIC waves, and REP preceded EMIC waves by 24 s. This time lag is consistent with the travel time difference between relativistic electrons and EMIC waves from the magnetospheric equatorial plane to the ionosphere.
Plain Language Summary
The flux of relativistic electrons in the outer radiation belt can vary in a time scale of hours to days during magnetically disturbed condition. One of the loss mechanisms of relativistic electrons is precipitation into the atmosphere due to interaction between electrons and plasma waves in the magnetosphere. Electromagnetic ion cyclotron waves, which are excited in the magnetosphere, are effective for causing precipitation loss of relativistic electrons. These waves can have rising spectral structure with an increase in frequency quasiperiodically. In this study, we made use of multiple ground‐based observations and confirmed where and when relativistic electrons precipitated due to scattering by these waves. For the first time, we found direct evidence of correspondence between each wave element with rising tone and each burst of electron precipitation. We suggest that the precipitation of relativistic electrons occurred when the intensity of waves increased in the period of a few tens of seconds to minutes.
Key Points
Relativistic electron precipitation and electromagnetic ion cyclotron waves were observed during the main phase of a geomagnetic storm
Isolated proton auroras appeared on the radio propagation paths on which relativistic electron precipitation was detected
We found a good correspondence between the time variations of relativistic electron precipitation and electromagnetic ion cyclotron waves
Granulopoiesis is tightly regulated to meet host demands during both "steady-state" and "emergency" situations, such as infections. The transcription factor CCAAT/enhancer binding protein β (C/EBPβ) ...plays critical roles in emergency granulopoiesis, but the precise developmental stages in which C/EBPβ is required are unknown. In this study, a novel flow cytometric method was developed that successfully dissected mouse bone marrow cells undergoing granulopoiesis into five distinct subpopulations (#1-5) according to their levels of c-Kit and Ly-6G expression. After the induction of candidemia, rapid mobilization of mature granulocytes and an increase in early granulocyte precursors accompanied by cell cycle acceleration was followed by a gradual increase in granulocytes originating from the immature populations. Upon infection, C/EBPβ was upregulated at the protein level in all the granulopoietic subpopulations. The rapid increase in immature subpopulations #1 and #2 observed in C/EBPβ knockout mice at 1 d postinfection was attenuated. Candidemia-induced cell cycle acceleration and proliferation of hematopoietic stem/progenitors were also impaired. Taken together, these data suggest that C/EBPβ is involved in the efficient amplification of early granulocyte precursors during candidemia-induced emergency granulopoiesis.
There have been only a few reports on follow-up results of serous cystic neoplasm (SCN) of the pancreas. The frequency of malignancy and surgical indication of SCN are not determined yet.
In this ...multi-institutional study of the Japan Pancreas Society, a total of 172 patients with SCN were enrolled. The mean follow-up period was 4.5 years. Surgical resection was performed in 90 patients, whereas the remaining 82 were simply observed.
Of all patients, 20% were symptomatic. The tumor was located in the pancreatic head (39%), body (35%), and tail (22%). The mean diameter of the tumor was 4.1 cm. None of the patients showed distant or lymph node metastasis except for liver metastasis found in 2 patients (1.2%). No patient died during the follow-up. The preoperative diagnosis did not correctly identify SCN in 57 (63%) of 90 resected cases. A honeycomb appearance, which is one of the most characteristic findings of SCN, could be diagnosed better by endoscopic ultrasonography than by other imaging diagnostic modalities.
Surgical resection should be considered only when clear distinction from other surgical diseases is difficult, when symptoms or mass effects are present, and when the tumor size is large.
Abstract This study was conducted to evaluate trends in the isolation of strains of nontuberculous mycobacteria (NTM) and trends in the number of patients with pulmonary Mycobacterium avium complex ...(MAC) disease. We retrospectively reviewed microbiological results and clinical data to identify patients who were diagnosed with pulmonary MAC disease at Kyoto University Hospital in Japan between 2000 and 2013. NTM were isolated from 6327 of 80,285 samples (7.9%) for mycobacterial culture. The proportion of NTM isolates among all mycobacterial isolates increased from 355 of 792 samples (44.8%) in 2000 to 688 of 847 samples (81.2%) in 2013. MAC was most frequently observed (5436 isolates, 85.9%), followed by Mycobacterium abscessus (175 isolates, 2.8%) and Mycobacterium kansasii (74 isolates, 1.2%). A total of 592 patients with pulmonary MAC disease were identified (age, 66.0 ± 11.5 years; females, 61.1%). Compared with the early cohort (2000–2006, 236 patients), more patients in the late cohort (2007–2013, 356 patients) had an underlying disease (157 66.5% vs. 284 79.8%, P = 0.0003), a Charlson comorbidity index score ≥1 (115 48.7% vs. 213 59.8%, P = 0.008), collagen vascular disease (18 7.6% vs. 60 16.9%, P = 0.001), rheumatoid arthritis (11 4.7% vs. 41 11.5%, P = 0.004), and used immunosuppressive drugs (22 9.3% vs. 63 17.7%, P = 0.004). The numbers of patients with lung disease, malignant disease and diabetes mellitus increased; however, their frequencies did not differ. The recovery rate of NTM and patients with pulmonary MAC disease increased, especially in patients with collagen vascular disease or rheumatoid arthritis or who used immunosuppressive drugs.
It is known that the mortality of pneumonia in patients with risk factors for aspiration is worse than that in those without these risk factors. However, it is still unknown which risk factors for ...aspiration predict prognosis. Therefore, we aimed to determine which risk factors for aspiration are associated with death or prolonged hospitalization.
We prospectively followed patients with community-acquired pneumonia at a single hospital providing acute to chronic care in Japan until they died or were discharged. Patients at any risk of aspiration were included. The associations between pneumonia severity, individual risk factors for aspiration, and in-hospital death or prolonged hospitalization were investigated. Overall survival was estimated by the Kaplan - Meier method, and the factors associated with in-hospital death or prolonged hospitalization were investigated by multivariate analysis using factors selected by a stepwise method.
In total, 765 patients with pneumonia and risk factors for aspiration were recruited. One hundred and ten patients deceased, and 259 patients were hospitalized over 27 days. In-hospital death increased as the number of risk factors for aspiration increased. In the multivariate analysis, male, impaired consciousness, acidemia, elevated blood urea nitrogen, and bedridden status before the onset of pneumonia were associated with in-hospital death (odds ratio OR: 2.5, 2.5, 3.6, 3.1, and 2.6; 95% confidence interval CI: 1.6-4.1, 1.4-4.2, 1.6-8.0, 1.9-5.0, and 1.6-4.2 respectively). In the Cox regression analysis, these factors were also associated with in-hospital death. None of the vital signs at admission were associated. Tachycardia, elevated blood urea nitrogen, hyponatremia, and bedridden status were associated with hospitalization for >27 days (OR: 4.1, 2.3, 4.3, and 2.9; 95% CI: 1.3-12.9, 1.5-3.4, 2.0-9.4, and 2.0-4.0, respectively).
Blood sampling findings and bedridden status are useful for predicting in-hospital mortality and long-term hospitalization in patients with pneumonia and any risk factor for aspiration.
Background Although previous clinical trials demonstrated the non-inferiority of a rate control to rhythm control strategy for management of atrial fibrillation (AF), the optimal treatment strategy ...for paroxysmal AF (PAF) remains unclear. Methods and Results A randomized, multicenter comparison of rate control vs rhythm control in Japanese patients with PAF (the Japanese Rhythm Management Trial for Atrial Fibrillation (J-RHYTHM) study) was conducted. The primary endpoint was a composite of total mortality, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for heart failure, or physical/psychological disability requiring alteration of treatment strategy. In the study, 823 patients with PAF were followed for a mean period of 578 days. The primary endpoint occurred in 64 patients (15.3%) assigned to rhythm control and in 89 patients (22.0%) to rate control (P=0.0128). No significant differences between the treatment strategies were observed in the incidences of death, stroke, bleeding and heart failure. Meanwhile, significantly fewer patients requested changes of assigned treatment strategy in the rhythm control vs the rate control group, which was accompanied by improvement in AF-specific quality of life scores. Conclusion The J-RHYTHM study showed that rhythm control was associated with fewer primary endpoints than rate control. However, mortality and cardiovascular morbidity were not affected by the treatment strategy (umin-CTR No. C000000106). (Circ J 2009; 73: 242 - 248)
Mycobacterium abscessus (M. abscessus) infection is resistant to multi‐antibacterial treatment, and surgical resection is often recommended. We report a case of M. abscessus infection in a young ...patient suspected of having a GATA2 mutation. A 19‐year‐old woman with a medical history of severe sinusitis and a family history of non‐tuberculous mycobacteriosis presented at our hospital. M. abscessus was confirmed by sputum culture. The patient received multidrug therapy, including clarithromycin. CT scan demonstrated bronchodilation and capacity decrease due to non‐obstructive atelectasis in the middle lobe. We performed thoracoscopic resection without complications. Congenital immunodeficiency was suspected given the patient's past medical and family history. The result of lymphocyte subset analysis revealed a GATA2 mutation, but no genetic mutation was detected by a next‐generation sequencer. The patient followed a good clinical course. This paper reports the successful treatment of an M. abscessus infection and the importance of checking the genetic background of young patients.
Bronchoalveolar lavage is commonly performed to assess inflammation and identify responsible pathogens in lung diseases. Findings from bronchoalveolar lavage might be used to evaluate the immune ...profile of the lung tumor microenvironment (TME). To investigate whether bronchoalveolar lavage fluid (BALF) analysis can help identify patients with non-small cell lung cancer (NSCLC) who respond to immune checkpoint inhibitors (ICIs), BALF and blood were prospectively collected before initiating nivolumab. The secreted molecules, microbiome, and cellular profiles based on BALF and blood analysis of 12 patients were compared with regard to therapeutic effect. Compared with ICI nonresponders, responders showed significantly higher CXCL9 levels and a greater diversity of the lung microbiome profile in BALF, along with a greater frequency of the CD56+ subset in blood T cells, whereas no significant difference in PD-L1 expression was found in tumor cells. Antibiotic treatment in a preclinical lung cancer model significantly decreased CXCL9 in the lung TME, resulting in reduced sensitivity to anti-PD-1 antibody, which was reversed by CXCL9 induction in tumor cells. Thus, CXCL9 might be associated with the lung TME microbiome, and the balance of CXCL9 and lung TME microbiome could contribute to nivolumab sensitivity in patients with NSCLC. BALF analysis can help predict the efficacy of ICIs when performed along with currently approved examinations.
Abe Y, Suzuki M, Shima H, et al. Int J Chron Obstruct Pulmon Dis. 2021;16:3243–3253. The authors have advised there is an error with the ethics approval number of Kyoto University on pages 3245 and ...3252. On page 3245, Kyoto University Cohort section, last sentence, the text “(E182 and R03112)” should read “(E182, R0311-2, and R1660-1)”. On page 3252, Ethics Approval and Informed Consent section, the text “(E182 and R0311-2)” should read “(E182, R0311-2, and R1660-1)”. The authors apologize for these errors.
Upstream open reading frames in the 5′ untranslated region of BOR1, a borate transporter, control boron-dependent translational suppression that, alongside BOR1 degradation, contributes to the ...avoidance of boron toxicity in plants.
Boron (B) is an essential element for plants; however, as high B concentrations are toxic, B transport must be tightly regulated. BOR1 is a borate exporter in Arabidopsis (
Arabidopsis thaliana
) that facilitates B translocation into shoots under B deficiency conditions. When the B supply is sufficient,
BOR1
expression is down-regulated by selective degradation of BOR1 protein, while additional
BOR1
regulatory mechanisms are proposed to exist. In this study, we identified a novel B-dependent
BOR1
translational suppression mechanism. In vivo and in vitro reporter assays demonstrated that
BOR1
translation was reduced in a B-dependent manner and that the 5′-untranslated region was both necessary and sufficient for this process. Mutational analysis revealed that multiple upstream open reading frames in the 5′-untranslated region were required for
BOR1
translational suppression, and this process depended on the efficiency of translational reinitiation at the
BOR1
open reading frame after translation of the upstream open reading frames. To understand the physiological significance of
BOR1
regulation, we characterized transgenic plants defective in either one or both of the
BOR1
regulation mechanisms.
BOR1
translational suppression was induced at higher B concentrations than those triggering BOR1 degradation. Plants lacking both regulation mechanisms exhibited more severe shoot growth reduction under high-B conditions than did plants lacking BOR1 degradation alone, thus demonstrating the importance of
BOR1
translational suppression. This study demonstrates that two mechanisms of posttranscriptional
BOR1
regulation, each induced under different B concentrations, contribute to the avoidance of B toxicity in plants.
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