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Introduction Distant recurrence of non‐muscle invasive bladder cancer is a rare condition that is poorly understood and difficult to detect in follow‐up protocols. Case presentation A 73‐year‐old female with a history of T1N0M0 bladder cancer 8 years ago suffered from a left axillary tumor, a left lung tumor, left mediastinal lymph node swelling, and bilateral adrenal gland tumors. Initially, she was diagnosed with metastatic left breast cancer of the left accessory mamma by needle biopsy of an axillary tumor. Subsequent bronchoscopic biopsy of the mediastinal lymph node revealed metastatic urothelial carcinoma, although no recurrence was detected in the urinary tract. She underwent systemic therapy, and all regions shrank without reprogression. Conclusion Non‐muscle invasive bladder cancer should be managed considering distant metastasis. If the origin of the metastatic lesions is unknown, this disease should be considered as a possible origin, even in the absence of urinary tract recurrence.

Introduction Pelvic arteriovenous malformation is often a source of intraoperative bleeding. Here, we report our experience with a case of ureteral cancer with pelvic arteriovenous malformation treated using laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery. Case presentation A 75‐year‐old man presented to our hospital with asymptomatic macro‐hematuria. Contrast‐enhanced computed tomography revealed right ureteral tumor with no apparent metastases, and right pelvic arteriovenous malformation. Three months later, multiple bladder cancers were identified and the patient underwent trans‐urethral resection of bladder tumor. The pathological diagnosis was urothelial carcinoma, pTa. We performed right laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery. There was little intraoperative bleeding, and the surgery was safely completed. The pathological diagnosis was urothelial carcinoma, pT2 + Tis. Conclusion A patient showing ureteral cancer with pelvic arteriovenous malformation was safely treated using laparoscopic nephroureterectomy with temporary occlusion of the internal iliac artery.

Abstract Wildlife observation is a popular activity, and sightings of rare or difficult‐to‐find animals are often highly desired. However, predicting the sighting probabilities of these animals is a challenge for many observers, and it may only be possible by limited experts with intimate knowledge and skills. To tackle this difficulty, we developed user‐friendly forecast systems of the daily observation probabilities of a rare Arctic seabird (Ross's Gull Rhodostethia rosea) in a coastal area in northern Japan. Using a dataset gathered during 16 successive winters, we applied a machine learning technique of self‐organizing maps and explored how days with gull sightings were related to the meteorological pressure patterns over the Sea of Okhotsk (Method A). We also built a regression model that explains the relationship between gull sightings and local‐scale environmental factors (Method B). We then applied these methods with the operational global numerical weather prediction model (a computer simulation application about the fluid dynamics of Earth's atmosphere) to forecast the daily observation probabilities of our target. Method A demonstrated a strong dependence of gull sightings on the 16 representative weather patterns and forecasted stepwise observation probabilities ranging from 0% to 85.7%. Method B also showed that the strength of the northerly wind and the advancement of the season explained gull sightings and forecasted continuous observation probabilities ranging from 0% to 95.5%. Applying these two methods with the operational global numerical weather prediction model successfully forecasted the varied observation probabilities of Ross's Gull from 1 to 5 days ahead from November to February. A 2‐year follow‐up observation also validated both forecast systems to be effective for successful observation, especially when both systems forecasted higher observation probabilities. The developed forecast systems would therefore allow cost‐effective animal observation and may facilitate a better experience for a variety of wildlife observers.

Abstract Together with rapid Arctic warming and sea ice decline, especially over the Barents–Kara seas (BKS), extreme cold winters have occurred frequently in mid-latitudes, particularly in Central Eurasia. A pattern with two distinct winter temperature anomalies centered over the BKS and Central Eurasia is known as the Warm Arctic–Cold Eurasia (WACE) pattern. The impacts of sea ice loss over the BKS and internal atmospheric variability on past WACE formation remain under discussion mainly due to the large internal atmospheric variability in the mid-latitudes. This study analyzed a large-ensemble historical experiment prescribing observed sea ice condition to investigate the role of internal atmospheric variability in the observed interannual variation of the WACE pattern. Comparison of ensemble members suggests that internal atmospheric variability is important for regulating the magnitude of the WACE pattern. Besides the strong effect of local sea ice loss, winter temperature over the BKS increases due to warm advection driven by the Ural blocking and positive phase of the North Atlantic Oscillation. A decrease in winter temperature over Central Eurasia is mainly attributable to the cold advection enhanced by Ural blocking rather than the remote effect of sea ice decline over the BKS. Our study reveals the importance of internal atmospheric variability in elucidating the observed interannual variation of the WACE pattern.

Abstract The responses of the East Asian summer monsoon (EASM) to the Indian summer monsoon (ISM) have been the subject of extensive investigation. Nevertheless, it remains uncertain whether the ISM can serve as a predictor for the EASM. Here, on the basis of both observations and a large-ensemble climate model experiment, we show that the subseasonal variability of abnormal diabatic heating over India enhances precipitation over central East China, the Korean Peninsula, and southern Japan in June. ISM heating triggers Rossby wave propagation along the subtropical jet, promoting southerly winds over East Asia. The southerly winds helps steer anomalous mid-tropospheric warm advection and lower-tropospheric moisture advection toward East Asia, providing conditions preferential for rainband formation. Cluster analysis shows that, depending on jet structures, ISM heating can serve as a trigger as well as a reinforcer of the rainband.

Abstract Rapid Arctic warming has altered the regional hydrological cycle through reduction in Arctic sea ice. Observational and modeling efforts provided evidence that the enhanced evaporation from the Arctic Ocean could increase snowfall over high latitude terrestrial zones. However, questions remain regarding the amount of equatorward moisture transport and its change over the decadal timescale. Here we show that the transport of atmospheric moisture to Siberia that originated from Arctic Ocean evaporation has increased significantly in autumn to early winter during 1981–2019 when substantial sea ice retreat was observed. The enhanced Arctic moisture content is found in western Siberia in September, consistent with the observed increase in snow cover investigated in earlier studies. Meanwhile, the annual maximum daily amount of Arctic moisture shows a sharp increase in eastern Siberia during October–December associated with cyclonic activities along coastal regions. Our results suggest the importance of monitoring equatorward moisture transport during snow accumulation seasons because it could enhance local snowstorms as evaporation from the Arctic Ocean increases in the near future.

Tyrosine kinase inhibitors (TKIs) play a crucial role in the treatment of advanced renal cell carcinoma (RCC). However, there is a lack of useful biomarkers for assessing treatment efficacy. Through urinary metabolite analysis, we identified the metabolites and pathways involved in TKI resistance and elucidated the mechanism of TKI resistance. To verify the involvement of the identified metabolites obtained from urine metabolite analysis, we established sunitinib-resistant RCC cells and elucidated the antitumor effects of controlling the identified metabolic pathways in sunitinib-resistant RCC cells. Through the analysis of VEGFR signaling, we aimed to explore the mechanisms underlying the antitumor effects of metabolic control. Glutamine metabolism has emerged as a significant pathway in urinary metabolite analyses. In vitro and in vivo studies have revealed the antitumor effects of sunitinib-resistant RCC cells via knockdown of glutamine transporters. Furthermore, this antitumor effect is mediated by the control of VEGFR signaling via PTEN. Our findings highlight the involvement of glutamine metabolism in the prognosis and sunitinib resistance in patients with advanced RCC. Additionally, the regulating glutamine metabolism resulted in antitumor effects through sunitinib re-sensitivity in sunitinib-resistant RCC. Our results are expected to contribute to the more effective utilization of TKIs with further improvements in prognosis through current drug therapies.

Genetic mechanisms influencing COVID-19 susceptibility are not well understood. Here, the authors analyzed whole blood RNA-seq data of 465 Japanese individuals with COVID-19, highlighting thousands of fine-mapped variants affecting expression and splicing of genes, as well as the presence of COVID-19 severity-interaction eQTLs.

Increasing food loss and waste (FLW) is a global problem, and efforts are being made to use waste food as potential livestock feed material. The amount of self-supplied feed is lower in Japan than in other countries, and the government recommends FLW use for animal feed. Sake (Japanese rice wine) is a traditional alcoholic beverage. During the sake manufacturing process, large amounts of squeezed solids or “lees” (sake lees) are generated. Sake lees are nutritious and functional, but are prone to spoilage. In this study, we investigated whether sake lees should be mixed with animal feed immediately or after drying. To assess the usefulness of sake lees as a poultry feed ingredient and determine the effect of sake lees on intestinal immunity, we performed a feeding trial with three treatments: a raw sake lees (RSL) diet, dried sake lees (DSL) diet, and control diet. Three-week-old broilers were fed these diets (n＝8 per group) for two weeks. We then calculated feed efficiency and performed RT-qPCR to assess the effects of diet on intestinal immunity. The growth performance in the RSL diet group was equivalent to that in the control diet group. The DSL diet became difficult for broilers to eat, resulting in decreased growth performance. In the ileum of RSL-diet broilers, the mRNA expression levels of TGF-β1 and avian β-defensin (AvBD)12 were significantly increased compared to those of control diet broilers (p

Abstract The role of the diurnal atmospheric circulation cycle around the eastern Indian subcontinent, leeward of the monsoon westerlies, on the hydroclimate of South Asia remains unknown. Here, we reveal that low‐level moist southerlies are greatly enhanced at night parallel to the coastline over the western Bay of Bengal (BoB), and then flow onto the Gangetic Plain enhancing onshore moisture flux and nocturnal precipitation over the Himalayas and the Meghalaya Plateau. This nocturnal surge is strongly controlled by the diurnal cycle of dynamic and thermodynamic effects around the subcontinent. At night, nocturnal westerly low‐level jets appear over the subcontinent. Strong low‐level southwesterly flow with a low‐level jet structure also appears parallel to the coastline over the western BoB, extending from the west of Sri Lanka. The low‐level westerlies from the subcontinent and the low‐level southwesterlies merge into a single strong southwesterly flow, forming the low‐level moist surge.

Abstract The intensity of extreme precipitation has been projected to increase with increasing air temperature according to the thermodynamic Clausius–Clapeyron (C-C) relation. Over the last decade, observational studies have succeeded in demonstrating the scaling relationship between extreme precipitation and temperature to understand the projected changes. In mid-latitude coastal regions, intense precipitation is strongly influenced by synoptic patterns and a particular characteristic is the long-lasting heavy precipitation driven by abundant moisture transport. However, the effect of synoptic patterns on the scaling relationship remains unclear. Here we conduct an event-based analysis using long-term historical records in Japan, to distinguish extreme precipitation arising from different synoptic patterns. We find that event peak intensity increases more sharply in persistent precipitation events, which lasted more than 10 h, sustained by atmospheric river-like circulation patterns. The long duration-accumulated precipitation extremes also increase with temperature at a rate considerably above the C-C rate at higher temperatures. Our result suggests that long-lasting precipitation events respond more to warming compared with short-duration events. This greatly increases the risks of future floods and landslides in the mid-latitude coastal regions.

Abstract The cellulose δ18O of plant tissues in peat is a potential climate proxy. However, understanding what is driving the shifts in δ18O of cellulose is required for its application. Here, we analyzed the δ18O values of Sphagnum and vascular plant cellulose, as well as the δ18O and δD values of pore water, in a 4‐m‐long peat core from the Bekanbeushi ombrotrophic bog to understand paleoclimatic changes in northern Japan over the past 2,000 years. The cellulose δ18O values of Sphagnum were lower than those of vascular plant tissues, although both draw water from the same layer. Whereas the cellulose δ18O values of Sphagnum more directly reflect those of precipitation, those of vascular plants become enriched through transpiration. Thus, the difference between vascular plants and Sphagnum (Δδ18Ovp–sp) is a potential proxy for relative humidity. Cellulose δ18O of Sphagnum revealed centennial variations with maxima around 800, 1300, and 1500 CE and minima around 500, 1000, 1700, and 1900 CE. The Δδ18Ovp–sp was inversely correlated with Sphagnum cellulose δ18O, indicating that the axis of summer westerlies was more frequently located to the north and the climate was moist in the former periods, whereas the axis of summer westerlies was generally located to the south and the climate was dry in the latter periods. These results suggest a warm and moist climate during the former periods due to frequent rainy summers driven by strong East Asian summer monsoon activity, and the opposite conditions in the latter periods.

The connection between Arctic sea ice loss and mid-latitude cooling in Eurasia has been widely debated. Here, model experiments reveal that the persistence of sea ice loss-related snow and soil temperature anomalies in Eurasia may lead to further cooling in the following winters.

Abstract In summer 2002, abnormally high-temperature events and associated low soil moisture conditions were observed in Northeast Eurasia. In this study, two regional climate model experiments, one with and the other without soil moisture–atmosphere interaction, were conducted to investigate the role of soil moisture in surface air temperature and precipitation in Northeast Eurasia utilizing the Weather Research and Forecasting (WRF) model. In the experiment without interaction, satellite-based soil moisture was prescribed. Under the persistent mid-tropospheric ridge pattern with prolonged clear skies, both experiments captured the magnitude of the extreme surface air temperature events. A comparison of the model experiments demonstrated that the mid-tropospheric ridge pattern was intensified by dry soil moisture conditions that further increase the surface air temperature. The temporal variability of surface air temperature for the experiments with and without soil moisture–atmosphere interaction reveals the strong coupling of soil moisture to surface air temperature in June–August, raising the possibility that extreme hot temperature events in Northeast Eurasia were strengthened by the soil moisture anomaly. These results also indicate that the impact of soil moisture–atmosphere coupling on surface air temperature varies spatially and temporally, having higher importance for the predictability of extreme high-temperature events in Northeast Eurasia during mid-summer. This also suggests that the performance of the land surface model in simulating appropriate land–atmosphere coupling intensity is a key to evaluating the impact of climate change on extreme heat events in this region.

Abstract Extremely heavy precipitation affects human society and the natural environment, and its behaviour under a warming climate needs to be elucidated. Recent studies have demonstrated that observed extreme precipitation increases with surface air temperature (SAT) at approximately the Clausius–Clapeyron (CC) rate, suggesting that atmospheric water vapour content can explain the relationship between extreme precipitation and SAT. However, the relationship between atmospheric water vapour content and SAT is poorly understood due to the lack of reliable observations with sufficient spatial and temporal coverage for statistical analyses. Here, we analyse the relationship between atmospheric water vapour content and SAT using precipitable water vapour (PWV) derived from global positioning system satellites. A super-CC rate appears in hourly PWV when the SAT is below 16 °C, whereas the rate decreases at high SAT, which is different from the precipitation-SAT relationship. The effects of upper air temperature and water vapour can consistently explain the super-CC rate of PWV relative to SAT. The difference between moist and dry adiabatic lapse rates increases with SAT, in consequence of more ability to hold water vapour in the free atmosphere under higher SAT conditions; therefore, attainable PWV increases more rapidly than the CC rate as SAT increases.

Wind energy development has been limited by concerns associated to the varying features in wind speed which tends to destabilize the power system. This study aims to clarify the variability of winds within a day in the Philippines, specifically the hourly changes of onshore horizontal winds at 100-m hub-heights. A whole one-year experiment using the Weather Research and Forecasting model shows that onshore wind speeds decrease during the transitional hours between land breeze and sea breeze. The decreases in wind speed are most significant over coastal regions with high sloping topography. The extreme decreases in wind speed during morning hours, due to the natural processes, are found to often occur at the same time as the extreme electricity undersupply caused by the morning increase in energy demand. This result warns that the power system stability in the Philippines may become more sensitive to the variability of wind as the share of wind energy generation increases in the future. The findings of this study can contribute to promote sustainability in the operation of existing wind-reliant power systems and planning of future wind energy developments.

Metabolomics analysis possibly identifies new therapeutic targets in treatment resistance by measuring changes in metabolites accompanying cancer progression. We previously conducted a global metabolomics (G-Met) study of renal cell carcinoma (RCC) and identified metabolites that may be involved in sunitinib resistance in RCC. Here, we aimed to elucidate possible mechanisms of sunitinib resistance in RCC through intracellular metabolites. We established sunitinib-resistant and control RCC cell lines from tumor tissues of RCC cell (786-O)-injected mice. We also quantified characteristic metabolites identified in our G-Met study to compare intracellular metabolism between the two cell lines using liquid chromatography-mass spectrometry. The established sunitinib-resistant RCC cell line demonstrated significantly desuppressed protein kinase B (Akt) and mesenchymal-to-epithelial transition (MET) phosphorylation compared with the control RCC cell line under sunitinib exposure. Among identified metabolites, glutamine, glutamic acid, and α-KG (involved in glutamine uptake into the tricarboxylic acid (TCA) cycle for energy metabolism); fructose 6-phosphate, D-sedoheptulose 7-phosphate, and glucose 1-phosphate (involved in increased glycolysis and its intermediate metabolites); and glutathione and myoinositol (antioxidant effects) were significantly increased in the sunitinib-resistant RCC cell line. Particularly, glutamine transporter (SLC1A5) expression was significantly increased in sunitinib-resistant RCC cells compared with control cells. In this study, we demonstrated energy metabolism with glutamine uptake and glycolysis upregulation, as well as antioxidant activity, was also associated with sunitinib resistance in RCC cells.

We report a histologically pure stage 1 seminoma with an elevated human chorionic gonadotropin (hCG). A 38 year-old man was referred for the evaluation of the left testicular swelling. He showed an elevated serum hCG level of 25,265 mIU/ml with normal a fetoprotein and lactate dehydrogenase. Imaging showed heterogeneous tumor without any metastatic lesions. We conducted 4 courses of chemotherapy before detecting hCG nadir. The final pathological report showed pure seminoma with syncytiotrophoblastic cells but no choriocarcinoma components. The patient remains disease free until present time. The case raised several questions regarding diagnosis and treatment strategy for bulky testicular seminoma.

It has recently been proposed that microrefugia played an important role in species survival during past climate change events. However, the current distributions of microrefugia remain largely unknown. Wind-hole sites are areas affected by preferential flows of cool air generated in interstitial spaces created by rock fragments or colluvia. Alpine plant species occurring in lowland wind-hole sites isolated from alpine zones may be relicts of the last glacial period. Hokkaido, northern Japan, is known to contain many wind-hole sites in which alpine plant species can occur. Here we surveyed 55 wind-hole sites in the Kitami region, eastern Hokkaido, and observed two alpine plant species (lingonberry, Vaccinium vitis-idaea, and Labrador tea, Rhododendron groenlandicum ssp. diversipilosum var. diversipilosum) in 14 wind-hole sites. Statistical modeling showed that wind-hole sites are likely to occur in areas with high maximum slope angles and volcanic rock cover, and concave surfaces. Our predictions of wind-hole site distributions suggest that such topographic conditions are common in our study area, and that many undiscovered wind-hole sites exist. Ignoring microhabitats may greatly underestimate species distributions in topographically complex regions, and dispersed cool spots may also function as stepping stones and temporal habitats for cold-adapted species. Because these localized unique habitats usually occur in economically unproductive sites, identifying and protecting potential microrefugia (cool spots) would be a robust and cost-effective mitigation of climate change impacts.

Introduction: the purpose of this study was to put forth hypotheses regarding possible wear patterns of the articular cartilage of the trapeziometacarpal (TMC) joints in Japanese cadavers. The TMC joint is frequently affected by osteoarthritis (OA), which is associated with degeneration of the articular cartilage. Detailed knowledge about the wear locations of the articular cartilage is important to obtain a clearer understanding of the etiology of the TMC OA and better manage the condition. This article presents an overview of the anatomy, biomechanics, and wear locations of the articular cartilage of the TMC joint. We further discuss "what might be expected in future studies in Japanese cadavers in relation to the wear patterns of the articular cartilage of the TMC joint". [ABSTRACT FROM AUTHOR]

Increasing food loss and waste (FLW) is a global problem, and efforts are being made to use waste food as potential livestock feed material. The amount of self-supplied feed is lower in Japan than in other countries, and the government recommends FLW use for animal feed. Sake (Japanese rice wine) is a traditional alcoholic beverage. During the sake manufacturing process, large amounts of squeezed solids or "lees" (sake lees) are generated. Sake lees are nutritious and functional, but are prone to spoilage. In this study, we investigated whether sake lees should be mixed with animal feed immediately or after drying. To assess the usefulness of sake lees as a poultry feed ingredient and determine the effect of sake lees on intestinal immunity, we performed a feeding trial with three treatments: a raw sake lees (RSL) diet, dried sake lees (DSL) diet, and control diet. Three-week-old broilers were fed these diets (n=8 per group) for two weeks. We then calculated feed efficiency and performed RT-qPCR to assess the effects of diet on intestinal immunity. The growth performance in the RSL diet group was equivalent to that in the control diet group. The DSL diet became difficult for broilers to eat, resulting in decreased growth performance. In the ileum of RSL-diet broilers, the mRNA expression levels of TGF-ß1 and avian ß-defensin (AvBD)12 were significantly increased compared to those of control diet broilers (p<0.05), and a significant correlation was observed between the two genes (p<0.05). Our results indicated that sake lees should not be dried and should be mixed immediately with feed, and this sake lees when fed to chicken activates the intestinal immunity. However, sake lees have a lower fat content than corn, and it is thus important to combine sake lees with high-energy feed. [ABSTRACT FROM AUTHOR]

To evaluate the effect of oxidants, which are formed by radiolysis of water under gamma-ray irradiation, on the corrosion of a carbon steel in a humid environment, ozone was introduced as a model oxidant into humidity-controlled air at 50°C in a thermo-hygrostat chamber. Corrosion monitoring of carbon steel was performed by using an Atmospheric Corrosion Monitor-type (ACM) sensor consisting of a carbon steel anode and an Ag cathode, and a Resistmetric Corrosion Monitor (RCM) sensor consisting of carbon steel sheets. The corrosion rates obtained from the outputs of the sensors were increased with the increase in relative humidity and were obviously increased with the increase in the introduced ozone concentration at each relative humidity, indicating that ozone accelerates the corrosion of the carbon steel. The effect of ozone on the corrosion acceleration is attributed to its easy reduction reaction and/or fast dissolution reaction into water compared to that of oxygen. [ABSTRACT FROM AUTHOR]

A numerical experiment with a 2-km resolution was conducted using the Weather Research and Forecasting (WRF) Model to investigate physical processes driving nocturnal precipitation over the Himalayas during the mature monsoon seasons between 2003 and 2010. The WRF Model simulations of increases in precipitation twice a day, one in the afternoon and another around midnight, over the Himalayan slopes, and of the single nocturnal peak over the Himalayan foothills were reasonably accurate. To understand the synoptic-scale moisture transport and its local-scale convergence generating the nocturnal precipitation, composite analyses were conducted using the reanalysis dataset and model outputs. In the synoptic scale, moisture transport associated with the westward propagation of low pressure systems was found when nocturnal precipitation dominated over the Himalayan slopes. In contrast, moisture was directly provided from the synoptic-scale monsoon westerlies for nocturnal precipitation over the foothills. The model outputs suggested that precipitation occurred on the mountain ridges in the Himalayas during the afternoon and expanded horizontally toward lower-elevation areas through the night. During the nighttime, the downslope wind was caused by radiative cooling at the surface and was intensified by evaporative cooling by hydrometeors in the near-surface layer. As a result, convergence between the downslope wind and the synoptic-scale flow promoted nocturnal precipitation over the Himalayas and to the south, as well as the moisture convergence by orography and/or synoptic-scale circulation patterns. The nocturnal precipitation over the Himalayas was not simulated well when we used the coarse topographic resolution and the smaller number of vertical layers. [ABSTRACT FROM AUTHOR]

Polar mesocyclones (PMCs) occur frequently over the northern Sea of Japan. In the present study, topographic effects on PMC genesis in this region were investigated using long-term numerical simulations extending over 36 winter seasons. Sensitivity experiments showed that PMC genesis decreases in the part of the northern Sea of Japan when the mountain region at the eastern end of the Eurasian continent is removed. For instance, the generation of PMCs over offshore west of Hokkaido decreases significantly when the mountain range is removed, whereas the generation of PMCs over the Strait of Tartary remains unchanged. According to a composite analysis, this result can be attributed to the different responses of subregional oceanic surface wind to the removal of the mountains. In the experiment without mountains, cold air outbreaks from the continent blow directly over the Sea of Japan causing strong westerly winds over the offshore west of Hokkaido. Consequently, PMCs tend to make landfall earlier and before reaching maturity. The uniformly distributed westerly wind also has a negative impact on PMC genesis because of weakened horizontal wind shear and meridional temperature gradient. By contrast, the low-level wind over the Strait of Tartary before PMC genesis is unaffected by the mountains, and thus, topographic effects are not required for PMC genesis in this region. These results indicate that the responses of PMCs to topographic forcing have a regional variability. [ABSTRACT FROM AUTHOR]

Carbohydrate antigens are associated with carcinogenesis, cancer invasion, and metastasis and their expression reflect biological activities of various cancers. We previously reported that expression of disialosyl globopentaosyl ceramide (DSGb5), one of carbohydrate antigens, in radical prostatectomy specimens independently predicted biochemical recurrence (i.e., elevating serum prostate specific antigen without recurrent lesions in the image) after radical prostatectomy. However, it is important to evaluate the prognosis at the diagnosis. In this study we investigated DSGb5 expression in prostate biopsy specimens to develop a novel biomarker for providing appropriate management. Between 2005 and 2011, patients who underwent both prostate biopsy and radical prostatectomy in our institution were included. The median follow-up period was 88 months. DSGb5 expression was assessed by immunohistochemical staining and defined 116 patients as high DSGb5 expression (42 patients) or low DSGb5 expression (74 patients). High DSGb5 expression was significantly associated with lymphovascular invasion in radical prostatectomy specimens on both univariate and multivariable analyses (p = 0.028, 0.027). On multivariable analysis, Gleason Score in prostatectomy specimen, positive resection margin, and DSGb5 expression in the biopsy specimen were independently associated with biochemical recurrence-free survival following radical prostatectomy (p = 0.004, 0.008, 0.024). When targeting only patients with negative resection margin, DSGb5 expression was significantly associated with biochemical recurrencefree survival on both univariate and multivariable analyses (p = 0.006, 0.007). DSGb5 expression in prostate biopsy specimens is predictive of lymphovascular invasion and biochemical recurrence-free survival following radical prostatectomy. DSGb5 is a potential biomarker for preoperatively predicting oncological outcomes of prostate cancer. [ABSTRACT FROM AUTHOR]

This study investigated future changes in extreme precipitation associated with tropical cyclones (TCs) around Japan using large ensemble regional climate simulations for historical and +4 K climates. Under the warmer climate, extreme TC precipitation, defined as the 90th percentile value of the maximum daily precipitation derived from each TC (TCP90), is projected to increase throughout Japan from Kyushu to Kanto. We attributed most of the increase in TCP90 to increased atmospheric moisture due to global warming. Furthermore, it was found that TCP90 is projected to increase for all TC intensity categories. However, the projected increase in intense TCs affects TCP90 in only a limited area. Stronger TCs enhance TCP90 over east- and north-facing slopes of mountainous terrain, while TCP90 in most other areas is insensitive to TC intensity. These results suggest that even relatively weak TCs could have potential to produce extreme precipitation that might cause natural disasters. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the 'One Stretch' exercise's effect on improvements in low back pain (LBP), psychological factors, and fear avoidance in a large number of nurses. Methods: Between July 2015 and June 2016, we performed a prospective, randomized, parallel-group, multi-center study with central evaluations. Eligible patients were randomly assigned (1:1:1 ratio) to either the control group (Group A) or an intervention group (Group B: 30-min seminar about the 'One Stretch' exercise, Group C: Bþphysical and psychological approaches to LBP treatment). The primary outcome was subjective improvement from baseline to 6 months (improved/unchanged/worsened) and overall exercise habits (good/poor). Results: There were 4767 participants: 1799, 1430, and 1548 in Groups A, B, and C, respectively. We collected data on 3439 participants (949, 706, and 751 in Groups A, B, and C, respectively) at the 6-month follow-up. The improvement rates in Groups A, B, and C were 13.3%, 23.5%, and 22.6%, respectively. The worsened pain rates were 13.0%, 9.6%, and 8.1%, which decreased as the intervention degree increased (the Cochran-Armitage trend test: p<.0001). In Groups A, B, and C, 15.6%, 64.9%, 48.8% of the patients, respectively, exhibited exercise habits. Conclusion: The 'One Stretch' exercise is useful for improving LBP. [ABSTRACT FROM AUTHOR]

We investigated extremely heavy precipitation that occurred around the Kinugawa River, Japan, in September 2015, and the probability of extreme precipitation occurrence, using data from a large ensemble forecast of more than 1,000 members that were dynamically downscaled to 1.6 km horizontal grid spacing. The observed event was statistically rare among simulated cases and the 3-day accumulated precipitation around the target area was equivalent to the 95th percentile among all simulated ensemble members. Our results show that this extreme precipitation event occurred under specific conditions: two coexisting typhoons at close proximity that produced a high atmospheric instability, and water vapor transported from the Pacific Ocean. We also assessed the probability of extreme precipitation in mountainous areas other than the Kinugawa River case. Heavy precipitation also occurred southwest of the Kinugawa River region due to two typhoons, similar to the Kinugawa River case. The tracks of these typhoons shifted marginally; however, there was a difference in the water vapor supplied to the area, causing heavy precipitation. The large-ensemble downscaled data used in this study hence enabled us to evaluate the occurrence probability of a torrential rainfall event that was rarely observed, which may contribute to updating a disaster-mitigating plan for possible similar disasters in future. [ABSTRACT FROM AUTHOR]

This study investigated the impact of land surface heterogeneity on Mesoscale Convective System (MCS) initiations in East Asia, using geostationary satellite data during June-August from 1996 through 2018. The detected MCSs over land exhibited clear diurnal variation with the lowest existence frequency at 10:00 and highest initiation frequency during 12:00-17:00 local time. To quantify land surface heterogeneity, the spatial standard deviation of equivalent Black-Body Temperature (TBB) within a cloud-free 0.35° × 0.35° box (σLSTBB: Land Surface TBB) was computed for 10:00 each day. A comparison of the σLSTBB and MCS databases revealed that the probability of MCS initiations increased with increasing σLSTBB in East Mongolia while the probability was not sensitive to σLSTBB in East China. This indicated that MCSs tend to form over heterogeneous land surface conditions in the semiarid region. We found that the impact of land surface heterogeneity on MCS initiations was highest over flat terrain in East Mongolia, where the convection trigger due to topographically-induced circulation was absent. These results suggest that the impact of land surface heterogeneity on MCS initiations during the warm season varies with climate zones and terrain complexities in East Asia, with strongest impact in semiarid and flat regions. [ABSTRACT FROM AUTHOR]

Introduction: Predictive biomarkers for the therapeutic outcome of induction therapy with systemic corticosteroid for active ulcerative colitis (UC) have not been established. This study aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR) and/or platelet-to-lymphocyte ratio (PLR) can be predictive biomarkers for the therapeutic outcomes of systemic corticosteroid therapy in UC. Methods: This was a single-center retrospective cohort study. In total, 48 patients with UC who received induction therapy with systemic corticosteroid were enrolled. Based on the achievement of clinical remission after 8 weeks of treatment, the patients were divided into the remission group (n = 28) and the nonremission group (n = 20). Clinical characteristics, NLR, and PLR at baseline between the remission and nonremission groups were compared via a univariate analysis. The independent risk factors of nonremission were identified via a multivariate analysis. Results: The baseline Mayo score, platelet count, lymphocyte count, C-reactive protein (CRP) levels, NLR, and PLR between the 2 groups significantly differed. The nonremission group had higher NLR and PLR than the remission group (4.70 [3.04–11.3] vs. 3.10 [1.36–16.42]; p < 0.05, and 353.6 [220.3–499.8] vs. 207.2 [174.4–243.6]; p < 0.001, respectively). A multivariate analysis revealed that a Mayo score of ≥9, CRP level of ≥1.26 mg/dL, and PLR of ≥262 (hazard ratio: 23.1, 95% confidence interval: 1.29–413.7, p = 0.033) were considered independent risk factors for nonremission. Conclusion: This report first identified the efficacy of NLR and PLR as candidate biomarkers for predicting the therapeutic outcomes of systemic corticosteroid therapy in UC.

Tubulointerstitial nephritis is primary injury to renal tubules and interstititum which could be resulting in decreased renal function. The acute and chronic forms are most often due to allergic drug reactions or to infections. Tubulointerstitial nephritis in Crohn’s disease has rarely been reported. Imaging findings of a striated nephrogram on enhanced computed tomography (CT) could represent the clinical state of tubulointerstitial nephritis. This is the first report of tubulointerstitial nephritis caused by infliximab, monoclonal antibody against human tumor necrosis factor-α , showing striated nephrograms in Crohn’s disease. The case of a 28-year-old man treated with infliximab for Crohn’s disease is described. Infliximab was added to his maintenance therapy, and bowel symptoms were stable. The patient presented with a 2-month history of fever and an elevated C-reactive protein after infliximab administration for 4.5 years. Contrast-enhanced CT showed striated nephrograms in both kidneys. Urinalysis showed no abnormal findings. The pathological diagnosis on CT-guided percutaneous renal needle biopsy was drug-induced tubulointerstitial nephritis because of eosinophilic infiltration with neutrophils mainly in the tubulointerstitial areas. The imaging findings of striated nephrogram are important for the diagnosis of tubulointerstitial nephritis. Tubulointerstitial nephritis could be caused by drug-induced inflammation or direct extension of Crohn’s disease as an extra-interstitial manifestation. The treatment strategies for these two diseases are contradictory to each other and inappropriate treatment could worsen the renal function. Needle biopsy is therefore indispensable for differential diagnosis. [ABSTRACT FROM AUTHOR]

Climate monitoring in urban areas is important because climate change in densely populated areas has a strong influence on society. The rate of long-term temperature increase in high-latitude snowy urban areas is relatively large due to global warming and urban heat islands. However, the influence of snow cover on urban heat islands is unclear. The purpose of this study is to assess the effect of snow cover in urban canopy layer on winter heat islands using a mesoscale atmospheric model coupled with an urban canopy model. Numerical experiments indicate that snow cover in urban areas serves to decrease surface air temperature, with a stronger decrease in daily maximum temperatures (0.4 - 0.6°C) than daily minimum temperatures (0.1 - 0.3°C). The increase in surface albedo is primarily responsible for the decrease in net shortwave radiation and sensible heat flux. In addition, increased evaporation causes a weakened sensible heat flux. The estimated snow cover effect during the day is comparable with the typical magnitude of anthropogenic heat release. In urban canopy layer, snow cover on roofs plays a significant role in reducing surface air temperature. Snow clearing on roads tends to increase nocturnal surface air temperature, especially in suburban areas because decreased snow depth increases ground heat transfer. These results indicate that snow cover in urban canopy layer reduces surface air temperature, resulting in weakened urban heat islands. [ABSTRACT FROM AUTHOR]