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In June-July 2020 two remarkable weather events occurred in northern Eurasia. One is a severe heat wave that produced a record-breaking temperature of 38 degrees C at Verkhoyansk, eastern Siberia on 20 June. The other one is heavy rainfall events observed in East Asia (southern China and southwestern Japan) in early July, causing severe floods that brought about considerable damage to infrastructure and the economy, as well as the loss of human lives. Despite the accumulated evidence of stronger and more extreme heat waves and heavy rainfall as a result of global warming, little is known about the linkage between these phenomena. Given that the Arctic is warming twice as fast as the global mean, Arctic warming might be enhancing the increase of heavy rainfall events in East Asia. Here, we investigated the relationship between the Siberian heat wave and the East Asian heavy rainfall that occurred summer in 2020. An empirical orthogonal function (EOF) analysis applied to atmospheric reanalysis data of 1958-2020 period captures dominant summer circulation patterns reflecting atmospheric internal variability and externally forced anomalies. On the basis of these EOF patterns, operational forecasts of summer 2020 using the global model from the Japan Meteorological Agency (JMA) and a global climate model experiment based on 2-K warming future projection are utilized to examine roles of the internal variability and external forcing, respectively. Consistent results between them reveal that development of the blocking high over eastern Siberia has certain impacts on rainfall anomalies over East Asia. By a statistical technique applied to the ensemble forecast data, prediction of the East Asian precipitation is improved by 10-20% of its amplitude. Our research demonstrates possibility that East Asian rainfall is being enhanced by high-latitude atmospheric circulations due to the Arctic warming even in the current climate in which the tropical warming is not yet severe. Suggestions are given that continued Arctic warming and a future increase of tropical warming will lead to increases of the frequency and severity of heavy rainfall events in East Asia.

Surgery is the standard of care for T1bN0M0 esophageal squamous cell carcinoma (ESCC), whereas chemoradiotherapy (CRT) is a treatment option. This trial aimed to investigate the noninferiority of CRT relative to surgery for T1bN0M0 ESCC.Clinical T1bN0M0 ESCC patients were eligible for enrollment in this prospective nonrandomized controlled study of surgery versus CRT. The primary endpoint was overall survival, which was determined using inverse probability weighting with propensity scoring. Surgery consisted of an esophagectomy with 2- or 3-field lymph node dissection. CRT consisted of 2 courses of 5-fluorouracil (700 mg/mFrom December 20, 2006 to February 5, 2013, a total of 368 patients were enrolled in the nonrandomized portion of the study. The patient characteristics in surgery arm and CRT arm, respectively, were as follows: median age, 62 and 65 years; proportion of males, 82.8% and 88.1%; and proportion of performance status 0, 99.5% and 98.1%. Comparisons were made using the nonrandomized groups. The 5-year overall survival rate was 86.5% in the surgery arm and 85.5% in the CRT arm (adjusted hazard ratio, 1.05; 95% confidence interval, 0.67-1.64 [1.78]). The complete response rate in the CRT arm was 87.3% (95% confidence interval, 81.1-92.1). The 5-year progression-free survival rate was 81.7% in the surgery arm and 71.6% in the CRT arm. Treatment-related deaths occurred in 2 patients in the surgery arm and none in the CRT arm.CRT is noninferior to surgery and should be considered for the treatment of T1bN0M0 ESCC.

In the framework of atmospheric circulation regimes, we study whether the recent Arctic sea ice loss and Arctic Amplification are associated with changes in the frequency of occurrence of preferred atmospheric circulation patterns during the extended winter season from December to March. To determine regimes we applied a cluster analysis to sea-level pressure fields from reanalysis data and output from an atmospheric general circulation model. The specific set up of the two analyzed model simulations for low and high ice conditions allows for attributing differences between the simulations to the prescribed sea ice changes only. The reanalysis data revealed two circulation patterns that occur more frequently for low Arctic sea ice conditions: a Scandinavian blocking in December and January and a negative North Atlantic Oscillation pattern in February and March. An analysis of related patterns of synoptic-scale activity and 2 m temperatures provides a synoptic interpretation of the corresponding large-scale regimes. The regimes that occur more frequently for low sea ice conditions are resembled reasonably well by the model simulations. Based on those results we conclude that the detected changes in the frequency of occurrence of large-scale circulation patterns can be associated with changes in Arctic sea ice conditions. (C) 2017 The Authors. Published by Elsevier B.V.

This report describes a case of esophageal intramural pseudodiverticulosis associated with an inflammatory esophageal mass with high 18F-fluorodeoxyglucose (FDG) uptake. A 48-year-old man presented with dysphagia caused by an esophageal stricture. Simultaneous positron emission tomography and magnetic resonance imaging showed an FDG-avid lesion in the lower esophagus. Because of suspected malignancy, the patient underwent subtotal esophagectomy. Histologic examination confirmed the diagnosis of an inflammatory tumor associated with esophageal pseudodiverticulosis. Unlike typical cases, this patient's pseudodiverticula involved both the submucosa and the muscularis propria. This case suggests that esophageal intramural pseudodiverticulosis can manifest with a tumorlike mass that may be FDG positive in response to associated inflammation.

We found a statistically significant relationship between the stratospheric quasi-biennial oscillation (QBO) and Antarctic sea ice concentration (SIC) in austral winter. SIC differences between the easterly phase of the QBO (EQBO) and westerly phase of the QBO (WQBO) show positive anomalies of SIC in the following regions: over the Ross Sea, Weddell Sea, and around 90°E. This wave-3 pattern is clearly seen in June and July, and decays in August. The increased SIC regions correspond to anomalous offshore wind regions, and the reduced SIC regions correspond to onshore wind regions, indicating the atmospheric circulation anomaly produced the SIC anomaly. The atmospheric circulation anomaly is barotropic and closely related with the upper atmospheric flow. The upper circulation anomaly shows a stationary Rossby wave train propagating from Indian Ocean. We show the enhanced convection in the tropical Indian Ocean in EQBO can excite the Rossby wave train. In summary, the stratospheric QBO affects the tropical convection, then generating the Rossby wave train which propagates into southern high latitude, and finally affecting Antarctic sea ice. There exists a possibility to predict winter sea ice in one-year advance, because the QBO is a quasi-regular oscillation.

Objectives The number of geriatric patients with esophageal cancer has been increasing. Geriatric syndromes such as sarcopenia might adversely affect postoperative recovery. The aim of this study was to evaluate the relationships between sarcopenia and postoperative complications, and the associations between sarcopenia and perioperative functional changes in patients with esophageal cancer following esophagectomy. Materials and Methods Participants comprised 104 patients who underwent esophagectomy from July 2011 to April 2015. Preoperative sarcopenia was diagnosed by the presence of low muscle mass and low physical functions according to Asian Working Group for Sarcopenia criteria. Low physical function was defined by loss of grip strength and/or slow walking speed. Postoperative pulmonary, cardiac, infectious, and surgical complications were extracted. Perioperative functional changes were calculated (value at postoperative day 30−value before surgery). For statistical analyses, both uni- and multivariate logistic regression analyses were performed. Results Twenty-nine patients (27.9%) were diagnosed with sarcopenia. The incidence of postoperative pulmonary complications was significantly higher in the sarcopenia group (37.9%) than in the non-sarcopenia group (17.3%; P =0.04). There was no relationship between sarcopenia and other complications or perioperative functional changes. Multivariate analysis identified sarcopenia (odds ratio (OR), 3.13; 95% confidence interval (CI), 1.12–8.93) and high Brinkman index (OR, 3.46; 95% CI, 1.20–11.77) as independent risk factors for the development of pulmonary complications. Conclusion The assessment of sarcopenia may be useful to predict the postoperative pulmonary complications following esophagectomy. On the other hand, sarcopenia does not predict cardiac, infectious, and surgical complications or perioperative function.

Reaction of (diacetoxyiodo)benzene [PhI(OAc) 2 ] in trifluoromethanesulfonic acid (TfOH) resulted in oligomerization of PhI(OAc) 2 . Quenching with NaBr gave the bromide salts of hypervalent iodine oligomers that were determined by thermolysis with KI to be a para phenylene type of oligomers. Neutralization of the reaction mixture of PhI(OAc) 2 and TfOH with aqueous NaHCO 3 yielded the triflate salts of iodine oligomers. Furthermore, quenching the reaction mixture with aromatic substrates afforded arylated iodine oligomers. These iodine oligomers were found to be 3–4 of the number average degree of polymerization ( P n ) by GC analysis of the thermolysis products and 1 H NMR analysis. The major products, trimer and tetramer, were synthesized independently.

Reaction of iodosylbenzene (PhIO) with H2SO4 was reexamined. When PhIO was treated with excess H2SO4, followed by reaction with aromatic substrates such as benzene, toluene, and bromobenzene, aryl(phenyl)(p-phenylene)bisiodonium salts were obtained in good to high yields. In stead of aromatic substrates, treatment of the reagent prepared from PhIO and H2SO4 with KI afforded (p-iodophenyl)(phenyl)iodonium iodide. Similarly, the (p-phenylene) type of bisiodonium salts were obtained with a fairly strong acid (−Ho > 8.0) such as chlorosulfonic acid and trifluoromethanesulfonic acid. These results indicate that the reaction of PhIO with a strong acid gives rise to the formation of (p-phenylene)bisiodine(III) type of reagent, which leads to (p-iodophenyl)(phenyl)iodonium salt by the decomposition or to (p-phenylene)bis(aryliodonium) salts by the reaction with aromatic substrates. The selfcondensation of iodosylbenzene to (p-phenylene)bisiodine(III) type of reagents is discussed.