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Yumi Otaka,1 Yukinori Harada,1 Norio Sugawara,2 Taro Shimizu,1 Norio Yasui-Furukori2 1Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, School of Medicine, Tochigi, Japan; 2Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, JapanCorrespondence: Norio Yasui-Furukori, Department of Psychiatry, Dokkyo Medical University, School of Medicine, Mibu, Shimotsuga, Tochigi, 321-0293, Japan, Tel +81-282-86-1111, Fax +81-282-86-5187, Email furukori@dokkyomed.ac.jpBackground: Diabetic chorea is a rare complication of diabetes mellitus for which head MRI is the most common diagnostic imaging modality. Cases have been reported where CT and/or MRI findings are inconsistent or clinical symptoms and imaging findings do not appear simultaneously. We aimed to compile the cases in which imaging findings appeared on MRI retests and to examine in a systematic review whether temporal differences in the appearance of imaging findings correlate with clinical characteristics.Case Presentation: An 80-year-old man with type 2 diabetes mellitus came to a hospital with abnormal movements of the left upper and lower extremities. Two days after the first visit, his symptoms flared up, and his head MRI showed an old cerebral infarction and no new lesion. On day 14, he retested T1-weighted imaging and showed a high signal in the right putamen, which was considered diabetic chorea. Blood glucose was controlled with insulin, and the involuntary movements disappeared.Methods: PubMed and ICHUSHI were searched to identify patients with diabetic chorea who had undergone MRI retests. Patients grouped by the temporal change in the presence/absence of imaging findings were compared on age, sex, duration of diabetes mellitus, blood glucose level, HbA1c level, side of involuntary movement, time to first MRI, and follow-up MRI.Results: Of the 64 cases analyzed, 43 (67.2%) were female. The mean age was 69.0 years. 16 (25.0%) had worsening findings upon MRI retesting, 37 (57.8%) had improvement, and 10 (15.6%) had unchanged findings. There were no significant differences in age, sex, mean blood glucose level or HbA1c at onset among the groups.Conclusion: There was no association between the pattern of appearance of imaging findings over time and clinical characteristics, including glucose levels. If initial MRI findings are negative, MRI retesting after a certain time may help diagnose diabetic chorea.Keywords: hyperglycemia, hemichorea, hemiballismus, diabetes, movement disorders

Takanobu Hirosawa,1 Tetsu Sakamoto,1 Shogo Hanai,2 Yukinori Harada,1 Taro Shimizu1 1Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga, Tochigi, Japan; 2Departments of Microbiology and Infectious Diseases, Fujita Health University School of Medicine, Aichi, JapanCorrespondence: Takanobu Hirosawa, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu-cho, Shimotsuga, Tochigi, 321-0293, Japan, Tel +81 282 87 2498, Fax +81 282 87 2502, Email hirosawa@dokkyomed.ac.jpPurpose: The effect of antibiotics administered before blood cultures performed in general internal medicine outpatient settings is not well known.Patients and Methods: We conducted a retrospective case–control study including adult patients who underwent blood cultures in the general internal medicine outpatient department of a Japanese university hospital between 2016 and 2022. Patients with positive blood cultures were included as cases and matched patients with negative blood cultures were included as controls. Univariable and multivariable logistic regression analyses were performed.Results: A total of 200 patients and 200 controls were included. Antibiotics were administered prior to blood culture in 20% of patients (79/400). Oral antibiotics were prescribed to 69.6% of the prior antibiotics (55/79). Prior antibiotic use was significantly lower among patients with positive than negative blood cultures (13.5% vs 26.0%, p = 0.002) and was an independent predictive factor in univariable (odds ratio, 0.44; 95% confidence interval, 0.26– 0.73; p = 0.002) and multivariable (adjusted odds ratio, 0.31; 95% confidence interval, 0.15– 0.63; p = 0.002) logistic regression models for positive blood culture. The area under the receiver operating characteristic (AUROC) curve of the multivariable model for predicting positive blood cultures was 0.86.Conclusion: There was a negative correlation between prior antibiotic use and positive blood cultures in the general internal medicine outpatient department. Therefore, physicians should interpret the negative results of blood cultures performed after the administration of antibiotics with care.Keywords: bacteremia, fever, infection, antibacterial agent, antimicrobial, sepsis

Ren Kawamura, Yukinori Harada, Masashi Yokose, Shogo Hanai, Yudai Suzuki, Taro Shimizu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, JapanCorrespondence: Taro Shimizu, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan, Tel +8128286-1111, Email shimizutaro7@gmail.comPurpose: The general internal medicine (GIM) department can be an effective diagnostic coordinator for undiagnosed outpatients. We investigated the contribution of GIM consultations to the diagnosis of patients admitted to specialty departments in hospitals in Japan that have not yet adopted a hospitalist system.Patients and Methods: This single-center, retrospective observational study was conducted at a university hospital in Japan. GIM consultations from other departments on inpatients aged ≥ 20 years, from April 2016 to March 2021, were included. Data were extracted from electronic medical records, and consultation purposes were categorized into diagnosis, treatment, and diagnosis and treatment. The primary outcome was new diagnosis during hospitalization for patients with consultation purpose of diagnosis or diagnosis and treatment. The secondary outcomes were the purposes of consultation with the Diagnostic and Generalist Medicine department.Results: In total, 342 patients were included in the analysis. The purpose of the consultations was diagnosis for 253 patients (74%), treatment for 60 (17.5%), and diagnosis and treatment for 29 patients (8.5%). In 282 consultations for diagnosis and diagnosis and treatment, 179 new diagnoses were established for 162 patients (57.5%, 95% confidence interval [CI], 51.5– 63.3).Conclusion: The GIM department can function as a diagnostic consultant for inpatients with diagnostic problems admitted to other specialty departments in hospitals where hospitalist or other similar systems are not adopted.Keywords: diagnosis, diagnostic excellence, consultation, consultative medicine, hospital admission

Masayuki Amano,1,2 Yukinori Harada,2 Taro Shimizu2 1Department of Generalist Medicine, Minaminara General Medical Center, Oyodo, Nara, Japan; 2Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, JapanCorrespondence: Taro Shimizu, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, 880, Kitakobayashi, Shimotsuga, Mibu, 321-0923, Japan, Tel +81-282-86-1111, Fax +81-282-86-4775, Email shimizutaro7@gmail.comAbstract: The accumulation of optimal decision-making is vital to achieving diagnostic excellence and preventing diagnostic errors. Diagnostic uncertainty (DU) determines the difficulty of each team member’s decision-making process, including the patient, care partners, physicians, and healthcare professionals. The diagnostic approach in the low DU is already available, while the one in the high DU still needs to be clarified. In cognitive science, Sarasvathy et al established “effectuation”, a theory of decision-making under the high-uncertainty condition, by analyzing how outstanding entrepreneurs make decisions when the future is unpredictable. Based on this theory, we developed the “effectual diagnostic approach (EDA).” This simple approach allows patients and physicians to “set” problems co-creatively, emerging the outlines of the clusters of health issues under high DU conditions. After DU declines enough, the traditional problem-solving approach will help the diagnostic team achieve the patient’s well-being. EDA will offer us a guiding principle for action in the high DU. The co-creation of the “patient as an entrepreneur” with the “physician as a co-founder” will contribute to achieving diagnostic excellence.Keywords: diagnostic excellence, diagnostic uncertainty, diagnostic error, effectuation, co-creation

Masashi Yokose, Yukinori Harada, Shogo Hanai, Shusaku Tomiyama, Taro Shimizu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, 321-0293, JapanCorrespondence: Taro Shimizu, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Kitakobayashi 880, Shimotsuga, Mibu, Tochigi, 321-0293, Japan, Tel +81 282 86-1111, Email shimizutaro7@gmail.comPurpose: The data on the diagnostic contribution of general internal medicine (GIM) consultations for undiagnosed health problems from specialists are scarce. This study aims to explore the role of generalists as diagnostic medicine consultants in tertiary care settings.Patients and Methods: We conducted a retrospective observational study at a Japanese university hospital. GIM consultations for diagnosis from other departments on outpatients aged ≧ 20 years from January 2018 to December 2020 were included. Data were extracted from electronic medical records. The primary outcome was new diagnosis rates. The secondary outcomes were new diagnosis rates with clinical significance and clinical outcomes at 90 days from the index visit.Results: A total of 328 patients were included. The top five consulting departments were orthopedics (17.0%), cardiovascular (10.3%), otorhinolaryngology (8.8%), neurology (8.8%), and gastroenterology (7.9%). GIM identified 456 chief complaints (CCs), and the top five were fever (10.9%), abnormal laboratory results (8.3%), fatigue (5.9%), and pain (7.4%) or numbness (4.6%) in the extremities. There were 139 (104/328 patients: 31.8%) specialty consultations from GIM, and the top five departments were rheumatology (21.1%), gastroenterology (19.2%), orthopedics (9.6%), psychiatry (9.6%), and neurology (9.6%). In total, 277 new diagnoses were established in 232 patients (70.7%), and 203 patients had new diagnoses with clinical significance (61.8%). Clinical outcomes at 90 days from the time of the index visit were resolution/improvement (60.7%), unchanged/worsened (22.3%), and unknown (17.0%).Conclusion: Over 70% of GIM consultations from other departments established new diagnoses with favorable outcomes in > 60% of the patients.Keywords: consultation, specialists, diagnostic error, diagnostic excellence, diagnostic uncertainty

Takanobu Hirosawa, Arisa Hayashi, Yukinori Harada, Taro Shimizu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, JapanCorrespondence: Taro Shimizu, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu-cho, Shimotsuga, Tochigi, 321-0293, Japan, Tel + 81 282 87 2498, Fax + 81-282-87-2502, Email shimizu7@dokkyomed.ac.jpPurpose: The clinical presentation of iron deficiency is not well understood. We aimed to identify the clinical manifestations of iron deficiency without anemia in women.Patients and Methods: We conducted a retrospective cohort study of women who visited the general internal medicine outpatient department of a university hospital in Japan between 2016 and 2022. Women who were prescribed iron supplements were included in the study. Anemia was defined as hemoglobin levels below 12 g/dl. Iron deficiency was defined as serum ferritin levels < 30.0 μg/l. The primary outcome was the difference in symptoms between patients with iron deficiency with and without anemia. The secondary outcome was the ratio of symptom, hemoglobin, and serum ferritin improvement (levels > 30.0 μg/l after treatment), comparing the measurements at the beginning and after supplementation.Results: A total of 147 women were included in the final analysis. There were no significant differences in the initial symptoms and the ratio of symptom improvement between the groups. Compared to patients with iron deficiency anemia, patients with iron deficiency without anemia had high initial serum ferritin levels (14.8 vs 7.1 μg/l, p< 0.001), and hemoglobin (13.2 vs 9.9 g/dl, p< 0.001). Iron supplements significantly improved the serum ferritin level in two groups and the hemoglobin in iron deficiency anemia. After treatment, iron deficiency without anemia still had high serum ferritin levels (37.7 vs 28.2 μg/l, p=0.017) and hemoglobin (13.3 vs 12.3 g/dl, p < 0.001).Conclusion: There were no differences in any of the investigated symptoms and the ratio of the symptom improvement depending on the anemic state in iron deficiency. After iron supplementation, the serum ferritin levels in the iron deficiency without anemia group improved. Hemoglobin and serum ferritin in iron deficiency without anemia were still highly comparable to that of iron deficiency anemia.Keywords: women, hemoglobin, iron deficiency without anemia, serum ferritin

Masashi Izumi,1 Yohei Harada,2,3 Yukihiro Kajita,2 Yoshitaka Muramatsu,2,4 Toru Morimoto,1 Yutaka Morisawa,5 Yusuke Iwahori,2,6 Masahiko Ikeuchi1 1Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku-City, Japan; 2Department of Orthopaedic Surgery, Aichi Medical University, Nagakute, Japan; 3Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; 4Department of Orthopaedic Surgery, Saiseikai Futsukaichi Hospital, Futsukaichi, Japan; 5Department of Orthopaedic Surgery, Aki General Hospital, Aki, Japan; 6Department of Orthopaedic Surgery, Sports Medicine and Joint Center, Asahi Hospital, Kasugai, JapanCorrespondence: Masashi IzumiDepartment of Orthopaedic Surgery, Kochi Medical School, Kochi University, 185-1 Kohasu, Oko-cho, Nankoku-City, Kochi Pref, 783-8505, JapanTel +81 88-880-2386Fax +81 88-880-2388Email izumim@kochi-u.ac.jpPurpose: Degenerative long head of biceps tendon (LHBT) has been recognized as a notable pain source in patients with rotator cuff tear (RCT). Tenotomy or tenodesis of LHBT is frequently indicated together with arthroscopic rotator cuff repair (ARCR) aiming for complete pain relief; however, it has not been fully investigated whether resected LHBT is really a source of pain. The purpose of this study was to investigate expression levels of pain-associated mediators in LHBT and its association with preoperative pain profiles.Methods: Twenty-seven RCT patients who underwent ARCR with LHBT resection were included. Each LHBT was resected due to its abnormal arthroscopic findings including tenosynovitis, hypertrophy, and partial tear. Worst macroscopic lesion of the LHBT was obtained, and expression levels of substance P (SP) and nerve growth factor (NGF) were evaluated using enzyme-linked immunosorbent assay (ELISA). Ten healthy knee flexor tendons were analyzed as non-degenerative samples. Preoperatively, subjective shoulder pain VAS and pain duration were investigated. Conventional LHBT pain provocation tests (Speed, Yergason, O’Brien) were performed. Pressure pain threshold (PPT) of bilateral LHBT on the groove was recorded.Results: Levels of SP and NGF expression were significantly higher compared with non-degenerative tendons (P< 0.01). Shoulder pain VAS and pain duration were not directly associated with SP and NGF expression level. Patients with positive O’Brien test expressed greater SP than negative patients (P=0.001). Significant negative correlation between the PPT ratio (ipsilateral/contralateral) and SP expression level was observed (r=− 0.453, P=0.034).Conclusion: Greater expression of SP and NGF in degenerative LHBT supported our hypothesis that it would be a pain source in RCT patients. SP was likely to be expressed highly in patients with localized pressure pain hypersensitivity and positive O’Brien test (ie, altered mechanistic pain profile of LHBT), which may help when considering simultaneous LHBT resection during ARCR.Clinical Registration: UMIN000023943.Keywords: long head of biceps tendon, pain, tendinopathy, substance P, nerve growth factor, pressure pain threshold

Yosuke Harada,1,2 Ken Fukuda,1 Asami Nakahira,1 Kentaro Tada,1 Tamaki Sumi,1 Atsuki Fukushima1 1Department of Ophthalmology and Visual Science, Kochi Medical School, Nankoku, Japan; 2Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Background: The aim of the study was to investigate the efficacy of therapy in patients with cytomegalovirus (CMV) anterior uveitis. Patients and methods: We reviewed the records of patients with CMV anterior uveitis who attended our institution between October 2010 and December 2015 and who were confirmed to have CMV DNA in the aqueous humor by polymerase chain reaction analysis. Results: Fourteen immunocompetent patients (10 men and 4 women, total of 17 eyes) were enrolled. The mean ± SD age at the onset of antiviral therapy was 63.1 ± 11.3 years (range, 44–87 years). CMV DNA was not detected in the aqueous humor of 3 patients on initial testing, but it was detected on subsequent analysis. All patients underwent systemic antiviral therapy. Among the patients who were followed up for more than 6 months after starting systemic antiviral therapy, systemic antiviral therapy was successfully terminated in all 4 patients without corneal endothelial loss but had to be continued because of disease recurrence on its termination in 5 of 8 patients (62.5%) with corneal endothelial damage (P = 0.038). Conclusions: Patients with corneal endothelial cell loss are likely to require longer term antiviral therapy than those without endothelial damage. In addition, whereas definitive diagnosis of CMV anterior uveitis requires the detection of CMV DNA in aqueous humor by polymerase chain reaction, one-fifth of patients in the present study tested negative on initial examination. Keywords: cytomegalovirus, anterior uveitis, corneal endothelial cell, polymerase chain reaction, clinical course

Yosuke Harada,1 Tomoyuki Akita,2 Joji Takenaka,1 Yuko Nakamura-Kadohiro,1 Junko Tanaka,2 Yoshiaki Kiuchi1 1Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, 2Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Aim: The aim of this study was to determine the reproducibility and reliability of optic disk evaluation in supine subjects with a Heidelberg Retina Tomograph II (HRT II).Methods: One eye was randomly selected for evaluation by HRT II in each of eleven healthy subjects. Five images were obtained by each of two experienced operators at two separate visits with the subjects in both sitting and supine positions. A stand was constructed to allow stable, handheld operation of the HRT II head for imaging of the supine subjects. Measurements of optic disk parameters obtained in the supine position were compared with those obtained in the sitting position. The reliability of measurements in the supine position was evaluated by calculating both the coefficients of variation for measurements made by one observer on the first visit and the interobserver and intervisit intraclass correlation coefficients (ICCs); the values obtained were compared with those obtained for the sitting position. Results: Measurements of all parameters made in the supine position were highly similar to those made in the sitting position. The coefficients of variation obtained for each parameter in the sitting and supine positions ranged from 5.67% to 14.16% and from 2.18% to 16.08%, respectively. The interobserver ICC values in the sitting and supine positions were ≥0.978 and ≥0.989, respectively. The intervisit ICC values in the sitting and supine positions were ≥0.958 and ≥0.983, respectively.Conclusion: Handheld operation of the HRT II in a custom-designed stand is feasible for optic disk evaluation in the supine subjects who were not able to maintain the sitting position. Keywords: glaucoma, optic disk evaluation, supine position, Heidelberg retina tomograph

Junichi Yoshida, Yukiko Harada, Tetsuya Kikuchi, Ikuyo Asano, Takako Ueno, Nobuo Matsubara Infection Control Committee, Shimonoseki City Hospital, Shimonoseki, Japan Abstract: The aim of this study was to elucidate risk factors, including ward antimicrobial use density (AUD), for central line-associated bloodstream infection (CLABSI) as defined by the Centers for Disease Control and Prevention in a 430-bed community hospital using central venous lines with closed-hub systems. We calculated AUD as (total dose)/(defined daily dose × patient days) ×1,000 for a total of 20 drugs, nine wards, and 24 months. Into each line day data, we inputed AUD and device utilization ratios, number of central line days, and CLABSI. The ratio of susceptible strains in isolates were subjected to correlation analysis with AUD. Of a total of 9,997 line days over 24 months, CLABSI was present in 33 cases (3.3 ‰), 14 (42.4%) of which were on surgical wards out of nine wards. Of a total of 43 strains isolated, eight (18.6%) were methicillin-resistant Staphylococcus aureus (MRSA); none of the MRSA-positive patients had received cefotiam before the onset of infection. Receiver-operating characteristic analysis showed that central line day 7 had the highest accuracy. Logistic regression analysis showed the central line day showed an odds ratio of 5.511 with a 95% confidence interval of 1.936–15.690 as did AUD of cefotiam showing an odds ratio of 0.220 with 95% confidence interval of 0.00527–0.922 (P=0.038). Susceptible strains ratio and AUD showed a negative correlation (R2=0.1897). Thus, CLABSI could be prevented by making the number of central line days as short as possible. The preventative role of AUD remains to be investigated. Keywords: bloodstream infection, central line, antimicrobial use density

Optical image stabilization (OIS) systems maintain the three-dimensional focal position of a lens through mechanical actuation systems. This paper examines an optical lens for OIS that utilizes ultrasound vibration to alter the focal position, not only in the depth direction but also in the radial direction. The lens has a simple structure with no mechanical moving parts and consists of an ultrasound transducer divided into four pieces, a glass disk, and a transparent viscoelastic gel film that functions as a lens. The acoustic radiation force generated by the resonant flexural vibration of the glass disk can alter the surface profile of the gel film, allowing for a variable-focus function. The concave and convex lenses can be interchanged using two resonant vibration modes: the standing-wave mode, in which the vibration loop appears at the center, and the traveling-wave mode, in which the vibration node appears at the center. The positions of ultrasound vibrations on the lens can be controlled in a two-dimensional plane by adjusting the driving amplitudes of each channel, thereby achieving focus control in the radial direction. The focusing characteristics of the lens are evaluated through ray-tracing simulation. [ABSTRACT FROM AUTHOR]

The identification of lattice multiphases in TiO2 nanocrystals is studied by high resolution transmission electron microscope and electron diffraction patterns. Based on the spectroscopic analysis using soft x-ray absorption and resonant inelastic soft x-ray scattering, it is believed that the oxygen vacancies at the interface exhibit structural distortion of the TiO68−cluster around the defect site as for the multiphase lattice. We elucidate that the extra 3d electrons nearby induce the inelastic scattering features with the excitation energy dependence owing to different energy relaxation processes, a characteristic of the electron-phonon coupling or the nature of the electron-hole pair at the intermediate state. The manifold dd excitations driven by the strong interaction between Ti-3d and O-2p electrons are noticeably rich, coexisting on both Ti and O sites. This sophisticated experiment can advance the perspective of nanocomposite TiO2 for various interactions of surface Ti3+ in applications of future devices.

Modulation of the refractive index in a medium by external stimuli enables fast and reversible control of light propagation. This technology for controlling light has led to new discoveries in a wide range of research fields from physics to life sciences and has played a major role in the development of photonics devices. In this article, we focus on ultrasound as an external stimulus and have devised a method to control the refractive index of a medium using ultrasound. Our research group has previously discovered that a giant refractive-index gradient (Δn on the order of 10−2) was induced when water was irradiated with high-frequency (100 MHz range), high-intensity (on the order of MPa) ultrasound. Here, we report ray-tracing simulations in a medium with a refractive-index gradient induced by ultrasonic radiation. A numerical model of the refractive-index gradient was developed based on the experimental data, and ray-tracing simulations were performed using the Euler–Lagrange equation. The ray-tracing simulation results were close numerically to the profiles of the laser beam observed in the experiment when the laser beam was incident on the refractive-index-gradient medium. [ABSTRACT FROM AUTHOR]

With the advent of the Heliophysics/Geospace System Observatory (H/GSO), a complement of multi-spacecraft missions and ground-based observatories to study the space environment, data retrieval, analysis, and visualization of space physics data can be daunting. The Space Physics Environment Data Analysis System (SPEDAS), a grass-roots software development platform (www.spedas.org), is now officially supported by NASA Heliophysics as part of its data environment infrastructure. It serves more than a dozen space missions and ground observatories and can integrate the full complement of past and upcoming space physics missions with minimal resources, following clear, simple, and well-proven guidelines. Free, modular and configurable to the needs of individual missions, it works in both command-line (ideal for experienced users) and Graphical User Interface (GUI) mode (reducing the learning curve for first-time users). Both options have "crib-sheets," user-command sequences in ASCII format that can facilitate record-and-repeat actions, especially for complex operations and plotting. Crib-sheets enhance scientific interactions, as users can move rapidly and accurately from exchanges of technical information on data processing to efficient discussions regarding data interpretation and science. SPEDAS can readily query and ingest all International Solar Terrestrial Physics (ISTP)-compatible products from the Space Physics Data Facility (SPDF), enabling access to a vast collection of historic and current mission data. The planned incorporation of Heliophysics Application Programmer's Interface (HAPI) standards will facilitate data ingestion from distributed datasets that adhere to these standards. Although SPEDAS is currently Interactive Data Language (IDL)-based (and interfaces to Java-based tools such as Autoplot), efforts are under-way to expand it further to work with python (first as an interface tool and potentially even receiving an under-the-hood replacement). We review the SPEDAS development history, goals, and current implementation. We explain its "modes of use" with examples geared for users and outline its technical implementation and requirements with software developers in mind. We also describe SPEDAS personnel and software management, interfaces with other organizations, resources and support structure available to the community, and future development plans.Electronic supplementary materialThe online version of this article (10.1007/s11214-018-0576-4) contains supplementary material, which is available to authorized users.

Context. The Mercury electron analyzer (MEA) obtained new electron observations during the first three Mercury flybys by BepiColombo on October 1, 2021 (MFB1), June 23 , 2022 (MFB2), and June 19, 2023 (MFB3). BepiColombo entered the dusk side magnetotail from the flank magnetosheath in the northern hemisphere, crossed the Mercury solar orbital equator around midnight in the magnetotail, traveled from midnight to dawn in the southern hemisphere near the closest approach, and exited from the post-dawn magnetosphere into the dayside magnetosheath. Aims. We aim to identify the magnetospheric boundaries and describe the structure and dynamics of the electron populations observed in the various regions explored along the flyby trajectories. Methods. We derive 4s time resolution electron densities and temperatures from MEA observations. We compare and contrast our new BepiColombo electron observations with those obtained from the Mariner 10 scanning electron spectrometer (SES) 49 yr ago. Results. A comparison to the averaged magnetospheric boundary crossings of MESSENGER indicates that the magnetosphere of Mercury was compressed during MFB1, close to its average state during MFB2, and highly compressed during MFB3. Our new MEA observations reveal the presence of a wake effect very close behind Mercury when BepiColombo entered the shadow region, a significant dusk-dawn asymmetry in electron fluxes in the nightside magnetosphere, and strongly fluctuating electrons with energies above 100s eV in the dawnside magnetosphere. Magnetospheric electron densities and temperatures are in the range of 10–30 cm−3 and above a few 100s eV in the pre-midnight-sector, and in the range of 1–100 cm−3 and well below 100 eV in the post-midnight sector, respectively. Conclusions. The MEA electron observations of different solar wind properties encountered during the first three Mercury flybys reveal the highly dynamic response and variability of the solar wind-magnetosphere interactions at Mercury. A good match is found between the electron plasma parameters derived by MEA in the various regions of the Hermean environment and similar ones derived in a few cases from other instruments on board BepiColombo. [ABSTRACT FROM AUTHOR]