We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
OBJECTIVES/GOALS: Triple-negative breast cancer (TNBC) is a subtype of breast cancer that lacks effective targeted treatment options. TNBC's greater degree of immunogenicity than other breast tumors makes immunotherapy a viable strategy. Strategies to improve the immunotherapy response includes targeting the cGAS-STING innate immune pathway with STING agonists. METHODS/STUDY POPULATION: We have previously shown in vitro that eribulin, a microtubule destabilizer currently used in the treatment of TNBC, functions as an indirect STING agonist because it promotes the release of mitochondrial DNA into the cytoplasm. Separately, eribulin also significantly enhances type I interferon expression induced by STING agonists measured by qRT-PCR through a second TBK1-dependent mechanism downstream of STING activation through detecting higher amounts of phosphorylated IRF-3 by western blot protein analysis. Mechanisms of eribulin-mediated interferon expression occur in immune and TNBC cells and are shared with other microtubule destabilizers but not with the microtubule stabilizing agent paclitaxel. RESULTS/ANTICIPATED RESULTS: We determine that the enhancement of type I interferon expression by eribulin is pharmacologically synergistic with multiple STING agonists. The significant enhancement by eribulin led us to evaluate the antitumor efficacy of eribulin in combination the STING agonist ADU-S100 in a challenging spontaneous mammary tumor model MMTV-PyVT. We show that the combination treatment significantly decreased tumor growth which allowed for longer survival compared to other groups. This is particularly interesting because of our previous studies showing that eribulin alone, but not paclitaxel, promotes the activation of CD4+ T-cells in the spleen and draining lymph nodes of BALB/c mice with 4T1 tumors through flow cytometric analysis. DISCUSSION/SIGNIFICANCE: These data contribute to accumulating evidence that there are important mechanistic differences between the microtubule targeted chemotherapeutics currently used in the treatment of TNBC and suggest that eribulin can act as an immune adjuvant in addition to its anti-mitotic effect.
Occupational burnout has become a pervasive problem in human services. Medical professionals are particularly vulnerable to burnout, which may lead to reduced motivation, medical errors, and voluntary absenteeism. To ensure effect functioning of medical systems, better understanding of burnout among medical professionals is warranted.
Objectives
We aimed to investigate the structural brain correlates of burnout severity among medical professionals.
Methods
Nurses in active service underwent structural magnetic resonance imaging. We assessed their burnout severity using self-reported psychological questionnaires. This study was approved by the Committee on Medical Ethics of Kyoto University and was conducted in accordance with the Code of Ethics of the World Medical Association.
Results
The results reflected considerable individual differences in burnout severity in our sample. Our findngs revealed that the levels of burnout severity were associated with the regional gray matter volumes in brain areas such as ventromedial prefrontal cortex and insula.
Conclusions
Since the outbreak of the COVID-19 pandemic, medical professionals have faced even greater stress. We hope that our findings will contribute to a better understanding of the mechanisms of burnout and offer useful insights for developing effective interventions to manage stress and burnout.
First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders.
Aims
We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE) – a historically large earthquake that resulted in a tsunami and a nuclear disaster.
Method
A total of 55 632 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this 7-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised. Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analysed using multinomial logistic regression.
Results
Five symptom severity trajectories were identified: ‘resilient’ (54.8%), ‘recovery’ (24.6%), ‘incomplete recovery’ (10.7%), ‘late-onset’ (5.7%), and ‘chronic’ (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave and longer post-deployment overtime.
Conclusions
The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection and intervention in individuals at risk of developing symptomatic trajectories.
Cervical nodal metastasis is a key prognostic factor in patients with papillary thyroid carcinoma. The role of lymph nodes in papillary thyroid carcinoma management and prognosis remains controversial.
Methods
Level IIb lymph nodes obtained from 44 patients with papillary thyroid carcinoma were histopathologically examined retrospectively. Specimens were classified as ipsilateral or contralateral. The number of dissected nodes and prevalence of level IIb metastasis were compared according to pre-operative clinical nodal stage.
Results
In the node-negative neck, the prevalence of contralateral and ipsilateral IIb nodes was 0 out of 20 and 0 out of 3, respectively. In the node-positive neck, the prevalence of contralateral and ipsilateral IIb nodes was 1 out of 13 (7.70 per cent) and 3 out of 41 (7.32 per cent), respectively. Clinically determined and pathologically confirmed level IIb node negativity were significantly associated. Thirty-four patients (77.3 per cent) developed accessory nerve complications from level IIb dissection.
Conclusion
Level IIb neck dissection for papillary thyroid carcinoma may be required if pre-operative examination reveals multilevel, level IIa or suspicious level IIb metastasis.
In the present study, compressible low-Reynolds-number flow past a stationary isolated sphere was investigated by direct numerical simulations of the Navier–Stokes equations using a body-fitted grid with high-order schemes. The Reynolds number based on free-stream quantities and the diameter of the sphere was set to be between 250 and 1000, and the free-stream Mach number was set to be between 0.3 and 2.0. As a result, it was clarified that the wake of the sphere is significantly stabilized as the Mach number increases, particularly at the Mach number greater than or equal to 0.95, but turbulent kinetic energy at the higher Mach numbers conditions is higher than that at the lower Mach numbers conditions of similar flow regimes. A rapid extension of the length of the recirculation region was observed under the transitional condition between the steady and unsteady flows. The drag coefficient increases as the Mach number increases mainly in the transonic regime and its increment is almost due to the increment in the pressure component. In addition, the increment in the drag coefficient is approximately a function of the Mach number and independent of the Reynolds number in the continuum regime. Moreover, the effect of the Mach and Reynolds numbers on the flow properties such as the drag coefficient and flow regime can approximately be characterized by the position of the separation point.
Studies on community-acquired pneumonia (CAP) and pneumococcal pneumonia (PP) related to the 13-valent pneumococcal conjugate vaccine (PCV13) introduction in Asia are scarce. This study aimed to investigate the epidemiological and microbiological determinants of hospitalised CAP and PP after PCV13 was introduced in Japan. This observational hospital-based surveillance study included children aged ⩽15 years, admitted to hospitals in and around Chiba City, Japan. Participants had bacterial pneumonia based on a positive blood or sputum culture for bacterial pathogens. Serotype and antibiotic-susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae isolates from patients with bacterial pneumonia were assessed. The CAP hospitalisation rate per 1000 child-years was 17.7, 14.3 and 9.7 in children aged <5 years and 1.18, 2.64 and 0.69 in children aged 5–15 years in 2008, 2012 and 2018, respectively. There was a 45% and 41% reduction in CAP hospitalisation rates, between the pre-PCV7 and PCV13 periods, respectively. Significant reductions occurred in the proportion of CAP due to PP and PCV13 serotypes. Conversely, no change occurred in the proportion of CAP caused by H. influenzae. The incidence of hospitalised CAP in children aged ⩽15 years was significantly reduced after the introduction of PCV13 in Japan. Continuous surveillance is necessary to detect emerging PP serotypes.
Reduced white matter integrity in the corpus callosum (CC) has been reported in treatment-resistant depression (TRD). rTMS is assumed to have remote effect on interconnected area with the stimulation site, and this effect is speculated to be one of the therapeutic mechanisms of rTMS treatment. In this preliminary study, we examined changes of callosal fiber integrity in 5 segments of the CC before and after rTMS treatment for TRD.
Methods:
The subjects were 2 patients with treatment-resistant unipolar depression and 1 patient with treatment-resistant bipolar depression, and 24 healthy controls (HC group). The patients underwent 4-week high frequency rTMS to their left DLPFC. In diffusion tensor imaging (DTI) tractography, the CC was divided into 5 segments (orbital, frontal, parietal, temporal, and occipital) based on their cortical projection zones, and fractional anisotropy (FA) value of each segment was estimated. We compared FA in the CC between the patients and the HC groups, and examined changes of FA in the CC after rTMS treatment in the patients.
Results:
The patients showed reduced FA in the frontal, parietal, temporal, and occipital-callosal segments compared to the HC group. All patients responded to the rTMS treatment, and FA in the orbital, frontal, parietal, temporal-callosal segments increased after the rTMS treatment.
Conclusions:
Our results suggest that white matter integrity in the CC is reduced in TRD and that increased white matter integrity in the CC might be related with the therapeutic mechanisms of rTMS treatment.
In bipolar disorder (BD), reduced white matter (WM) integrity in the corpus callosum has been reported, but its detailed localization difference has not been clarified. In this study, we examined fiber integrity in 7 segments of the corpus callosum and their relationships with clinical symptoms in BD.
Methods:
Patients with BD (BD group, n = 17) and age-matched healthy controls (HC group, n = 24) were examined using diffusion tensor imaging tractography. The corpus callosum was divided into 7 segments (orbital frontal, anterior frontal, superior frontal, superior parietal, posterior parietal, temporal, and occipital) based on their cortical projection zones, and fractional anisotropy (FA) value of each segment was estimated. Differences in FA of each segment between the groups were examined using ANOVA with repeated measures. Correlations between FA of each segment and clinical symptoms (HAM-D, YMRS) were assessed using Spearman's rank correlation test in the BD group.
Results:
The BD group showed reduced FA in the orbital frontal, superior frontal, and posterior parietal-callosal segments compared to the HC group. In addition, the BD group showed a significant negative correlation between FA in the orbital frontal-callosal segment and HAM-D scores.
Conclusions:
Our results suggest that WM integrity in the anterior part of the corpus callosum is reduced in BD and that orbital frontal-callosal disintegrity may be related with severity of bipolar depression.
The Murchison Widefield Array (MWA) is an open access telescope dedicated to studying the low-frequency (80–300 MHz) southern sky. Since beginning operations in mid-2013, the MWA has opened a new observational window in the southern hemisphere enabling many science areas. The driving science objectives of the original design were to observe 21 cm radiation from the Epoch of Reionisation (EoR), explore the radio time domain, perform Galactic and extragalactic surveys, and monitor solar, heliospheric, and ionospheric phenomena. All together
$60+$
programs recorded 20 000 h producing 146 papers to date. In 2016, the telescope underwent a major upgrade resulting in alternating compact and extended configurations. Other upgrades, including digital back-ends and a rapid-response triggering system, have been developed since the original array was commissioned. In this paper, we review the major results from the prior operation of the MWA and then discuss the new science paths enabled by the improved capabilities. We group these science opportunities by the four original science themes but also include ideas for directions outside these categories.
Disturbed sleep and activity are prominent features of bipolar disorder type I (BP-I). However, the relationship of sleep and activity characteristics to brain structure and behavior in euthymic BP-I patients and their non-BP-I relatives is unknown. Additionally, underlying genetic relationships between these traits have not been investigated.
Methods
Relationships between sleep and activity phenotypes, assessed using actigraphy, with structural neuroimaging (brain) and cognitive and temperament (behavior) phenotypes were investigated in 558 euthymic individuals from multi-generational pedigrees including at least one member with BP-I. Genetic correlations between actigraphy-brain and actigraphy-behavior associations were assessed, and bivariate linkage analysis was conducted for trait pairs with evidence of shared genetic influences.
Results
More physical activity and longer awake time were significantly associated with increased brain volumes and cortical thickness, better performance on neurocognitive measures of long-term memory and executive function, and less extreme scores on measures of temperament (impulsivity, cyclothymia). These associations did not differ between BP-I patients and their non-BP-I relatives. For nine activity-brain or activity-behavior pairs there was evidence for shared genetic influence (genetic correlations); of these pairs, a suggestive bivariate quantitative trait locus on chromosome 7 for wake duration and verbal working memory was identified.
Conclusions
Our findings indicate that increased physical activity and more adequate sleep are associated with increased brain size, better cognitive function and more stable temperament in BP-I patients and their non-BP-I relatives. Additionally, we found evidence for pleiotropy of several actigraphy-behavior and actigraphy-brain phenotypes, suggesting a shared genetic basis for these traits.
We studied a suitable procedure for preparing of water samples used in radiocarbon intercomparisons involving dissolved inorganic carbon (DIC). The water samples must have inter-batch consistency and stable 14C concentrations and no sterilizing agent (e.g., HgCl2) should be added, in order to avoid the production of hazardous material. Six water samples, containing widely different amounts and types of salts, DIC, and 14C concentrations (1–100 pMC), were prepared in order to assess the procedure. Sample consistency was investigated through δ13C and chemical compositions; their low variabilities indicate that our procedure can be applied to radiocarbon intercomparison. A specific sample preparation protocol was developed for this kind of applications.
We apply two methods to estimate the 21-cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly spaced triangles of antenna tiles, as well as an estimate based on data gridded to the uv-plane. The direct and gridded bispectrum estimators are applied to 21 h of high-band (167–197 MHz; z = 6.2–7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point-source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 h, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21-cm bispectrum may be accessible in less time than the 21-cm power spectrum for some wave modes, with detections in hundreds of hours.
In this study, direct numerical simulation of the flow around a rotating sphere at high Mach and low Reynolds numbers is conducted to investigate the effects of rotation rate and Mach number upon aerodynamic force coefficients and wake structures. The simulation is carried out by solving the three-dimensional compressible Navier–Stokes equations. A free-stream Reynolds number (based on the free-stream velocity, density and viscosity coefficient and the diameter of the sphere) is set to be between 100 and 300, the free-stream Mach number is set to be between 0.2 and 2.0, and the dimensionless rotation rate defined by the ratio of the free-stream and surface velocities above the equator is set between 0.0 and 1.0. Thus, we have clarified the following points: (1) as free-stream Mach number increased, the increment of the lift coefficient due to rotation was reduced; (2) under subsonic conditions, the drag coefficient increased with increase of the rotation rate, whereas under supersonic conditions, the increment of the drag coefficient was reduced with increasing Mach number; and (3) the mode of the wake structure becomes low-Reynolds-number-like as the Mach number is increased.
For livestock production systems to play a positive role in global food security, the balance between their benefits and disbenefits to society must be appropriately managed. Based on the evidence provided by field-scale randomised controlled trials around the world, this debate has traditionally centred on the concept of economic-environmental trade-offs, of which existence is theoretically assured when resource allocation is perfect on the farm. Recent research conducted on commercial farms indicates, however, that the economic-environmental nexus is not nearly as straightforward in the real world, with environmental performances of enterprises often positively correlated with their economic profitability. Using high-resolution primary data from the North Wyke Farm Platform, an intensively instrumented farm-scale ruminant research facility located in southwest United Kingdom, this paper proposes a novel, information-driven approach to carry out comprehensive assessments of economic-environmental trade-offs inherent within pasture-based cattle and sheep production systems. The results of a data-mining exercise suggest that a potentially systematic interaction exists between ‘soil health’, ecological surroundings and livestock grazing, whereby a higher level of soil organic carbon (SOC) stock is associated with a better animal performance and less nutrient losses into watercourses, and a higher stocking density with greater botanical diversity and elevated SOC. We contend that a combination of farming system-wide trials and environmental instrumentation provides an ideal setting for enrolling scientifically sound and biologically informative metrics for agricultural sustainability, through which agricultural producers could obtain guidance to manage soils, water, pasture and livestock in an economically and environmentally acceptable manner. Priority areas for future farm-scale research to ensure long-term sustainability are also discussed.
The Japanese Antarctic Research Expedition (JARE) has set up automatic weather stations at six sites on a 1000 km long traverse route between Syowa station (21 ma.s.l..) and Dome Fuji station (3810 ma.s.l.) since 1993. Large temperature rises in winter were observed several times in this area. There were two patterns of time delay of the temperature rises. One was that the temperature rise at Mizuho station preceded that at other stations, and the other was that the temperature rise at Dome Fuji station preceded the others. The former occurred when a disturbance came from the coast between east Enderby Land and the Amery Ice Shelf and strong winds destroyed the stable inversion layer. The latter occurred when the low-pressure center was near the coast of west Wilkes Land. in this case, temperature rise was caused by adveclion of warm air. The atmospheric pressure at Dome Fuji station and Relay Point oscillated with a period of 0.5 year and amplitude of about 15hPa. The pressure was higher in July and December, and was accompanied by a temperature rise. Fluctuations of hourly air temperature at Dome Fuji station were approximately twice as large as fluctuations at the other sites. The lapse rale of the annual mean temperature increased with elevation, while the monthly lapse rate was largest in April.
A good correlation was found between the ablation of snow and degree day index (cumulative values of positive daily mean air temperature) during the summer of 1978 on the Yukikabe snow patch in the Daisetsu mountains, central Hokkaido. The volume change of the snow patch in the ablation season of any year can hence be estimated from air temperature using this relationship. Each of the heat-balance terms controlling the ablation is evaluated separately by using empirical equations and assumed values for meteorological parameters at the snow patch. Triangular diagrams are constructed in order to illustrate the relative contributions of sensible heat, latent heat, and net radiation, the main three heat sources. A higher contribution from sensible and latent heat is found for the snow patches of Japan than for many glaciers and ice caps elsewhere. This may be due to higher mid-summer air temperatures than in other glaciated parts of the world.