First near-relativistic solar electron events observed by EPD onboard Solar Orbiter

Context. Solar Orbiter, launched in February 2020, started its cruise phase in June 2020, in coincidence with its first perihelion at 0.51 au from the Sun. The in situ instruments onboard, including the Energetic Particle Detector (EPD), operate continuously during the cruise phase enabling the observation of solar energetic particles. Aims. In situ measurements of the first near-relativistic solar electron events observed in July 2020 by EPD are analyzed and the solar origins and the conditions for the interplanetary transport of these particles investigated. Methods. Electron observations from keV energies to the near-relativistic range were combined with the detection of type III radio bursts and extreme ultraviolet (EUV) observations from multiple spacecraft in order to identify the solar origin of the electron events. Electron anisotropies and timing as well as the plasma and magnetic field environment were evaluated to characterize the interplanetary transport conditions. Results. All electron events were clearly associated with type III radio bursts. EUV jets were also found in association with all of them except one. A diversity of time profiles and pitch-angle distributions was observed. Different source locations and different magnetic connectivity and transport conditions were likely involved. The July 11 event was also detected by Wind, separated 107 degrees in longitude from Solar Orbiter. For the July 22 event, the Suprathermal Electron and Proton sensor of EPD allowed for us to not only resolve multiple electron injections at low energies, but it also provided an exceptionally high pitch-angle resolution of a very anisotropic beam. This, together with radio observations of local Langmuir waves suggest a very good magnetic connection during the July 22 event. This scenario is challenged by a high-frequency occultation of the type III radio burst and a nominally non-direct connection to the source; therefore, magnetic connectivity requires further investigation.Agencia Estatal de Investigació

Coexisting sarcoidosis and systemic lupus erythematosus: a case report and literature review

The coexistence of sarcoidosis and SLE in the same patient has uncommonly been reported. Information on the epidemiology, clinical presentation, and management of this rare association is scarce. We report a 46-year-old Hispanic man who was recently diagnosed with concomitant SLE and sarcoidosis at our institution. A diagnosis of sarcoidosis was established due to the presence of dyspnea, fever, and malaise along with bilateral hilar lymphadenopathy and histological evidence of non-caseating granuloma. In addition, he fulfilled the American Rheumatism Association (ACR) criteria for SLE due to a history of photosensitivity, polyarthritis, lymphocytopenia, and positivity of ANA and anti-dsDNA antibodies. He was successfully treated with a combination of oral glucocorticoids, hydroxychloroquine, and methotrexate. In a further step, we conducted an extensive literature review to further investigate into the association of sarcoidosis and SLE. We identified 25 additional published cases. The concurrence of these two conditions may be more common than previously reported, mainly affecting young female adults in the fourth decade of life. The most common manifestation of sarcoidosis was mild pulmonary symptoms whereas SLE presentation was highly variable. Most patients were positive for anti-dsDNA antibodies. Different therapeutic strategies included oral glucocorticoids, hydroxychloroquine, conventional immunosuppressive drugs and, cyclophosphamide in severe cases. Our study reinforces the need of considering the potential concurrence of sarcoidosis and SLE. Clinicians should be aware of the potential presence of SLE in patients with a diagnosis of sarcoidosis presenting with cutaneous manifestations, cytopenia, renal involvement, and/or positivity for ANA and anti-dsDNA antibodies

Automatic Burst Detection in Solar Radio Spectrograms Using Deep Learning: deARCE Method

We present in detail an automatic radio-burst detection system, based on the AlexNet con- volutional neural network, for use with any kind of solar spectrogram. A full methodology for model training, performance evaluation, and feedback to the model generator has been developed with special emphasis on i) robustness tests against stochastic and overfitting ef- fects, ii) specific metrics adapted to the unbalanced nature of the solar-burst scenario, iii) tunable parameters for probability-threshold optimization, and iv) burst-coincidence cross match among e-Callisto stations and with external observatories (NOAA-SWPC). The re- sulting neural network configuration has been designed to accept data from observatories other than e-Callisto, either ground- or spacecraft-based. Typical False Negative and False Positive Scores in single-observatory mode are, respectively, in the 10 ? 16% and 6 ? 8% ranges, which improve further in cross-match mode. This mode includes new services ( deARCE , Xmatch ) allowing the end-user to check at a glance if a solar radio burst has taken place with a high level of confidence.Junta de Comunidades de Castilla La Mancha; European Unio

The first widespread solar energetic particle event observed by Solar Orbiter on 2020 November 29

Context. On 2020 November 29, the first widespread solar energetic particle (SEP) event of solar cycle 25 was observed at four widely separated locations in the inner (.1 AU) heliosphere. Relativistic electrons as well as protons with energies >50 MeV were observed by Solar Orbiter (SolO), Parker Solar Probe, the Solar Terrestrial Relations Observatory (STEREO)-A and multiple near-Earth spacecraft. The SEP event was associated with an M4.4 class X-ray flare and accompanied by a coronal mass ejection and an extreme ultraviolet (EUV) wave as well as a type II radio burst and multiple type III radio bursts. Aims. We present multi-spacecraft particle observations and place them in context with source observations from remote sensing instruments and discuss how such observations may further our understanding of particle acceleration and transport in this widespread event. Methods. Velocity dispersion analysis (VDA) and time shift analysis (TSA) were used to infer the particle release times at the Sun. Solar wind plasma and magnetic field measurements were examined to identify structures that influence the properties of the energetic particles such as their intensity. Pitch angle distributions and first-order anisotropies were analyzed in order to characterize the particle propagation in the interplanetary medium. Results. We find that during the 2020 November 29 SEP event, particles spread over more than 230◦ in longitude close to 1 AU. The particle onset delays observed at the different spacecraft are larger as the flare–footpoint angle increases and are consistent with those from previous STEREO observations. Comparing the timing when the EUV wave intersects the estimated magnetic footpoints of each spacecraft with particle release times from TSA and VDA, we conclude that a simple scenario where the particle release is only determined by the EUV wave propagation is unlikely for this event. Observations of anisotropic particle distributions at SolO, Wind, and STEREO-A do not rule out that particles are injected over a wide longitudinal range close to the Sun. However, the low values of the first-order anisotropy observed by near-Earth spacecraft suggest that diffusive propagation processes are likely involved.Agencia Estatal de Investigació

Cosmic ray observations from Livingston Island

ORCA, from the Spanish name Observatorio de Rayos Cósmicos Antártico, is a cosmic ray detector devoted to the observation of secondary cosmic rays at Juan Carlos I Spanish Antarctic Base (62° 39′ 46″ S, 60° 23′ 20″ W, 12 m above sea level). ORCA was installed at the beginning of January 2019 after performing a latitudinal survey from Vigo (Spain) to Livingston Island aboard the Sarmiento de Gamboa Research Vessel. ORCA was in commissioning phase from January 2019 to March 2020, being in normal operation mode from March 2020. A vertical cutoff rigidity of 2.37GV has been computed at ORCA location and during the first year of operation, i. e. from March 2020 to March 2021. ORCA consists of three detectors stacked in a shared structure that maintains the relative distances between the detectors. A muon telescope (ORCM), a neutron monitor without any shielding around (ORCB) and a 3NM64 neutron monitor (ORCA). This configuration allows the measurement of neutron count rates at two different energy thresholds, muon count rate and muon incident directions. Measurements recorded during the first year of operation and ORCA potential capabilities are shown in this work.Agencia Estatal de Investigació

Rituximab in the treatment of interstitial lung disease associated with autoimmune diseases: experience from a single referral center and literature review

ABSTRACT: In the present study, we aimed to report our experience with rituximab (RTX) in the treatment of patients with ILD associated with AD (AD-ILD) at a single center. For this purpose, clinical characteristics, radiological findings, and pulmonary function tests (PFTs) of RTX-treated AD-ILD-patients seen from May 2016 until March 2020 at a referral center for individuals with ILD were retrospectively reviewed. Additionally, an updated literature review was conducted. A total of 26 patients (mean age 58.3 ± 11.1 years at ILD diagnosis) was included. The most common ADs related to ILD were systemic sclerosis, idiopathic inflammatory myositis (including anti-synthetase syndrome) and rheumatoid arthritis. Non-specific interstitial pneumonia (n = 12) and usual interstitial pneumonia (n = 11) were the predominant radiological patterns. The sustained improvement in PFTs was observed from the start of RTX, with a statistically significant increase in DLCO from basal to one year after RTX (mean + 4.2%, p = 0.024). Overall, there were no differences when comparing PFT outcome according to the radiological pattern or the specific type of AD. In conclusion, RTX constitutes a good therapeutic option to preserve lung function in patients with AD-ILD, regardless of the radiological pattern or the underlying AD.This research received no external funding. B.A.-M. is recipient of a and “López Albo” Post-Residency Programme funded by Servicio Cántabro de Salud. S.R.-M. is supported by funds of the RETICS Program (RD16/0012/0009) (Instituto de Salud Carlos III, co-funded by the European Regional Development Fund)

The Spectrum of Interstitial Lung Disease Associated With Autoimmune Diseases: Data of a 3.6-Year Prospective Study From a Referral Center of Interstitial Lung Disease and Lung Transplantation

Interstitial lung disease (ILD) may occur in patients with a rheumatic autoimmune disease (AD), increasing their risk of morbidity and mortality. However, little is known about the prevalence of AD in patients diagnosed with an ILD. In this prospective study, we determined the spectrum of ILD associated with AD (AD-ILD) among patients sent for assessment to a single clinic of ILD and lung transplantation from a referral center between May 2016 and December 2019. ILD diagnosis was made by pneumologists based on clinical and radiological findings and pulmonary function test abnormalities. All patients with ILD were also assessed by experienced rheumatologists. During the period of assessment, 338 patients were diagnosed with ILD. Among them, 32.8% fulfilled definitions for an AD. Most cases with AD-ILD had a diagnosis of rheumatoid arthritis (27.0%), systemic sclerosis (26.1%) or anti-synthetase syndrome (17.1%). Interestingly, 18% of the patients with AD-ILD were diagnosed as having an interstitial pneumonia with autoimmune features. Antinuclear antibodies and non-specific interstitial pneumonia were the most frequent positive autoantibodies and radiological pattern found in AD-ILD patients, respectively. In conclusion, our study indicates that a high number of ILD patients have a related AD. Consequently, close collaboration among rheumatologists and pneumologists is needed.This research received no external funding. SR-M is supported by funds of the RETICS Program (RD16/0012/0009) (Instituto de Salud Carlos III, co-funded by the European Regional Development Fund)

Endothelial Progenitor Cells: Relevant Players in the Vasculopathy and Lung Fibrosis Associated with the Presence of Interstitial Lung Disease in Systemic Sclerosis Patients

Endothelial progenitor cells (EPC), which are key effectors in the physiologic vascular network, have been described as relevant players in autoimmune diseases. We previously showed that EPC frequency may help to identify the presence of interstitial lung disease (ILD) in rheumatoid arthritis patients. Given that ILD constitutes the main cause of mortality in systemic sclerosis (SSc) patients, we aimed to determine the EPC contribution to the pathogenic processes of vasculopathy and lung fibrosis in SSc-ILD+. EPC quantification was performed by flow cytometry on blood from 83 individuals: 21 SSc-ILD+ patients and subjects from comparative groups (20 SSc-ILD- and 21 idiopathic pulmonary fibrosis (IPF) patients and 21 healthy controls (HC)). EPC were considered as CD34+, CD45low, CD309+, and CD133+. A significant increase in EPC frequency was found in SSc-ILD+ patients when compared to HC (p < 0.001). SSc-ILD+ patients exhibited a higher EPC frequency than SSc-ILD- patients (p = 0.012), whereas it was markedly reduced compared to IPF patients (p < 0.001). EPC frequency was higher in males (p = 0.04) and negatively correlated to SSc duration (p = 0.04) in SSc-ILD+ patients. Our results indicate a role of EPC in the processes of vasculopathy and lung fibrosis in SSc-ILD+. EPC frequency may be considered as a biomarker of ILD in SSc patients.V.P.-C. is supported by a pre-doctoral grant from IDIVAL [PREVAL 18/01]. S.R.-M. is supported by funds from the RETICS Program [RD16/0012/0009, Instituto de Salud Carlos III (ISCIII), co-funded by the European Regional Development Fund (ERDF)]. B.A.-M. is a recipient of a ‘López Albo’ Post-Residency Programme funded by Servicio Cántabro de Salud. L.L.-G. is supported by funds from INNVAL20/06 (IDIVAL). R.P.-F. is supported by funds from the START project [FOREUM18/34]. O.G. is staff personnel of Xunta de Galicia (Servizo Galego de Saude (SERGAS) through a research-staff stabilization contract (ISCIII/SERGAS), and his work is funded by ISCIII and the ERDF [grants RD16/0012/0014 (RIER) and PI17/00409]. He is a beneficiary of project funds from the Research Executive Agency (REA) of the European Union in the framework of MSCA-RISE Action of the H2020 Programme, project 734899—Olive-Net. R.L.-M. is a recipient of a Miguel Servet type I fellowship [ISCIII, co-funded by the European Social Fund, ‘Investing in your future’, CP16/00033]

Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Interstitial lung disease (ILD) increases morbidity and mortality in patients with rheumatoid arthritis (RA). Although the pathogenesis of ILD associated with RA (RA-ILD+) remains poorly defined, vascular tissue is crucial in lung physiology. In this context, endothelial progenitor cells (EPC) are involved in endothelial tissue repair. However, little is known about their implication in RA-ILD+. Accordingly, we aimed to investigate the potential role of EPC related to endothelial damage in RA-ILD+. EPC quantification in peripheral blood from 80 individuals (20 RA-ILD+ patients, 25 RA-ILD? patients, 21 idiopathic pulmonary fibrosis (IPF) patients, and 14 healthy controls) was performed by flow cytometry. EPC were considered as CD34+, CD45low, CD309+ and CD133+. A significant increase in EPC frequency in RA-ILD+ patients, as well as in RA-ILD? and IPF patients, was found when compared with controls (p < 0.001, p = 0.02 and p < 0.001, respectively). RA-ILD+ patients exhibited a higher EPC frequency than the RA-ILD? ones (p = 0.003), but lower than IPF patients (p < 0.001). Our results suggest that EPC increase may represent a reparative compensatory mechanism in patients with RA-ILD+. The degree of EPC frequency may help to identify the presence of ILD in RA patients and to discriminate RA-ILD+ from IPFThis work was partially supported by the European Regional Development Fund (ERDF) and ‘Fondo de Investigación Sanitaria’ [PI18/00043] from Instituto de Salud Carlos III (ISCIII), Health Ministry, Spain. VP-C is supported by a pre-doctoral grant from IDIVAL [PREVAL 18/01]. SR-M is supported by funds of RETICS Program [RD16/0012/0009, ISCIII, co-funded by ERDF]. BA-M is a recipient of a ‘López Albo’ Post-Residency Programme funded by Servicio Cántabro de Salud. LL-G is supported by funds of ISCIII, co-funded by ERDF [PI18/00042]. OG is beneficiary of a grant funded by Xunta de Galicia, Consellería de Educación, Universidade Formación Profesional and Consellería de Economía, Emprego e Industria (GAIN), GPC IN607B2019/10. RL-M is a recipient of a Miguel Servet type I fellowship [ISCIII, co-funded by European Social Fund—ESF, CP16/00033]