Open Access

Cost-effective length and timing of school closure during an influenza pandemic depend on the severit

Clinical Usefulness of the VS Classification System Using Magnifying Endoscopy with Blue Laser Imaging for Early Gastric Cancer

Background. Blue laser imaging (BLI) enables the acquisition of more information from tumors’ surfaces compared with white light imaging. Few reports confirm the validity of magnifying endoscopy (ME) with BLI (ME-BLI) for early gastric cancer (EGC). We aimed to assess the detailed endoscopic findings from EGCs using ME-BLI. Methods. We enrolled 386 consecutive patients with 417 EGCs that were diagnosed using ME-BLI and resected by endoscopic submucosal dissection. Using the VS classification system, three highly experienced endoscopists (HEEs) and three less experienced endoscopists (LEEs) evaluated the demarcation line (DL), microsurface pattern (MSP), and microvascular pattern (MVP) within the endoscopic images of EGCs obtained using ME-BLI, assigning high-confidence (HC) or low-confidence (LC) levels. We investigated the clinicopathological features associated with each confidence level. Results. The HEEs’ evaluations determined the presence of DL in 99%, irregular MSP in 96%, and irregular MVP in 96%, and the LEEs’ evaluations determined the presence of DL in 98%, irregular MSP in 95%, and irregular MVP in 95% of the EGCs. When DL was present, HC levels in the Helicobacter pylori- (H. pylori-) eradicated group and noneradicated group were evident in 65% and 89%, a difference that was significant (p<0.001). Conclusions. In the diagnosis of EGC with ME-BLI, the VS classification system with ME-NBI can be applied, but identifying the DL after H. pylori was difficult

Design Study of CANGAROO-III, Stereoscopic Imaging Atmospheric Cherenkov Telescopes for sub-TeV Gamma-ray

CANGAROO-III is an Imaging Atmospheric Cherenkov Telescope (IACT) array of four 10 m telescopes for very high energy (sub-TeV) gamma-ray astronomy. A design study of the CANGAROO-III telescope system was carried out using the Monte Carlo technique in order to optimize the pixel size and the telescope spacing. Studies were also made of observations at low elevation angles.Comment: 17pages, 13 figures, elsart, to appear in Astro. Part. Phy

Detection of Gamma-rays around 1TeV from RX J0852.0-4622 by CANGAROO-II

We have detected gamma-ray emission at the 6sigma level at energies greater than 500GeV from the supernova remnant RX J0852.0-4622 (G266.2-1.2) using the CANGAROO-II Imaging Atmospheric Cherenkov Telescope (IACT). The flux was 0.12 times of that of Crab at 1TeV. The signal centroid is consistent with the peak of the X-ray emission in the north-west rim of the remnant.Comment: 12pages, 4figures, to be published in ApJ

Impact of neoadjuvant intensity-modulated radiation therapy on borderline resectable pancreatic cancer with arterial abutment; a prospective, open-label, phase II study in a single institution

BACKGROUND: Borderline resectable pancreatic cancer (BRPC) is a category of pancreatic cancer that is anatomically widely spread, and curative resection is uncommon with upfront surgery. Intensity-modulated radiation therapy (IMRT) is a form of radiation therapy that delivers precise radiation to a tumor while minimizing the dose to surrounding normal tissues. Here, we conducted a phase 2 study to estimate the curability and efficacy of neoadjuvant chemoradiotherapy using IMRT (NACIMRT) for patients with BRPC with arterial abutment (BRPC-A). METHODS: A total of 49 BRPC-A patients were enrolled in this study and were treated at our hospital according to the study protocol between June 2013 and March 2021. The primary endpoint was microscopically margin-negative resection (R0) rates and we subsequently analyzed safety, histological effect of the treatment as well as survivals among patients with NACIMRT. RESULTS: Twenty-nine patients (59.2%) received pancreatectomy after NACIMRT. The R0 rate in resection patients was 93.1% and that in the whole cohort was 55.1%. No mortality was encountered. Local therapeutic effects as assessed by Evans classification showed good therapeutic effect (Grade 1, 3.4%; Grade 2a, 31.0%; Grade 2b, 48.3%; Grade 3, 3.4%; Grade 4, 3.4%). Median disease-free survival was 15.5 months. Median overall survival in the whole cohort was 35.1 months. The only independent prognostic pre-NACIMRT factor identified was serum carbohydrate antigen 19-9 (CA19-9) > 400 U/ml before NACIMRT. CONCLUSIONS: NACIMRT showed preferable outcome without significant operative morbidity for BRPC-A patients. NACIMRT contributes to good local tumor control, but a high initial serum CA19-9 implies poor prognosis even after neoadjuvant treatment. TRIAL REGISTRATION: UMIN-CTR Clinical Trial: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000011776 Registration number: UMIN000010113. Date of first registration: 01/03/2013

Convective storms in closed cyclones in Jupiter's South Temperate Belt: (I) observations

On May 31, 2020 a short-lived convective storm appeared in one of the small cyclones of Jupiter's South Temperate Belt (STB) at planetographic latitude 30.8S. The outbreak was captured by amateur astronomer Clyde Foster in methane-band images, became widely known as Clyde's Spot, and was imaged at very high resolution by the Junocam instrument on board the Juno mission 2.5 days later. Junocam images showed a white two-lobed cyclonic system with high clouds observed in the methane-band at 890 nm. The storm evolved over a few days to become a dark feature that showed turbulence for months, presented oscillations in its drift rate, and slowly expanded, first into a Folded Filamentary Region (FFR), and later into a turbulent segment of the STB over a timescale of one year. On August 7, 2021, a new storm strikingly similar to Clyde's Spot erupted in a cyclone of the STB. The new storm exhibited first a similar transformation into a turbulent dark feature, and later transformed into a dark cyclone fully formed by January 2022. We compare the evolution into a FFR of Clyde's Spot with the formation of a FFR observed by Voyager 2 in 1979 in the South South Temperate Belt (SSTB) after a convective outburst in a cyclone that also developed a two-lobed shape. We also discuss the contemporaneous evolution of an additional cyclone of the STB, which was similar to the one were Clyde's Spot developed. This cyclone did not exhibit visible internal convective activity, and transformed from pale white in 2019, with low contrast with the environment, to dark red in 2020, and thus, was very similar to the outcome of the second storm. This cyclone became bright again in 2021 after interacting with Oval BA. We present observations of these phenomena obtained by amateur astronomers, ground-based telescopes, Hubble Space Telescope and Junocam. This study reveals that short-lived small storms that are active for only a few days can produce complex longterm changes that extend over much larger areas than those initially covered by the storms. In a second paper [In tilde urrigarro et al., 2022] we use the EPIC numerical model to simulate these storms and study moist convection in closed cyclones.We are very thankful to the large community of amateur observers operating small telescopes that submit their Jupiter observations to databases such as PVOL and ALPO-Japan. We are also grateful to two anonymous reviewers for their comments that improved the clarity of this paper. This work has been supported by Grant PID2019-109467GB-I00 funded by MCIN/AEI/10.13039/501100011033/and by Grupos Gobierno Vasco IT1366-19. PI acknowledges a PhD scholarship from Gobierno Vasco. GSO and TM were supported by NASA with funds distributed to the Jet Propulsion Laboratory, California Institute of Technology under contract 80NM0018D0004. C. J. Hansen was sup-ported by funds from NASA, USA to the Juno mission via the Planetary Science Institute. IOE was supported by a contract funded by Europlanet 2024 RI to navigate Junocam images, now available as maps in PVOL at http://pvol2.ehu.eus. Europlanet 2024 RI has received funding from the European Unions Horizon 2020 research and innovation programme under grant agreement No 871149. G.S. Orton, S. R. Brueshaber, T. W. Momary, K. H. Baines and E. K. Dahl were visiting Astronomers at the Infrared Telescope Facility, which is operated by the University of Hawaii under contract 80HQTR19D0030 with the National Aeronautics and Space Administration. In addition, support from NASA Juno Participating Scientist award 80NSSC19K1265 was provided to M.H. Wong. This work has used data acquired from the NASA/ESA Hubble Space Telescope (HST) , which is operated by the Association of 807 Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These HST observations are associated with several HST observing programs: GO/DD 14661 (PI: M.H. Wong) , GO/DD 15665 (PI: I. de Pater) , GO/DD 15159 (PI: M. H. Wong) , GO/DD 15502 (PI: A. Simon) , GO/DD 14661 (PI: M. H. Wong) , GO/DD 16074 (PI: M.H. Wong) , GO/DD 16053 (PI: I. de Pater) , GO/DD 15929 (PI: A. Simon) , GO/DD 16269 (PI: A. Simon) . PlanetCam observations were collected at the Centro Astronomico Hispanico en Andalucia (CAHA) , operated jointly by the Instituto de Astrofisica de Andalucia (CSIC) and the Andalusian Universities (Junta de Andalucia) . This work was enabled by the location of the IRTF and Gemini North telescopes within the Mauakea Science Reserve, adjacent to the summit of Maunakea. We are grateful for the privilege of observing Kaawela (Jupiter) from a place that is unique in both its astronomical quality and its cultural signifi-cance. This research has made use of the USGS Integrated Software for Imagers and Spectrometers (ISIS) . Voyager 2 images were accessed through The PDS Ring-Moon Systems Nodes OPUS search service

A Search for TeV Gamma-ray Emission from the PSR B1259-63/SS2883 Binary System with the CANGAROO-II 10-m Telescope

Observations of the PSR B1259-63/SS2883 binary system using the CANGAROO-II Cherenkov telescope are reported. This nearby binary consists of a 48msec radio pulsar in a highly eccentric orbit around a Be star, and offers a unique laboratory to investigate the interactions between the outflows of the pulsar and Be star at various distances. It has been pointed out that the relativistic pulsar wind and the dense mass outflow of the Be star may result in the emission of gamma rays up to TeV energies. We have observed the binary in 2000 and 2001, 47 and 157 days after the October 2000 periastron. Upper limits at the 0.13--0.54 Crab level are obtained. A new model calculation for high-energy gamma-ray emission from the Be star outflow is introduced and the estimated gamma-ray flux considering Bremsstrahlung, inverse Compton scattering, and the decay of neutral pions produced in proton-proton interactions, is found to be comparable to the upper limits of these observations. Comparing our results with these model calculations, the mass-outflow parameters of the Be star are constrained.Comment: 29 pages, 10 figures, accepted by Ap

Proton Beam Therapy for Large Hepatocellular Carcinoma

PurposeTo investigate the safety and efficacy of proton beam therapy (PBT) in patients with large hepatocellular carcinoma (HCC).Methods and MaterialsTwenty-two patients with HCC larger than 10 cm were treated with proton beam therapy at our institution between 1985 and 2006. Twenty-one of the 22 patients were not surgical candidates because of advanced HCC, intercurrent disease, or old age. Median tumor size was 11 cm (range, 10–14cm), and median clinical target volume was 567 cm3 (range, 335–1,398 cm3). Hepatocellular carcinoma was solitary in 18 patients and multifocal in 4 patients. Tumor types were nodular and diffuse in 18 and 4 patients, respectively. Portal vein tumor thrombosis was present in 11 patients. Median total dose delivered was 72.6 GyE in 22 fractions (range, 47.3–89.1 GyE in 10–35 fractions).ResultsThe median follow-up period was 13.4 months (range, 1.5–85 months). Tumor control rate at 2 years was 87%. One-year overall and progression-free survival rates were 64% and 62%, respectively. Two-year overall and progression-free survival rates were 36% and 24%, respectively. The predominant tumor progression pattern was new hepatic tumor development outside the irradiated field. No late treatment-related toxicity of Grade 3 or higher was observed.ConclusionsThe Bragg peak properties of PBT allow for improved conformality of the treatment field. As such, large tumor volumes can be irradiated to high doses without significant dose exposure to surrounding normal tissue. Proton beam therapy therefore represents a promising modality for the treatment of large-volume HCC. Our study shows that PBT is an effective and safe method for the treatment of patients with large HCC