Clues to growth and disruption of two neighbouring spiral arms of the Milky Way

Studying the nature of spiral arms is essential for understanding the formation of the intricate disc structure of the Milky Way. The European Space Agency's Gaia mission has provided revolutionary observational data that have uncovered detailed kinematical features of stars in the Milky Way. However, so far the nature of spiral arms continues to remain a mystery. Here we present that the stellar kinematics traced by the classical Cepheids around the Perseus and Outer spiral arms in the Milky Way shows strikingly different kinematical properties from each other: the radial and azimuthal velocities of Cepheids with respect to the Galactic centre show positive and negative correlations in the Perseus and Outer arms, respectively. We also found that the dynamic spiral arms commonly seen in an N-body/hydrodynamics simulation of a Milky Way-like galaxy can naturally explain the observed kinematic trends. Furthermore, a comparison with such a simulation suggests that the Perseus arm is being disrupted while the Outer arm is growing. Our findings suggest that two neighbouring spiral arms in distinct evolutionary phases - growing and disrupting phases - coexist in the Milky Way.Comment: 8 pages, 7 figures; Submitted to MNRA

食事内容の工夫が咀嚼回数および食事時間や咀嚼行動に対する意識に及ぼす影響

調理法を工夫して食事内容を変えた2種類の被験食において咀嚼回数や食事時間がどのように変化するかを調べた｡また､咀嚼行動に対する意識についてｱﾝｹｰﾄ調査を行い､咀嚼力､咀嚼回数および食事時間との関連性について検討した｡被験食Aに比し､被験食Bは有意にかたい食事内容であった｡咀嚼回数は被験食AとBともに個人差があり､その差はかたい食事内容になるように工夫したBの方が顕著であった｡被験食Aの咀嚼回数と被験食Bの咀嚼回数との間に正の相関を認めた(r=0.799, p<0.01)｡また､被験食Bにおける咀嚼回数と食事時間との間に正の相関を認めた(r=0.727,p<0.01)｡咀嚼力が高い人ほど被験食Aにおける｢自分の一口量｣が多くなり､被験食Bであっても｢噛みごたえ｣をあまり感じていなかった｡We examined how mastication count and meal duration varied with two kinds of test meals that differed in terms of their specifically devised dietary constituents using a cooking method. We also conducted a questionnaire survey to understand the awareness surrounding mastication behavior and examined the relationship between mastication force, mastication frequency, and meal duration. In comparison with test meal A, test meal B contained harder constituents. Mastication frequency was notably different from person to person between test meal A and test meal B owing to the harder constituents in test meal B. A positive correlation existed in terms of mastication count between test meal A and test meal B (r=0.799, p<0.01) . Furthermore, a positive correlation was observed between mastication count and meal duration (r=0.727, p<0.01) for test meal B. The higher the mastication force, the more amount of food per mouthful. Moreover, the chewy feeling was found to be less even in test meal B

病院における摂食･嚥下機能に対応した食事のﾃｸｽﾁｬｰ

佐世保市内の病院で提供されている摂食･嚥下機能に対応した食事(嚥下調整食)について､ﾃｸｽﾁｬｰ測定により数値化して客観的ﾃﾞｰﾀに基づいた食品条件を把握することを目的に､ﾃｸｽﾁｬｰ測定値からみた食事形態の現状を検討した｡嚥下調整食は､同じ食種であっても硬さ､凝集性､付着性の範囲が広く､食事形態には差があった｡病院における提供の目安とﾃｸｽﾁｬｰ測定値からみた UDF の区分や嚥下食ﾋﾟﾗﾐｯﾄﾞのﾚﾍﾞﾙを比較した結果､UDF の区分4の｢かまなくてよい｣を目安に提供している食事には､測定値からみた区分が3の｢舌でつぶせる｣に該当するものもあり､また､嚥下食ﾋﾟﾗﾐｯﾄﾞのﾚﾍﾞﾙ1･2･3の｢嚥下食｣を目安に提供している食事には､測定値からみたﾚﾍﾞﾙが4の｢移行食｣に該当するものもあった｡We analyzed objective data from texture measurements of food for the dysphagia diet provided in a hospital at the Sasebo city, to examine and understand the current food style in this hospital. Dysphagia diets vary in food style (hardness, cohesiveness, and adhesiveness) even when the same kind of food is provided. We compared the classified UDFs with the levels of the standard dysphagia diets provided at hospitals. We found that some foods in Class 4 (i.e., "Do not need to chew") provided in accordance with the standard regulations, actually belonged to Class 3 (i.e., "can crush with the tongue") based on our texture measurements. Moreover, among the classes of food provided under the "dysphagia diet" standard at levels 1, 2, and 3 of the dysphagia diet pyramid, several foods belonged to level 4 of the "transition diet" standard

摂食･嚥下機能に対応した食事に関するｱﾝｹｰﾄ調査

嚥下調整食の提供を取り巻く現状を把握することで､よりよい嚥下調整食の提供に向けた情報の交換･伝達を行うための基礎資料を得ることを目的に､摂食･嚥下機能に対応した食事に関するｱﾝｹｰﾄ調査を行った｡摂食･嚥下等の判定方法について､病院では嚥下造影検査と嚥下内視鏡検査が多かったが､施設では､水飲みﾃｽﾄ､体調の確認など日頃より行える判定方法が採られていた｡摂食･嚥下訓練の実施頻度や訓練によって改善がみられた患者または利用者の割合は､病院･施設で様々であった｡また､摂食･嚥下障害の原因は､病院では加齢が最も多く､次いで脳血管疾患であった｡一方､施設では認知症が最も多かった｡佐世保市内の病院で提供されている嚥下調整食の種類は､1病院あたり平均10種類､1施設あたり平均6種類であった｡また､一般的に用いられている名称以外に病院･施設独自に細分化した名称をつけているところも複数あった｡To understand the present situation for serving the dysphagia diets and gain the basic knowledge and materials for sharing the information necessary to improve the situation, we carried out a questionnaire-based survey of the foods, regarding eating and swallowing function. While videofluoroscopic and endoscopic examinations of swallowing and endoscopic examination were mostly employed at hospitals, easily administered methods such as the water drinking test and physical examination were adopted at welfare facilities for the elderly. The percentage of patients who showed improvement by the implementation of and training in the eating and swallowing exercise varied among hospitals and facilities. In the hospitals, aging was found to be the most prominent cause of difficulty in swallowing, followed by cerebrovascular diseases. On the contrary, in the facilities, dementia was the most frequent cause. On an average, hospitals provided 10 kinds of dysphagia diets, whereas facilities provided 6 kinds of diets, in Sasebo city. Moreover, several hospitals / facilities employed sub-divided names other than the ones generally used

咀嚼能力低下者に対する食事のテクスチャーからみた食品選択と調理法

本研究では、既存のレシピに基づいて調理した介護食について、テクスチャーを測定後、ユニバーサルデザインフード（UDF）に基づいて分類し、調理上の工夫と食品テクスチャーの調整の現状分析を行った。さらに UDF の「容易にかめる」であったものは、UDF の「歯ぐきでつぶせる」「舌でつぶせる」「かまなくてよい」介護食への展開を検討し、咀嚼能力低下者が摂取できる食品の制約を軽減する調理上の工夫を食品テクスチャーから調べた。①食塊を形成しやすくする②かみ切りやすくする③食品の水分含量を保持・増加するという工夫により UDF の「歯ぐきでつぶせる」「舌でつぶせる」「かまなくてよい」にかたさを調整することができ、咀嚼能力低下者の食生活の維持、向上に寄与することが示唆された

Efficacy of salvage therapies for advanced acral melanoma after anti-PD-1 monotherapy failure: a multicenter retrospective study of 108 Japanese patients

BackgroundAnti-programmed cell death protein 1 (PD-1) monotherapy is one of the standard systemic therapies for advanced melanoma; however, the efficacy of salvage systemic therapies after PD-1 monotherapy failure (PD-1 MF), particularly in acral melanoma (AM), the main clinical melanoma type in Japanese patients, is unclear. This study aimed to investigate the efficacy of salvage systemic therapies in Japanese patients with AM after PD-1 MF.Patients and methodsThe study included 108 patients with advanced AM (palm and sole, 72; nail apparatus, 36) who underwent salvage systemic therapy at 24 Japanese institutions. We mainly assessed the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).ResultsThirty-six (33%) patients received ipilimumab, 23 (21%) received nivolumab and ipilimumab (nivo/ipi), 10 (9%) received cytotoxic chemotherapy, 4 (4%) received BRAF and MEK inhibitors (BRAFi/MEKi), and the remaining 35 (32%) continued with PD-1 monotherapy after disease progression. The ORRs in the ipilimumab, nivo/ipi, cytotoxic chemotherapy, and BRAFi/MEKi groups were 8, 17, 0, and 100%, respectively. The nivo/ipi group showed the longest OS (median, 18.9 months); however, differences in ORR, PFS, and OS between the groups were insignificant. The OS in the nivo/ipi group was higher in the palm and sole groups than in the nail apparatus group (median: not reached vs. 8.7 months, p &lt; 0.001). Cox multivariate analysis demonstrated that nail apparatus melanoma independently predicted unfavorable PFS and OS (p = 0.006 and 0.001). The total OS (from PD-1 monotherapy initiation to death/last follow-up) was insignificant between the groups.ConclusionNivo/ipi was not more effective than cytotoxic chemotherapy and ipilimumab after PD-1 MF in patients with advanced AM. The prognosis after PD-1 MF would be poorer for nail apparatus melanoma than for palm and sole melanoma

A case of widespread unilateral subcutaneous sarcoidosis with ocular and pulmonary involvements with seropositivity for anti‐double strand‐DNA antibody and rheumatoid factor: A revisit of gap between humoral autoimmune abnormalities and clinical findings

We present a middle‐aged female Japanese case of subcutaneous sarcoidosis on the unilateral limb with pulmonary and eye involvements, who was seropositive for anti‐double strand DNA antibody and rheumatoid factor. The oculocutaneous and pulmonary lesions were subsided with persisted serological abnormalities. This paper provides updating evidence for the pathogenic significance of humoral autoimmune background in the disease

A Case of Erythema Multiforme Major Developed after Sequential Use of Two Immune Checkpoint Inhibitors, Nivolumab and Ipilimumab, for Advanced Melanoma: Possible Implication of Synergistic and/or Complementary Immunomodulatory Effects

Immune checkpoint inhibitors, such as ipilimumab and nivolumab, reverse the imbalance of antitumor self-tolerance and enhance T-cell responses. Currently, ipilimumab and nivolumab have a reported therapeutic impact on unresectable or metastatic melanomas; however, they also induce immune-related adverse events (irAEs). Ipilimumab-induced cutaneous irAEs are mostly low grade and manageable, although all-grade rash may occur in approximately 45% of all patients. We here report the case of a young woman with erythema multiforme major, which developed after sequential use of these 2 immune checkpoint inhibitors for advanced melanoma of the scalp. Initially, she received 12 cycles of nivolumab monotherapy followed by ipilimumab. A week later, multiple erythematous papulo-erythemas appeared on almost her entire body, with high-grade fever, mucosal involvements, and dyspnea. Immunohistochemistry using the lesioned skin revealed lymphocytic infiltration predominantly positive for CD8, contrasting with those for CD4 and Foxp3. Ipilimumab was stopped but she continued to receive empirical antibiotics; additionally, she was treated with intravenous steroid pulse therapy and immunoglobulin, followed by oral prednisolone. Her symptoms subsided rapidly, allowing a restart of nivolumab monotherapy alone. In our case, the long-standing preceding nivolumab monotherapy may synergistically and/or complementary have contributed to – in combination with the later administration of ipilimumab – recover antigen-responsive T-cell immunity, which is similar to the concept of immune reconstitution inflammatory syndrome, resulting in the establishment of an underlying immunopathology of erythema multiforme and life-threatening airway obstruction