The Onset of Subtalar Joint Monoarthritis in a Patient with Rheumatoid Arthritis

The involvement of the subtalar joint is uncommon in the early stages of rheumatoid arthritis (RA). We report a case of a 47-year-old female who had RA with isolated subtalar joint arthritis. The clinical history, magnetic resonance imaging, and pathological findings of the patient are presented. A careful evaluation of the patients for chronic ankle-to-heel pain should be conducted, and concomitant evaluation for inflammatory arthritis, including RA, should be considered

Local Gyrokinetic Vlasov Simulations with Realistic Tokamak MHD Equilibria

A local gyrokinetic Vlasov simulation code GKV is extended to incorporate realistic tokamak equilibria including up-down asymmetry, which are produced by a free-boundary 2D Grad-Shafranov equation solver MEUDAS. By using a newly developed interface code IGS, two dimensional rectangular equilibrium data from MEUDAS is converted to straight-field-line flux coordinates such as Hamada, Boozer, and axisymmetric coordinates, which are useful for gyrokinetic micro-instability and turbulent transport analyses. The developed codes have been verified by a cross-code benchmark test using Cyclone-base-case like MHD equilibrium, where good agreement in the dispersion relation of ion temperature gradient (ITG) driven mode has been confirmed. The extended GKV is applied to two types of shaped plasmas expected in JT-60SA tokamak devices, i.e., ITER-like and highly-shaped plasmas, and ITG-mode stability and residual zonal-flow level are investigated. Through the detailed comparisons, more favorable stability properties against the ITG mode are revealed for the highly-shaped case, where the lower ITG-mode growth rate and higher residual zonal-flow levels compared to the ITER-like case are identified

Impact of the COVID-19 Pandemic on Patients with Gastrointestinal Cancer Undergoing Active Cancer Treatment in an Ambulatory Therapy Center: The Patients’ Perspective

Background: The mortality risk increases greatly in patients with cancer if they are infected with severe acute respiratory syndrome coronavirus 2. The new American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) guidelines for the COVID-19 pandemic suggested modifications to the standards of care to reduce harm from treatment. However, it is unclear whether these changes suit the wishes of patients. Methods: We conducted a survey of patients with gastrointestinal cancer who were undergoing active chemotherapy in our ambulatory therapy center between 17 August and 11 September 2020. The survey comprised 18 questions on five topics: patient characteristics, lifestyle changes, disturbance in their psychological health, thoughts on the cancer treatment, and infection control in the hospital. Results: Among the 63 patients who received the questionnaire, 61 participated in the study. The COVID-19 pandemic has led to changes in their lifestyles and substantially impacted their psychological wellbeing. The incidence of anxiety and insomnia has considerably increased during the pandemic. However, female patients and patients aged 70 years or older reported no notable differences. There was no significant difference in the responses to the questions regarding thoughts on the cancer treatment. Conclusion: Our study revealed that the COVID-19 pandemic has substantially impacted patients’ lifestyles and psychological wellbeing. However, most patients preferred to continue their usual treatment without any change to their treatment plan. It is important to involve the patient in the decision-making process when formulating treatment goals