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Background: Clinical outcomes in neuromyelitis optica spectrum disorders (NMOSD) vary across different regions. Objective: To describe clinical profiles in Japanese and German NMOSD patients. Methods: Medical records of aquaporin-4-immunoglobulin G (AQP4-IgG) positive NMOSD patients from Japan (n = 54) and Germany (n = 38) were retrospectively analyzed. Results: The disability status was similar between both cohorts, although Japanese patients had a longer disease duration (13.3 ± 11.1 vs. 8.1 ± 6.9 years, p = 0.018) but similar relapse rates. Optic neuritis and myelitis were the most frequent attacks in both cohorts. Brain attacks occurred more frequently in Japanese patients (40.7% vs. 15.8%, p = 0.020). The time from disease onset (median [interquartile range] 2.3 [0.3-10.1] vs. 0.6 [0.2-1.9] years, p = 0.009) and the number of attacks (2.5 [1-7] vs. 2 [1-3], p = 0.047) until start of the first immunotherapy were higher in the Japanese cohort. Rituximab was the most common drug in the German cohort (52.6%) and not given in the Japanese cohort (p < 0.001), where oral prednisolone was the most common drug (92.6% vs. 15.8%, p < 0.001). The frequency of autoimmune comorbidities was higher in the German cohort (39.5% vs. 18.5%, p = 0.047). Conclusion: Compared with Japanese NMOSD patients, German patients presented with similar disability despite shorter disease duration and earlier and more frequent immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Background: Clinical outcomes in neuromyelitis optica spectrum disorders (NMOSD) vary across different regions. Objective: To describe clinical profiles in Japanese and German NMOSD patients. Methods: Medical records of aquaporin-4-immunoglobulin G (AQP4-IgG) positive NMOSD patients from Japan (n = 54) and Germany (n = 38) were retrospectively analyzed. Results: The disability status was similar between both cohorts, although Japanese patients had a longer disease duration (13.3 ± 11.1 vs. 8.1 ± 6.9 years, p = 0.018) but similar relapse rates. Optic neuritis and myelitis were the most frequent attacks in both cohorts. Brain attacks occurred more frequently in Japanese patients (40.7% vs. 15.8%, p = 0.020). The time from disease onset (median [interquartile range] 2.3 [0.3-10.1] vs. 0.6 [0.2-1.9] years, p = 0.009) and the number of attacks (2.5 [1-7] vs. 2 [1-3], p = 0.047) until start of the first immunotherapy were higher in the Japanese cohort. Rituximab was the most common drug in the German cohort (52.6%) and not given in the Japanese cohort (p < 0.001), where oral prednisolone was the most common drug (92.6% vs. 15.8%, p < 0.001). The frequency of autoimmune comorbidities was higher in the German cohort (39.5% vs. 18.5%, p = 0.047). Conclusion: Compared with Japanese NMOSD patients, German patients presented with similar disability despite shorter disease duration and earlier and more frequent immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Warm winters and high precipitation in north‐eastern Japan generate snow covers of more than three meters depth and densities of up to 0.55 g cm−3. Under these conditions, rain/snow ratio and snowmelt have increased significantly in the last decade under increasing warm winters. This study aims at understanding the effect of rain‐on‐snow and snowmelt on soil moisture under thick snow covers in mid‐winter, taking into account that snowmelt in spring is an important source of water for forests and agriculture. The study combines three components of the Hydrosphere (precipitation, snow cover and soil moisture) in order to trace water mobility in winter, since soil temperatures remained positive in winter at nearly 0.3°C. The results showed that soil moisture increased after snowmelt and especially after rain‐on‐snow events in mid‐winter 2018/2019. Rain‐on‐snow events were firstly buffered by fresh snow, increasing the snow water equivalent (SWE), followed by water soil infiltration once the water storage capacity of the snowpack was reached. The largest increase of soil moisture was 2.35 vol%. Early snowmelt increased soil moisture with rates between 0.02 and 0.035 vol% hr−1 while, rain‐on‐snow events infiltrated snow and soil faster than snowmelt and resulted in rates of up to 1.06 vol% hr−1. These results showed the strong connection of rain, snow and soil in winter and introduce possible hydrological scenarios in the forest ecosystems of the heavy snowfall regions of north‐eastern Japan. Effects of rain‐on‐snow events and snowmelt on soil moisture were estimated for the period 2012–2018. Rain/snow ratio showed that only 30% of the total precipitation in the winter season 2011/2012 was rain events while it was 50% for the winter 2018/2019. Increasing climate warming and weakening of the Siberian winter monsoons will probably increase rain/snow ratio and the number of rain‐on‐snow events in the near future. [ABSTRACT FROM AUTHOR]