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The objective of this retrospective study was to describe the clinical and histopathological findings associated with intranasal tumours in degus.Medical records of degus diagnosed with intranasal neoplasms on histopathological examination between the years 2007 and 2020 at one hospital were included in the study.Twenty degus (10 males and 10 females) were eligible for inclusion. Initial clinical signs included sneezing, abnormal nasal sounds, and nasal discharge, followed by anorexia and frequent nose rubbing. On radiography, 15 out of 20 animals showed space-occupying lesions in the nasal cavity. CT was performed in 16 animals and revealed various degrees of changes, including abnormal radiopacity within the nasal cavity and damaged nasal septum. Rhinostomy and excisional biopsy was performed in all 20 animals. Six out of 20 patients died during the perioperative period. Six and seven degus survived for 3 months and 1 year, respectively. One animal was lost to follow-up. In 16 cases the histological diagnosis was consistent with fibromas, while in 4 cases with osteomas.Intranasal neoplasms in degus are mostly benign mesenchymal tumours with various degrees of bone formation, which is unique to this animal species. This occurrence should be considered as an important differential diagnosis for upper respiratory tract disease in degus.

In Taiwan, older adults with cognitive impairment who undergo hip-fracture surgery are routinely cared for by family members. This study aimed to determine if nutritional status influenced the effects of a family-centered intervention for older adults with cognitive impairment recovering from hip-fracture surgery.Secondary data analysis of data from a randomized controlled trial was conducted to examine the influences of nutritional status 1 month after hospital discharge on the effects of a family-centered care intervention model, which was designed for older adults with hip fracture and cognitive impairment. Outcomes were compared among participants according to nutrition status (well-nourished/poorly-nourished) and treatment approach (control/intervention).The original study was conducted at a 3000-bed medical center from July 2015 to October 2019.Participants were older adults with cognitive impairment who had undergone hip-fracture surgery. Participants were assessed as poorly-nourished or well-nourished with the Mini-Nutritional Assessment (MNA) 1-month post-discharge and were then randomly assigned to either the intervention group or control group.A family-centered intervention model for family caregivers of older adults with cognitive impairment recovering from hip-fracture surgery was implemented. The intervention was delivered by geriatric nurses, which included instructions for family caregivers in overseeing exercises for strengthening the hip, understanding dietary requirements, and managing behavioral problems associated with cognitive impairment.Outcome measures included activities of daily living (ADLs), instrumental ADLs, hip range of motion, hip muscle strength, depression, measured with the Geriatric Depressive Scale, and physical and mental health related quality of life, measured with the Short Form Survey (SF-36), Taiwanese version. Participants were assessed at 1-, 3-, 6-, and 12-months post-discharge.Most of the 134 participants were assessed as poorly nourished (n = 122); 57 were the control group and 65 received the intervention. For the well-nourished participants (n = 12), four were in the intervention group and eight were controls. There were no significant differences in any outcome variables for poorly nourished participants who received the intervention compared with controls. For the sample of well-nourished participants, those who received the intervention performed significantly better in outcomes of IADLs (b = 1.74, p.05), hip muscle strength (b = 9.64, p.01), and physical health related quality of life (b = 10.47, p.01).The family-centered care intervention was only effective for older adults with cognitive impairment recovering from hip-fracture surgery who were well-nourished at 1 month following hospital discharge, but not for those at risk of malnutrition. Interventions should focus on enhancing nutritional status following hip surgery which could allow the family-centered in-home intervention to be beneficial for more older adults with cognitive impairment recovering from hip-fracture surgery.

Background The lack of better understanding of the pathophysiology and cellular mechanisms associated with high mortality seen in hepatic encephalopathy (HE), a neurological complication arising from acute hepatic failure, remains a challenging medical issue. Clinical reports showed that the degree of baroreflex dysregulation is related to the severity of HE. Furthermore, mitochondrial dysfunction in the rostral ventrolateral medulla (RVLM), a key component of the baroreflex loop that maintains blood pressure and sympathetic vasomotor tone, is known to underpin impairment of baroreflex. Realizing that in addition to angiogenic and vasculogenic effects, by acting on its key receptor (VEGFR2), vascular endothelial growth factor (VEGF) elicits neuroprotection via maintenance of mitochondrial function, the guiding hypothesis of the present study is that the VEGF/VEGFR2 signaling plays a protective role against mitochondrial dysfunction in the RVLM to ameliorate baroreflex dysregulation that underpins the high fatality associated with HE. Methods Physiological, pharmacological and biochemical investigations were carried out in proof-of-concept experiments using an in vitro model of HE that involved incubation of cultured mouse hippocampal neurons with ammonium chloride. This was followed by corroboratory experiments employing a mouse model of HE, in which adult male C57BL/6 mice and VEGFR2 wild-type and heterozygous mice received an intraperitoneal injection of azoxymethane, a toxin used to induce acute hepatic failure. Results We demonstrated that VEGFR2 is present in cultured neurons, and observed that whereas recombinant VEGF protein maintained cell viability, gene-knockdown of vegfr2 enhanced the reduction of cell viability in our in vitro model of HE. In our in vivo model of HE, we found that VEGFR2 heterozygous mice exhibited shorter survival rate and time when compared to wild-type mice. In C57BL/6 mice, there was a progressive reduction in VEGFR2 mRNA and protein expression, mitochondrial membrane potential and ATP levels, alongside augmentation of apoptotic cell death in the RVLM, accompanied by a decrease in baroreflex-mediated sympathetic vasomotor tone and hypotension. Immunoneutralization of VEGF exacerbated all those biochemical and physiological events. Conclusions Our results suggest that, acting via VEGFR2, the endogenous VEGF plays a protective role against high fatality associated with HE by amelioration of the dysregulated baroreflex-mediated sympathetic vasomotor tone through sustaining mitochondrial bioenergetics functions and eliciting antiapoptotic action in the RVLM.

In modern extreme ultraviolet (EUV) lithography machines, sensitive optical components, such as multilayer mirrors and photomasks, may be affected by plasma interactions. The new 13.5 nm EUV-beam-line 2, designed to provide accelerated tests for next generation lithography, is used to investigate EUV-induced plasma phenomena. First systematic measurements of ion fluxes produced in EUV-induced hydrogen plasma are reported, with operating conditions including 5 and 20 Pa gas pressure, 3 kHz EUV pulse repetition rate, and 4.2 W total EUV beam power produced in a 10–15 ns EUV pulse. Space- and time-resolved distributions of ion fluxes and ion energies were measured using a retarding-field ion energy analyzer mounted next to the EUV beam. Typical ion energies were in the range of 1–8 eV and typical ion fluxes were in the range of 2–8 × 1017 ions m−2 s−1. The obtained ion fluxes are applied in a photomask lifetime test to understand the material effects after an EUV exposure.

Little is known about whether venous thromboembolism (VTE) causes worse critical limb events in populations with atrial fibrillation (AF). A retrospective cohort study using claims data from Taiwan’s National Health Insurance program between 2001 and 2013 compared AF patients with or without VTE. Outcomes were percutaneous transluminal angioplasty (PTA), amputation, systemic thromboembolism, all-cause mortality, cardiovascular death, ischemic stroke, and acute myocardial infarction. Patients ( n = 316,817) with newly diagnosed AF were analyzed; of those, 2514 (0.79%) had VTE history. After inverse probability of treatment weighting, a history of VTE was significantly associated with higher risks of PTA (3.3 vs 2.2%; subdistribution hazard ratio [SHR] 1.47; 95% confidence interval [CI] 1.17–1.84); above knee amputation (0.7 vs 0.3%; HR 2.15; 95% CI 1.10–4.21); systemic thromboembolism (5.8 vs 3.9%; SHR 1.48; 95% CI 1.21–1.80); all-cause mortality (53 vs 46.4%; HR 1.20, 95% CI 1.12–1.29); and cardiovascular death (34.8 vs 29.4%; HR 1.25, 95% CI 1.14–1.36). In conclusion, VTE might increase the risk of critical lower limb events (PTA and above-knee amputation), systemic thromboembolism, and mortality in the AF population. However, current data cannot confirm a causal relationship between VTE and clinical outcomes in this population.

Objective The aim of this study was to explore the relationship between preoperative right ventricular (RV) function and high vasoactive-inotropic score (VIS) after cardiac surgery. Design Prospective observational study. Setting A single medical center setting. Participants One hundred three patients undergoing elective cardiac surgery. Interventions None. Measurements and Main Results Consecutive patients referred for cardiac surgery were enrolled prospectively. Comprehensive transesophageal echocardiography was performed before sternal incision. Specific RV indices, encompassing RV fractional area change, tricuspid annular plane systolic excursion, and RV global longitudinal strain (RVGLS), were measured offline. High VIS was defined as a maximum VIS of ≥20 in 24 hours postoperatively. Postoperative adverse events were recorded. One hundred three patients (mean age 61.2 ± 11.0, 72 men) were included in this study, where 17 patients (16.5%) achieved high VIS with a mean maximum VIS of 39 in 24 hours postoperatively. Patients with high VIS encountered increased occurrence of extracorporeal membrane oxygenation placement, acute kidney injury, and mortality. Risk factors for high VIS included operation type, cardiopulmonary bypass duration, left atrium size, and pre-incisional RV indices. After adjustment for age, left ventricular ejection fraction, and the covariates, only RVGLS (odds ratio 1.19, p = 0.011) showed an independent association with high VIS. The optimal cutoff of RVGLS was −16.7% (sensitivity of 88.2%, specificity of 75.6%). Conclusion Preoperative RV dysfunction is an independent risk factor for postoperative high VIS. Pre-incisional RVGLS is a reliable tool to predict high VIS after cardiac surgery. Patients with high VIS had increased adverse events postoperatively.

The aim of this study was to explore the effects of long non-coding ribonucleic acid (lncRNA) placenta-specific protein 2 (PLAC2) on the biological behaviors of gastric cancer (GC) cells by regulating the expression of c-Myc gene and its mechanism.The expression of PLAC2 in GC tissues and different GC cell lines was detected via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). The effects of PLAC2 on apoptosis and cycle, migration, and invasion of GC cells were detected using flow cytometry, wound healing assay, and transwell assay, respectively. After interference in PLAC2 expression, the changes in c-Myc expression were determined through qRT-PCR and Western blotting.The expression level of PLAC2 was downregulated in 38 out of 45 cases of GC tissues compared with that in normal gastric tissues, and it also declined in GC cells. The results of flow cytometry showed that after overexpression of PLAC2, the cell cycle was arrested in the G1/G0 phase, and the apoptosis rate was increased. The results of wound healing assay and transwell assay revealed that both migration and invasion of GC cells were inhibited. After overexpression of PLAC2, the mRNA and protein expression levels of c-Myc declined.LncRNA PLAC2 affects the biological behaviors of GC cells by regulating the expression of c-Myc gene.

We give the results of parameter fitting of the magnetic clouds (MCs) observed by the Wind spacecraft for the three year period – 2004 to the end of 2006 (the “Present period”) using the force-free MC model of Lepping, Jones, and Burlaga (J. Geophys. Res.95, 11957, 1990). There were 19 MCs identified in the Present period, which was mainly in the declining phase of the solar cycle. The long-term occurrence rate of MCs is 10.3/year (1995-2015), whereas the occurrence rate for the Present period is only 6.3/year, similar to that for the period 2007-2009. Hence, the MC occurrence rate has had an appreciable decrease for the six years 2004-2009. The MC modeling gives such basic MC quantities as size, axial orientation, field handedness, axial magnetic field strength, center time, and closest approach vector. A statistically based modification of the modeled field intensity is tested. Also calculated are derived quantities, such as axial magnetic flux, axial current density, and axial current. Quality ( $Q_{0}$ ) estimates are assigned representing excellent (1), good/fair (2), and poor (3). We provide error estimates on the specific fit parameters for the individual MCs for the $Q_{0} =1,2$ cases, and give a distribution of MC types (i.e. N ⇒ S, S ⇒ N, All N, All S, etc., ten categories in all). There is an inordinately large percentage of the N ⇒ S type in the Present period (32%). The Present period basic model fitting results are compared to the results of the full Wind mission and other 3-year periods. First, we notice that during the Present period the MCs are, on average, significantly faster (by 21%), distinctly stronger in axial magnetic field (by 37%), and smaller in diameter (by 5.5%), than those in the Long-term period. The quality of the MCs in the Present period is significantly better than that of the Long-term period, where the ratio $N(Q_{0} =1,2)/N(Q_{0} =1,2,3)$ for each is 0.79 and 0.58, respectively. The Present period is quite different from the Long-term period (1995-2015), it is from the other three 3-year periods between 2006 and the end of 2015. In the Present period upstream shocks occur for the first 12 MCs of the 19 cases (63%); for comparison the Long-term rate is 56%.

The accuracy of data-driven magnetohydrodynamics (MHD) models depends on accurate boundary conditions specified at the inner heliosphere. However, not all of the MHD parameters [$\boldsymbol{B}, \boldsymbol{v}, \rho , T$] are measurable close to the Sun at the present time, except the vector magnetic field [$\boldsymbol{B} $] at the photosphere. The solar wind speed [$\boldsymbol{v}$], which is probably most relevant to space-weather forecasting, is often modeled by the standard Wang–Sheeley (WS) formula, which is based on an inverse relationship between the solar wind speed [$\boldsymbol{v}$] at 1 AU and the expansion factor [$f_{\text{s}}$] estimated at 2.5 solar radii [$\text{R}_{ \odot }$], with the following generic form: ${v} = {v}_{1} + {v}_{2} f_{\text{s}}^{- \alpha }$ (where $\boldsymbol{v}$ is the solar wind speed at 18 $\text{R}_{\odot }$, $f_{\text{s}}$ is the magnetic-field expansion factor, and ${v}_{1}$, ${v}_{2}$, and $\alpha $ are three free parameters to be determined). While the WS formula uses “source projection” to determine the solar wind source, it does not treat the solar wind as plasma because it uses the solar wind speed observed at 1 AU to derive the empirical relationship. Thus, the resulting formula ignores the transport and acceleration of the solar wind as it propagates out into the heliosphere. The purpose of this study is to rectify this omission by using a numerical MHD simulation to find the optimal set of free parameters that relate the magnetic properties at the source surface to the plasma parameters at 1 AU. In addition to the expansion factor, conservation of mass [$\rho \boldsymbol{v}$], magnetic flux [$r ^{2} B$], and total pressure along the stream line are assumed to obtain the solar wind mass density, magnetic field, and temperature at 18 $\text{R}_{\odot }$. These parameters are used as the inner boundary conditions of our global three-dimensional MHD (G3DMHD) code to simulate solar wind plasma and field parameters out to ${\approx}\, 1~\mbox{AU}$. The simulation results are compared with the in-situ data from Wind to assess the accuracy. Such a procedure is repeated (880 times) to cover the three parameter regimes ($100 < {v}_{1} < 350~\mbox{km}\,\mbox{s}^{-1}$; $250 < {v}_{2} < 700~\mbox{km}\,\mbox{s}^{-1}$; and $0.2 < \alpha < 0.9$) to find the optimal set. The simulation is performed for the period of CR2082 [30 March 2019 to 27 April 2009]. It is found that $\boldsymbol{v} = 189 + 679 f_{\text{s}}^{-0.7}$ is the best formula to relate the solar wind speed at 18 $\text{R}_{\odot }$ to the expansion factor. Strictly speaking, this formula is most applicable for solar equatorial regions and near the times of solar minimum when there are few coronal mass ejection events.

China is ranked first by greenhouse area in the world; pesticide application using knapsack electric sprayers is the main tool used in these settings to prevent and control plant diseases and insect pests. This is the first report of an exposure assessment for 60 greenhouse operators to the insecticide clothianidin when applied with knapsack electric sprayers. The commercial clothianidin formulation used in the field trials was a 20% suspension concentrate. The assessment was based on the whole-body dosimetry method and a personal air sampler fitted with an XAD-2 resin tube located in the operator’s breathing zone to monitor dermal and inhalation exposure, respectively. During application, the total dermal unit exposure was 598.71 mg/kg. The leg was the largest exposure area, accounting for about 53% of total dermal exposure. Meanwhile, inhalation exposure was only 0.50 mg/kg. The margin of exposure was much greater than 100 in all cases, indicating that the risk is controllable with the use of protection equipment and comparable to that of the manual application of treated soil.

T cells and dendritic cells (DCs) that are positive for the tissue-resident marker CD103 play a vital role in antitumor immunity. In this study, multiplexed immunohistochemistry was applied to stain CD103 and the T-cell marker CD8 as well as the DC marker CD11c on formalin-fixed, paraffin-embedded oral squamous cell carcinoma (OSCC) tissues. Then, the density of CD103

In early September 2017, a series of solar flares and coronal mass ejections (CMEs) erupted from the Sun. The Cor2a coronagraph, a unit of the Sun Earth Connection Coronal and Heliospheric Investigation (SECCHI), onboard the Solar Terrestrial Relations Observatory (STEREO)-A spacecraft recorded two Sun–Earth-directed CMEs on 4 September (referred to as CME04) and 6 September (referred to as CME06). A few days later, the Wind spacecraft ( ${\approx}\,212.4$ solar radii: $\mathrm{R}_{\odot}$ ) recorded two interplanetary shocks, presumably driven by CME04 and CME06, at ${\approx}\,22\mbox{:}41~\mbox{UT}$ on 06 September 2017 (referred to as Shock06) and at ${\approx}\,22\mbox{:}48~\mbox{UT}$ on 07 September 2017 (referred to as Shock07), respectively. The travel time of the CME04/Shock06 [ $\Delta t_{\text{shock-CME@18R}\odot}$ ] and CME06/Shock07 from $18~\mathrm{R}_{\odot}$ to the Wind spacecraft was 41.52 hours and 32.47 hours, respectively. The propagating speed [ $V_{\mathrm{CME}}$ ] of the CME04 and CME06 at ${\approx}\,18~\mathrm{R}_{\odot}$ was determined with SECCHI/Cor2a as ${\approx}\,886~\mbox{km}\,\mbox{s}^{-1}$ and ${\approx}\,1368~\mbox{km}\,\mbox{s}^{-1}$ , respectively. Assuming a constant velocity after $18~\mathrm{R}_{\odot }$ , the estimated $\Delta t_{\text{shock-CME@18R}\odot}$ is 42.45 and 27.5 hours for CME04 and CME06, respectively. This simple estimate of the CME propagation speed provides a satisfactory result for the CME04 event (error ${\approx}\,2.3\%$ ) but not for the CME06 event (error ${\approx}\,15.3\%$ ). The second event, CME06, was delayed further due to an interaction with the preceding event (CME04). It is suggested that the CME speed estimated near the Sun with coronagraph images can be a good estimator for the interplanetary CME (ICME) transit time when there is no pre-event. A three-dimensional magnetohydrodynamic simulation is performed to address this issue by providing a panoramic view of the entire process not available from the observations. A southward interplanetary magnetic field [ $B_{\mathrm{s}}$ ] increased sharply to −31.6 nT on 7 September at Wind, followed by a severe geomagnetic storm ( $\mathrm{Dst} = -124~\mbox{nT}$ ). The sharp increase of the IMF [ $B_{\mathrm{s}}$ ] was a result of the interaction between Shock07 and the driver of Shock06 (CME04). This study suggests that a severe geomagnetic storm can be caused by the interaction between a MC, with an impinging IP shock from behind, and the Earth’s magnetosphere. The intensity of a geomagnetic storm will likely be stronger for an event associated with ICME–ICME interaction than for a geomagnetic event caused by only a single ICME.

Past independent studies of the heliospheric plasma sheet (HPS) have shown that the thickness is highly variable, ranging from $\approx 3.8 \times 10^{5}$ to $8.9 \times 10^{6}$ km. Here we conduct a survey of the previous results and find a solar cycle dependence – where the HPS tends to be wider during solar-minimum years and narrower during solar-maximum years. The HPS is thicker near solar minimum than near solar maximum by a factor of 1.6 (in Solar Cycle 23) and 8 (in Solar Cycle 24). We also found that the average HPS thickness in 2007 (near the minimum of Solar Cycle 23/24) was almost ten times larger than that in 1995 (near minimum of Solar Cycle 22/23), and it was associated with a weak polar magnetic field in 2007. Based on the solar-surface-field measurements, we found that the average solar magnetic-field strength [ $| \boldsymbol{B}|$ ] at 2.5 solar radii [R⊙] was $\approx 40$ % larger in 1995 than in 2007 (0.22 gauss versus 0.16 gauss). We also found a larger ( $\approx 27 $ %) magnetic pressure-gradient force in 1995 than in 2007. Because this magnetic gradient force points toward the Equator in the corona (which is probably also true farther out), a wider HPS is expected to occur in 2007 than in 1995, at least close to the Sun. This result supports the so-called heliospheric plasma-sheet inflation hypothesis, i.e. the HPS is wider if the Sun’s polar field is weaker and narrower if the Sun’s polar field is stronger.

SUMMARY The survival advantage associated with the addition of surgical therapy in esophageal squamous cell carcinoma (ESCC) patients who demonstrate a complete clinical response to chemoradiotherapy is unclear, and many institutions have adopted an organ-preserving strategy of selective surgery in this population. We sought to characterize our institutional experience of salvage esophagectomy (for failure of definitive bimodality therapy) and planned esophagectomy (as a component of trimodality therapy) by retrospectively analyzing patients with ESCC of the thoracic esophagus and GEJ who underwent esophagectomy following chemoradiotherapy between 2004 and 2016. Of 76 patients who met inclusion criteria, 46.1% (35) underwent salvage esophagectomy. Major postoperative complications (major cardiovascular and pulmonary events, anastomotic leak [grade ≥ 2], and 90-day mortality) were frequent and occurred in 52.6% of the cohort (planned resection: 36.6% [15/41]; salvage esophagectomy: 71.4% [25/35]). Observed rates of 30- and 90-day mortality for the entire cohort were 7.9% (planned: 7.3% [3/41]; salvage: 8.6% [3/35]) and 13.2% (planned: 9.8% [4/41]; salvage: 17.1% [6/35]), respectively. In summary, esophagectomy following chemoradiotherapy for ESCC at our institution has been associated with frequent postoperative morbidity and considerable rates of mortality in both planned and salvage settings. Although a selective approach to surgery may permit organ preservation in many patients with ESCC, these results highlight that salvage esophagectomy for failure of definitive-intent treatment of ESCC may also constitute a difficult clinical undertaking in some cases.

Whereas cadmium is a toxicant that has been shown to cause cardiovascular toxicity and mortality in mammals, few mechanistic studies address its acute circulatory actions. The present study assessed the hypothesis that cadmium effects dose-dependent acute circulatory fates via differential participation of the cardiovascular regulatory mechanisms in brain. In Sprague-Dawley rats maintained under propofol anesthesia, cadmium acetate (8 mg/kg, iv) induced significantly high mortality rate within 10 min, concomitant with progressive decline toward zero level of mean arterial pressure (MAP), heart rate (HR), baroreflex-mediated sympathetic vasomotor tone, and carotid blood flow (CBF). There were concurrent tissue anoxia, cessation of microvascular perfusion, reduction of mitochondrial membrane potential and ATP production, and necrotic cell death in the rostral ventrolateral medulla (RVLM), the brain stem site that maintains blood pressure and sympathetic vasomotor tone. On the other hand, a lower-dose of cadmium (4 mg/kg, iv) resulted in only a transient decrease in MAP that was mirrored by an increase in CBF and baroreflex-mediated sympathetic vasomotor tone, minor changes in HR, along with transient hypoxia, and apoptotic cell death in RVLM. We conclude that cadmium elicits dose-dependent acute cardiovascular effects with differential underlying biochemical and neural mechanisms. At a higher-dose, cadmium induces high mortality by effecting acute cardiovascular collapse via anoxia, diminished tissue perfusion, mitochondrial dysfunction and bioenergetics failure that echo failure of cerebral autoregulation, leading to necrosis, and loss of functionality in RVLM. On the other hand, a lower-dose of cadmium elicits low mortality, transient decrease in arterial pressure, and hypoxia and apoptosis in RVLM that reflect sustained cerebral autoregulation.

SUMMARY During peroral endoscopic myotomy (POEM), creation of the tunnel is highly technically demanding and mucosal injury is one of the most common potential complications. We explored a method without a submucosal tunnel, which we call open peroral endoscopic myotomy (O-POEM). This study aimed to assess the feasibility and safety of O-POEM. O-POEM was performed on 82 patients with achalasia. Treatment success was defined as an Eckardt score of less than or equal to 3 after the myotomy. Adverse events including operative and postoperative adverse events were recorded. Treatment success and procedure-related adverse events were analyzed. After a median follow-up of 18 months (range: 6–26 months), the treatment success (Eckhart score ≤3) was achieved in 96.3% of cases (mean score pre- vs. post-treatment (7.4 vs. 1.8); P < 0.001) with a recurrence of 3 cases. Ten patients (12.2%) had adverse events consisting of 2 cases of mediastinitis, 1 case of post-O-POEM bleeding, 1 case of subcutaneous emphysema, 6 cases of pleural effusion. Two cases of mediastinitis required intraprocedural drainage, and other patients were managed by endoscopy and conservative medical treatment. There were no deaths. No patients required surgical conversion. Clinical reflux occurred in 15.9% of patients (13/82). O-POEM was reliable and effective for the treatment of achalasia. In addition, O-POEM might be a better option for patients with severe submucosal fibrosis.

Allium chinense (G. Don) is an economically important vegetable that has been considered to be of Asian origin (2). In April of 2007, plants of cultivated A. chinense showing mosaic, chlorotic streak, twist, and crinkle on leaves were collected from fields at Jiangxia, a suburban district of Wuhan, Hubei Province, China, and transplanted into pots in a greenhouse. Ultrathin sections of diseased leaves were observed under an electron microscope. Pinwheel or cylindrical inclusions, typical of a potyvirus infection, were observed. Filamentous virus particles (820 nm long) were also observed in the crude extract from the same plant. To identify the virus species, viral RNAs were extracted from partially purified virion preparation (3) and used as a template. First-strand cDNA was synthesized with M4-T (5′-GTT TTC CCA GTC ACG AC (T)15-3′) as a complementary primer. The 3′-terminus of viral RNA was amplified using primer M4 (5′-GTT TTC CCA GTC ACG AC-3′) in combination with a degenerate primer (5′-GGXAAYAAYAGY GGX CARCC-3′) that was specific for potyviruses (1). Amplified products were cloned and nine clones were sequenced. Sequence analysis showed that the size of the amplified fragment, excluding the poly A tail, was 1,625 bp, which had the typical characteristics of the 3′-terminus of the potyvirus genome, including the partial NIb gene (636 bp) and the complete coat protein (CP gene; 771 bp). The 1,625-bp sequence from A. chinense (Genbank Accession No. FJ765739) had the highest identity at the nucleotide level with sequences of Onion yellow dwarf virus (OYDV), ranging from 76% (Genbank Accession Nos. AB219833 and AB219834) to 99% (Genbank Accession No. AJ409313). The CP gene had 88% (Genbank Accession Nos. AB219833 and AB219834) to 99% (Genbank Accession Nos. AJ409313 and AJ409310) identity at the amino acid level with corresponding regions of known OYDV isolates from other hosts. Until now, only Scallion mosaic virus (ScaMV), in the genus Potyvirus, had been detected from A. chinense (1); however, OYDV was reported in rakkyo, the same species as Chinese scallion, in Japan (4). To our knowledge, this is the first report of OYDV infecting A. chinense in China. References: (1) J. Chen et al. Arch. Virol. 147:683, 2002. (2) L. K. Mann and W. T. Stearn. Econ. Bot. 14:69, 1960. (3) T. Nagakubo et al. Phytopathology 84:640,1994. (4) I. Sako et al. Ann. Phytopathol. Soc. Jpn. 57:65, 1991.

Interplanetary magnetic field and solar wind plasma density observed at 1 AU during Solar Cycle 23 – 24 (SC-23/24) minimum were significantly smaller than those during its previous solar cycle (SC-22/23) minimum. Because the Earth’s orbit is embedded in the slow wind during solar minimum, changes in the geometry and/or content of the slow wind region (SWR) can have a direct influence on the solar wind parameters near the Earth. In this study, we analyze solar wind plasma and magnetic field data of hourly values acquired by Ulysses. It is found that the solar wind, when averaging over the first (1995.6 – 1995.8) and third (2006.9 – 2008.2) Ulysses’ perihelion ( ${\sim}\,1.4~\mbox{AU}$ ) crossings, was about the same speed, but significantly less dense ( ${\sim}\,34~\%$ ) and cooler ( ${\sim}\,20~\%$ ), and the total magnetic field was ${\sim}\,30~\%$ weaker during the third compared to the first crossing. It is also found that the SWR was ${\sim}\,50~\%$ wider in the third ( ${\sim}\,68.5^{\circ}$ in heliographic latitude) than in the first ( ${\sim}\,44.8^{\circ}$ ) solar orbit. The observed latitudinal increase in the SWR is sufficient to explain the excessive decline in the near-Earth solar wind density during the recent solar minimum without speculating that the total solar output may have been decreasing. The observed SWR inflation is also consistent with a cooler solar wind in the SC-23/24 than in the SC-22/23 minimum. Furthermore, the ratio of the high-to-low latitude photospheric magnetic field (or equatorward magnetic pressure force), as observed by the Mountain Wilson Observatory, is smaller during the third than the first Ulysses’ perihelion orbit. These findings suggest that the smaller equatorward magnetic pressure at the Sun may have led to the latitudinally-wider SRW observed by Ulysses in SC-23/24 minimum.