Evidence of an association between carbohydrate intake and atrial fibrillation (AF) incidence remains limited. We investigated the association between carbohydrate and staple food consumption and AF risk in a Japanese urban population.

Our population-based prospective cohort study included 5229 adult participants (mean age 56.9 years; 46.5% men) who completed a Food Frequency Questionnaire. Multivariable-adjusted Cox regression models were used to assess the association between carbohydrate intake (g/day) and staple food consumption (rice, noodles and bread) and AF incidence after adjusting for confounding factors. During 68 668 person-years of follow-up (mean, 13.1 years), 226 individuals developed AF. Total and simple carbohydrate intakes were associated with an increased AF risk in men (HR and 95% CI for Q4 vs Q1 were 2.51 (1.06 to 5.96) and 3.29 (1.33 to 8.13), respectively). In contrast, there were no significant associations between total carbohydrate, simple or complex carbohydrate intake and AF risk in women (HR and 95% CI for Q4 vs Q1 were 1.33 (0.27 to 6.65), 2.75 (0.74–10.26) and 1.04 (0.38-2.83), respectively). We found no association between staple foods and AF risk in men or women.

Our findings imply that the association between carbohydrate intake and AF risk is influenced by the type of carbohydrates. We found a positive association between high intake of simple carbohydrates and AF risk in men whereas the association was negative for complex carbohydrate intakes. Meanwhile, the results in the women’s group were inconclusive.

Japan’s physician-staffed helicopter emergency medical services (HEMS) are widely deployed but published evidence is heterogeneous across indications, outcomes and study designs. We aimed to map the internationally reported, English-language literature evaluating physician-staffed HEMS in Japan and to identify evidence gaps requiring further research.

Scoping review was conducted using established methodological frameworks and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

MEDLINE, Web of Science, CINAHL and the Cochrane Library, supplemented by backward and forward citation tracking.

Original studies evaluating physician-staffed HEMS in Japan and reporting patient outcomes for any emergency condition published in English-language journals.

We conducted a systematic database search using terms related to physician-staffed HEMS in Japan. The original search (28 May 2024) was updated on 25 February 2026 using the same eligibility criteria. Two reviewers independently performed title/abstract screening followed by full-text screening to determine eligibility. We additionally performed backward and forward citation tracking of the included studies. We summarised characteristics of eligible studies descriptively using counts and proportions.

The updated search identified 341 records, and citation tracking identified 16 further studies, yielding 76 included studies. Publications increased over time (2016–2020: 32.9%; 2021–2026: 52.6%). Most studies were single-centre observational (55.3%) or registry-based (39.5%), with few multi-centre studies (5.3%). Trauma was the most frequent study population (25.0%), and mortality the most common primary outcome (35.5%). First authors were university-affiliated in 88.2% of studies, 39.5% appeared in a single aeromedical journal, and no study compared physician-staffed with non-physician HEMS.

The internationally reported, English-language literature on physician-staffed HEMS in Japan has expanded over time, but remains dominated by retrospective observational designs, is produced largely by university-affiliated authors, and is concentrated in a small number of journals. Prospective multi-centre evaluation, comparison with non-physician HEMS, functional and longer-term outcomes, and economic evaluation were absent from the identified literature.

Patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs) may experience immune-confirmed stable disease (iSD) or progressive disease (iCPD). Abscopal responses following ultra-hypofractionated radiotherapy during immunotherapy have been reported, but their incidence, timing and associated clinical or biological factors remain poorly defined in prospective observational settings.

AURICRE is a prospective, multicentre observational study that plans to enrol 145 patients with mRCC who exhibit iSD or iCPD during ongoing ICI therapy. Participants undergo stereotactic ablative radiotherapy (SABR) to either the primary tumour or selected metastatic lesions. Prespecified SABR regimens include 42 Gy in three fractions or 40 Gy in five fractions for primary tumours, and fractionated schedules delivering ≥5 Gy per fraction for metastatic sites, with metastatic site regimens corresponding to a BED₁₀ range of 40–85 Gy. The primary outcome is the abscopal response rate, defined as objective responses in non-irradiated lesions assessed using iRECIST. Secondary outcomes include tumour shrinkage rates and 1-year overall survival. Exploratory analyses will evaluate changes in circulating cytokines measured centrally before and after radiotherapy.

This study was approved by the Institutional Review Board of the University of Yamanashi (Approval Number: CS0075). Written informed consent will be obtained from all participants before provisional registration. Study findings will be disseminated through peer-reviewed publications and scientific meetings.

This trial is registered at ClinicalTrials.gov (NCT07240610) and the University Hospital Medical Information Network (UMIN000059652); Pre-results.