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The pH of coastal seawater varies based on several local forcings, such as water circulation, terrestrial inputs, and biological processes, and these forcings can change along with global climate change. Understanding the mechanism of pH variation in each coastal area is thus important for a realistic future projection that considers changes in these forcings. From 2020 to 2021, we performed parallel year-round observations of pH and related ocean parameters at five stations around the Japanese coast (Miyako Bay, Shizugawa Bay, Kashiwazaki Coast, Hinase Archipelago, and Ohno Strait) to understand the characteristics of short-term pH variations and their forcings. Annual variability (~1 standard deviation) of pH and aragonite saturation state (Ωara) were 0.05–0.09 and 0.25–0.29, respectively, for three areas with low anthropogenic loadings (Miyako Bay, Kashiwazaki Coast, and Shizugawa Bay), while it increased to 0.16–0.21 and 0.52–0.58, respectively, in two areas with medium anthropogenic loadings (Hinase Archipelago and Ohno Strait in Seto Inland Sea). Statistical assessment of temporal variability at various timescales revealed that most of the annual variabilities in both pH and Ωara were derived by short-term variation at a timescale of < 10 days, rather than seasonal-scale variation. Our analyses further illustrated that most of the short-term pH variation was caused by biological processes, while both thermodynamic and biological processes equally contributed to the temporal variation in Ωara. The observed results showed that short-term acidification with Ωara < 1.5 occurred occasionally in Miyako and Shizugawa Bays, while it occurred frequently in the Hinase Archipelago and Ohno Strait. Most of such short-term acidified events were related to short-term low-salinity events. Our analyses showed that the amplitude of short-term pH variation was linearly correlated with that of short-term salinity variation, and its regression coefficient at the time of high freshwater input was positively correlated with the nutrient concentration of the main river that flows into the coastal area.

False-negatives on cytology may be observed during follow-ups for patients with persistent cervical intraepithelial neoplasia (CIN); however, the underlying reasons are unknown, and the relationship between the intra-individual variability of false-negatives and the menstrual cycle phase has not been elucidated. Therefore, this study aimed to determine whether the menstrual cycle influences cytological results to maximise the accuracy of such tests.A total of 154 liquid-based cytological (LBC) samples were obtained during follow-ups for 26 patients with CIN, and the relationship between cytological results and the menstrual cycle, which was classified into six phases, was analysed.All LBC smears were satisfactory, and 20 of 154 (13.0%) specimens were negative for intraepithelial lesions or malignancy (NILM). A statistically significant association was observed between the cytological results and the phase of the menstrual cycle, χThe present study revealed that false-negative cytological results were found to more likely to occur during the early secretory phase. More careful and precise microscopic observation of Pap smears collected at the early secretory phase may contribute to a reduction in the occurrence of false-negatives and improve cytological sensitivity.

Introduction: The morphology of high-grade squamous intraepithelial lesion (HSIL) on Papanicolaou (Pap) smears widely varied, including syncytial aggregates, sheets, and scattered single cells, and no particular cellular pattern is consistently observed. Therefore, this study aimed to determine whether the menstrual cycle affects the cellular pattern of HSILs, an effort to avoid false negatives due to the oversight of scattered small single HSIL cells in the cytological triage of human papillomavirus-positive women. Methods: A total of 147 HSIL samples of liquid-based cytology (LBC) in patients with cervical intraepithelial neoplasia grade 2 or 3 were obtained, and then, the relationship between cellular patterns, such as single-cell-like and syncytial aggregates, and menstrual cycles classified into six phases was analyzed. If a syncytial aggregate was present, the number of cells constituting the aggregate was visually counted under the microscope. Results: HSILs in scattered single cells and small sheets of 2 [3] = 9.423, p < 0.05) (Cramer’s V = 0.253). The value of adjusted residuals showed a statistically significant increased proportion of single-cell-like patterns during the late proliferative phase (p < 0.01). Conclusions: The present study demonstrated that HSIL cells in Pap smears in the late proliferation phase have a high frequency of single-cell-like patterns. In human papillomavirus-positive Pap smears with a clean background and predominantly superficial cells, careful microscopic observation by targeting single HSIL cells can potentially reduce false negatives.

Introduction; Infective endocarditis (IE) is a rare but serious disease with a wide range of phenotypes and clinical courses. The diagnosis of IE is often difficult and must be comprehensively judged. Case Presentation; We report the case of a 78-year-old woman with back pain and fever of unknown origin, who was transferred to our hospital due to acute radial artery occlusion. We diagnosed purulent spondylitis and IE. The mobile vegetation remained in the anterior mitral valve leaflet after embolism, and the embolism to the central nervous system was relatively mild, so we decided to perform early surgery. Mitral valve replacement was performed because of embolic symptoms without further complications. Conclusions; Early evaluation by echocardiography is required for the prompt diagnosis of IE and its associated high-risk features may benefit from surgical intervention. Early diagnosis of infective endocarditis and surgical intervention are associated with better outcome in patients with large vegetations, recurrent embolisms, and heart failure. While purulent spondylitis is not commonly associated with infective endocarditis, it is important to actively suspect the existence of IE in patients who complain of back pain along with fever. Both physicians and orthopedic surgeons need to recognize IE as a common disease, especially in the elderly society.

Coastal warming, acidification, and deoxygenation are progressing, primarily due to the increase in anthropogenic CO2. Coastal acidification has been reported to have effects that are expected to become more severe as acidification progresses, including inhibiting formation of the shells of calcifying organisms such as shellfish. However, compared to water temperature, an indicator of coastal warming, spatiotemporal variations in acidification and deoxygenation indicators such as pH, aragonite saturation state (Ωarag), and dissolved oxygen in coastal areas of Japan have not been observed and projected. Moreover, many species of shellfish are important fisheries resources, including Pacific oyster (Crassostrea gigas). Therefore, there is concern regarding the future combined impacts of coastal warming, acidification, and deoxygenation on Pacific oyster farming, necessitating evaluation of current and future impacts to facilitate mitigation measures. We deployed continuous monitoring systems for coastal warming, acidification, and deoxygenation in the Hinase area of Okayama Prefecture and Shizugawa Bay in Miyagi Prefecture, Japan. In Hinase, the Ωarag value was often lower than the critical level of acidification for Pacific oyster larvae, although no impact of acidification on larvae was identified by microscopy examination. Oyster larvae are anticipated to be affected more seriously by the combined impacts of coastal warming and acidification, with lower pH and Ωarag values and a prolonged spawning period, which may shorten the oyster shipping period and lower the quality of oysters. No significant future impact of surface-water deoxygenation on Pacific oysters was identified. To minimize the impacts of coastal warming and acidification on Pacific oyster and related local industries, cutting CO2 emissions is mandatory, but adaptation measures such as regulation of freshwater and organic matter inflow from rivers and changes in the form of oyster farming practiced locally might also be required.

We developed a new artificial placenta (AP) system consisting of a loop circuit configuration extracorporeal membrane oxygenation (ECMO) with a bridge circuit designed to be applied to the fetus in the form of an umbilical arterial-venous connection. We aimed to evaluate the feasibility of the AP system by performing a hydrodynamic simulation using a mechanical mock circulation system and fetal animal experiment. The effect of the working condition of the AP system on the fetal hemodynamics was evaluated by hydrodynamic simulation using a mechanical mock circulation system, assuming the weight of the fetus to be 2 kg. The AP system was introduced to two fetal goats at a gestational age of 135 days. The general conditions of the experimental animals were evaluated. The mock simulation showed that in an AP system with ECMO in the form of an umbilical arterial-venous connection in series, it could be difficult to maintain fetal hemodynamics when high ECMO flow was applied. The developed AP system could have high ECMO flow with less umbilical blood flow; however, the possibility of excessive load on the fetal right-sided heart should be noted. In the animal experiment, kid 1 (1.9 kg) was maintained on the AP system for 12 days and allowed to grow to term. In kid 2 (1.6 kg), the AP system could not be established because of the occlusion of the system by a thrombus. The developed AP system was feasible under both in vitro and in vivo conditions. Improvements in the AP system and management of the general fetal conditions are essential.

A heart failure (HF) model using coronary microembolization in large animals is indispensable for medical research. However, the heterogeneity of myocardial response to microembolization is a limitation. We hypothesized that adjusting the number of injected microspheres according to coronary blood flow could stabilize the severity of HF. This study aimed to evaluate the effect of microsphere injection based on the left coronary artery blood flow in an animal model.Microembolization was induced by injecting different numbers of microspheres (polystyrene, diameter: 90 μm) into the left descending coronary artery of the two groups of sheep (400 and 600 times coronary blood flow [ml/min]). Hemodynamic parameters, the pressure-volume loop of the left ventricle, and echocardiography findings were examined at 0.5, 1.5, 3.5, and 6.5 h after microembolization.End-diastolic pressure and normalized heart rate increased over time, and were significantly higher in 600 × coronary blood flow group than those in 400 × coronary blood flow group (p = 0.04 and p 0.01, respectively). The maximum rate of left-ventricular pressure rise and normalized stroke volume decreased over time, and were significantly lower in 600 × coronary blood flow group than those in 400 × coronary blood flow group (p 0.01 and p 0.01, respectively). The number of microspheres per coronary blood flow was significantly correlated with the decrease in stroke volume and the maximum rate of left ventricular pressure rise in 6.5 h (r = 0.74, p = 0.01 and r = 0.71, p = 0.02, respectively).Adjusting the number of injected microspheres based on the coronary blood flow enabled the creation of HF models with different degrees of severity.

Despite the expected importance, the changes in mangrove ecosystems and the main causes in Fiji have not been well addressed. To address the issues, we collected data from multiple sources to assess mangrove ecosystem variation due to both natural factors and human impacts in the Ba and Rewa deltas, Fiji. Landsat satellite data were used to map the land use and cover of the study area from 2000 to 2020. Questionnaire surveys were conducted to identify the main uses of mangroves that could influence mangrove ecosystems. Over the period investigated, the mangrove area increased by 572 ha (by 12%) in Ba and decreased by 697 ha (by 9%) in Rewa. The social survey revealed that 45% of respondents in the Ba delta and 20% in the Rewa delta visited the mangrove area daily in search of food resources. The net annual economic loss and lost functioning of mangroves as an anthropogenic CO2 reservoir caused by mangrove degradation in the two deltas were estimated to be 335,000 USD and 202 t-C, respectively. Because local livelihoods are strongly linked with mangroves, the outcomes of this study will provide preliminary information for policy interventions to ensure the sustainability of the mangrove ecosystem.

Cornflake artifacts are artifacts that commonly occur while the mounted medium starts to evaporate before coverslipping. This study aimed to determine factors contributing to the occurrence of these artifacts in Papanicolaou (Pap) smears. Residual specimens were used after cytology to microscopically evaluate various effects on cornflake artifacts. Four SurePath™ liquid cytology (LBC) cell specimens, diagnosed as negative for intraepithelial lesions or malignancy (NILM), were used. Each LBC smear was subjected to Pap staining under four different conditions (A, without air-drying; B, air-drying after dehydration; C, air-drying after xylene immersion; and D, air-drying after dehydration and xylene immersion) using two methods: conventional and poor dehydration. Cornflake artifacts were not observed in A and B in Pap staining. By contrast, cornflake artifacts were observed in conventional and poor dehydration methods when dried after xylene immersion. When comparing the four conditions, smears B and D, which were both air-dried after dehydration, had fewer cornflake artifacts than smear C, which was air-dried only after xylene. Therefore, the remaining water in the cells due to poor dehydration during xylene immersion is found to result in the development of cornflake artifacts. The present study revealed that cornflake artifacts in Pap smears are caused by poor dehydration in addition to drying before mounting.

A review was conducted to understand the current status of the water–energy–food nexus, focusing on its methodology, and the process through which the nexus approach has academically and geographically expanded across and synthesized more than one discourse, discipline, and domain via its methodology as interdisciplinary and integrated approaches. The review article types were categorized into five groups and comprehensively analyzed. Various indicators to assess the nexus methods and tools, reported in previous studies, that can be used to select appropriate methods and tools for methodology and research designs. The studies in the reviewed articles were characterized by various stages of interdisciplinary research. In addition, the water–energy–food nexus initiatives, which generalize methods and tools, applying mixed methods to the replicability of specific case studies, were discussed based on the findings.

Mangroves are one of the most valuable and productive coastal ecosystems. Previous studies show a severe loss of mangroves around the world over the last several decades due to natural and anthropogenic activities. Mangroves located in the southeastern part of the Mekong River Delta (MRD) are also affected by these activities. Shrimp farming is considered as one of the main drivers causing the rapid loss and degradation of mangroves. The goal of this study is to assess the spatiotemporal changes in land use and distribution of mangroves in the Soc Trang and Bac Lieu provinces of the southeastern part of the MRD. Multi-temporal Landsat data were used for land use and land cover (LULC) classification using the maximum-likelihood classification algorithm. The changes in mangrove forest areas were monitored using medium spatial resolution (Landsat-5 Thematic Mapper and Landsat-8 Operational Land Imager) satellite imageries from 1988 to 2018. In the study area, there were seven major LULC types namely, dense mangroves, sparse mangroves, aquaculture farms, arable land with crop cover, arable land without crop cover, settlements, and water bodies. The overall accuracies of the LULC maps in 1988, 1998, 2008, and 2018 were 81.2%, 83.3%, 78.3%, and 81.9%, respectively. This study reveals that dense and sparse mangrove forests have decreased by 90% from 5495 hectares (ha) to 515 ha and by 55% from 14,105 to 6289 ha, respectively from 1988 to 2018. On the other hand, the aquaculture farm has increased at the rate of 5024 ha/year for a period of 30 years. This rapid growth of aquaculture farming activities caused the rapid loss and degradation of mangroves in the MRD. Quantitative information about mangrove change obtained by this study is considered to be useful for future coastal management and relevant policies in the MRD.

This study has developed a methodology for the nexus approach by integrating interdisciplinary and transdisciplinary concepts and qualitative and quantitative mixed methods into the process of the systems thinking approach. The nexus approach was institutionalized in two projects using the location specific case study of Beppu, Japan where a set of interconnected issues in using geothermal hot spring resources have emerged due to the promotion of geothermal energy development under low-carbon policies at global and national levels. The interlinkages among geothermal hot spring resources, including heat, steam, nutrients, and drainage between land and coastal systems were analyzed to improve decision- and policy-making. This study discusses (1) how different discipline-oriented methods and data are integrated, (2) how much of the targeted water-energy-food nexus systems are understood using the nexus approach, and (3) how far does the nexus approach influence changes in the policy agenda and human behavior regarding sustainable geothermal hot spring resources use. The nexus approach facilitated the sequential integration of individual methods and data to better explain the causal linkages focusing on water-energy-food resources in the human-nature systems in Beppu. The proposed policy recommendations are based on the local government initiative for continuing to conduct citizen participatory surveys on geothermal hot spring resources. Transferring the developed methodology will help to effectively develop geothermal hot spring resources and compliment the current national renewable energy and natural resource policies and management.

Background Although rare, cytomegalovirus (CMV) reactivation can be lethal in patients with cancer. However, the criteria for the prevention of cytomegalovirus reactivation during cancer treatment are unclear. This study aimed to identify factors associated with CMV reactivation in patients with esophageal cancer who were receiving chemoradiotherapy. Methods This retrospective study included esophageal cancer patients receiving definitive or palliative chemoradiotherapy during April 2013–March 2020. Patients with fever during chemoradiotherapy underwent a systemic work‐up to detect the primary focus of infection, and CMV antigenemia was assessed in cases of unidentifiable infection. Results Among 132 patients (80.3% male, median age 69 years [range, 39–86 years]), 124 received 5‐fluorouracil plus cisplatin and 8 received oxaliplatin–5‐fluorouracil–levofolinate chemotherapy. Overall, 19 patients had CMV reactivation, 37 had other infections, and 76 had no identified infection (groups 1, 2, and 3, respectively). Median minimum lymphocyte counts were 81.0/µl (interquartile range: 52.0–144.0/µl), 120.0/µl (81.0–162.5/µl), and 185.5/µl (120.5–328.0/µl) in groups 1, 2, and 3, respectively, with counts being significantly lower in groups 1 and 2 than in group 3 (p, CMV reactivation is not rare in esophageal cancer patients receiving chemoradiotherapy and is associated with minimum lymphocyte counts. CMV reactivation should be considered in differential diagnosis when a patient receiving chemoradiotherapy presents with a marked decrease in the lymphocyte count.

Many genotypes of human papillomaviruses (HPVs) may lead to morphological changes in cells, resulting in various atypical cells, such as multinucleated cells (MNCs) and koilocytes, in the cervix. However, the relationships between the profiles of HPV genotypes and MNCs are not exactly known. Thus, this study comprehensively profiles the HPV genotypes in MNCs using a microdissection method. HPV genotypes and MNCs were detected in 651 cases with an abnormal Pap smear by liquid-based cytology. Specific HPV genotypes were also detected, including HPV16, 34, and 56, which might be associated with MNCs. This result suggests that the high-risk HPV genotypes, such as HPV16 and 56, are associated with the atypical changes in MNC morphology from normal cervical cells. The results also show that MNCs may be a predictor of squamous intraepithelial lesion.

Purpose : Postoperative pancreatic fistula (POPF) is a serious complication after gastrectomy for gastric cancer. The purpose of this study is to identify the risk factor of POPF and evaluate C-reactive protein on postoperative day 1 (POD1) as the predictor for POPF after laparoscopic gastrectomy (LG). Methods : Between May 2013 and September 2016, 226 patients who underwent LG for gastric cancer were investigated. Patients were divided into 2 groups; POPF group (n = 17) and control group (n = 209). Clinicopathological factors were compared between 2 groups. Results : In POPF group, there are more male patients (p = 0.003) compared with control group. Preoperative factors, such as age, BMI, and prevalence of previous operation and comorbidity showed no significant difference between 2 groups. Regarding tumor factors and perioperative data such as blood loss and operative time, there were also no significant difference between 2 groups. POPF group showed longer postoperative hospital stay, and higher serum CRP level on POD1 (p < 0.0001). Multivariate analysis revealed that high CRP level on POD1 ( ≥ 3mg/dl) was independent risk factor of POPF. Conclusions : High serum CRP level on POD1 can predict the occurrence of POPF. J. Med. Invest. 66 : 285-288, August, 2019.

Background: To compare the cytomorphological features of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) observed in a liquid-based Pap smear with the histopathological features observed in a concurrent colposcopic biopsy specimen obtained immediately after obtaining the Pap smear. Methods: Cytomorphological features such as cytoplasmic differentiation, nuclear/cytoplasm (N/C) ratio, chromatin pattern, thickening of nuclear contour, and the appearance of the nucleolus of 247 ASC-H obtained from 25 liquid-based Pap smear ASC-H cases were compared with those of the cells obtained from biopsied samples. Human papillomavirus (HPV) infection was tested for 39 HPV genotypes using Uniplex E6/E7 polymerase chain reaction method. Results: Of the 25 ASC-H cases, 22 (88%) showed cervical intraepithelial neoplasia grade 1 or greater (CIN1+) and 3 (12%) were benign. HPV infection was detected in 100% CIN1+ cases and 66.7% benign cases. Significant differences such as marked hyperchromasia, thickened nuclear contour, and prominent nucleoli were observed between ASC-H cases with CIN1+ and the benign cases. Conclusion: The presence of small dysplastic cells displaying marked hyperchromasia, thickening of nuclear contour, and prominent nucleoli on Pap smear strongly suggest the presence of CIN in ASC-H cases.

Coral reef ecosystems possess tangible and intangible economic benefits to human society that are still underestimated and not fully understood. This study aims: to determine 1) economic benefits and economic losses due to coral reef damage, 2) compensation values as replacement costs for damaged coral reefs as well as references to sustainable coral reef management. Based on the calculation, the TEV of coral reef ecosystems was estimated to be USD 11.96 billion or 2.82 million USD/ha. The economic losses due to coral reef destruction over the 20-year period from 1994 to 2014 were USD 1 billion or 50.18 million USD/yr. We anticipate that the economic loss of coral reefs will continue to rise due to the intensification of destructive fishing practices. Therefore, an effective management policy should be established to prevent further destruction of coral reefs in this area in the future. This study suggests that tangible procedures for compensation for coral damage and law enforcement for destroyers are required to be implemented to reduce the economic losses of coral reefs, and the economic values estimated in this study can be a quantitative reference for various stakeholders to build a concensus for designing coral reef recovery programs in the future.

AIM To characterise the effects of antipsychotics on brain functions of patients with behavioural psychological symptoms of dementia (BPSD). METHODS Studies were performed during 6 weeks of intervention with either a nonantipsychotic drug (group A, n = 38) or an antipsychotic drug (group B, n = 10). RESULTS Neuropsychiatric Inventory scores were significantly decreased in both groups. Scores on the Mini-Mental State Examination did not change with intervention. By contrast, favourable natures of emotional functions, scored using the Delightful Emotional Index of 10 items, were significantly lower in the antipsychotic drug treatment group B relative to scores in the nonantipsychotic drug treatment group A. CONCLUSIONS Antipsychotics reduce favourite emotions as well as BPSD, and this should be considered in prescribing medications for patients with dementia.

The effect of deuterium oxide (D2O) on the stabilization of membrane structure in human erythrocytes was examined on the basis of hemolysis under high pressure and extraction of cytoskeletal protei...

Disseminated intravascular coagulation (DIC) is an infrequent aortic dissection complication, and its optimal treatment remains controversial. A 55-year-old woman developed DIC associated with Stanford type B aortic dissection, which improved by administration of low-molecular-weight heparin combined with tranexamic acid, but the dissecting aneurysm of the descending aorta was dilated. After thoracic endovascular aortic repair for occlusion of entry tears detected by transesophageal echocardiography, DIC improved without anticoagulant therapy. Three months after treatment, the patient is doing well without complications. Endovascular repair is effective for DIC due to aortic dissection that requires anticoagulant therapy. Keywords: Aortic dissection, Disseminated intravascular coagulation, Endovascular therapy

Behavioral and psychological symptoms of dementia (BPSD) challenge caregivers, leading to caregiver burden and subsequent nursing home or inpatient placement in a psychiatric hospital for dementia. Favorable positive emotions should be an important goal for the treatment of negative emotions of BPSD. Arts are one of the most profound areas to stimulate favorable emotions. We have asked a professional actor, who was not involved in the daily care and regular rehabilitations, to give a dramatic performance by reading selected stories as if the patients with BPSD felt to be in the audiences of a theater. We wondered whether a dramatic performance by the actor might be a way to respond to the complex needs of inpatients with BPSD, especially focused on favorable emotions. New inpatients (Alzheimer's disease, vascular dementia, or dementia with Lewy bodies) were randomly assigned to a control group (n = 20) and a dramatic performance group (n = 14) in Sendai Tomizawa Hospital, a psychiatric hospital for dementia, in Japan. Dramatic performances were performed for one and half hours once per week for 3 months. Neuropsychiatric Inventory for BPSD decreased in both groups and delightful emotional index (DEI) for favorable emotions increased in the intervention group but not in the control group after 3 months. At 3 months, there was an increase of DEI in intervention group compared with control group. We conclude that dramatic performance may be one of the appropriate interventions in patients with BPSD, as it appears to help in their favorable emotional state.

The suspension feeding benthic bivalve surf clam, Pseudocardium sachalinense , which feeds on phytoplankton , benthic microalgae, and detritus in coastal waters, is one of the most important marine resources in Hamanaka, Hokkaido Prefecture, Japan. We measured stable carbon and nitrogen isotope ratios (δ 13C and δ15 N) and carbon‑nitrogen (C/N) ratios of surf clam adductor muscle and stomach contents, oceanic particulate organic matter (POM), oceanic sediments, riverine POM, and soil, as well as physical and chemical parameters such as temperature, salinity, chlorophyll-a, and nutrients in Hamanaka from April through September 2015. We also examined the food sources that support the surf clam, the possible connection between wetlands and coastal waters, and the spatial and seasonal variation. Our results showed that the isotope and C/N values of surf clams and oceanic organic matter were significantly different from those of riverine organic matter, and that there were no significant differences among different sites of coastal areas. This means that land-derived organic matter is not a direct food source for the surf clam and does not affect the coastal environment. In addition, benthic microalgae and epiphytes are considered to be the major food sources for the surf clam in all sampling seasons, since they have isotope and C/N values similar to those of the surf clam. The overall results, also with reference to previous relevant studies, imply the importance of conservation of wetlands which buffer excessive inflow of land-derived organic matter that may harm surf clams and the coastal environment.

Objectives To elucidate the effect of tricuspid annuloplasty concomitant with left-sided valve surgery on the right heart in patients with mild or more tricuspid regurgitation (TR). Methods We enrolled 78 patients with mild or more TR who underwent left-sided valve surgery. Forty-three patients underwent only left-sided valve surgery (group non-T) and 35 underwent concomitant tricuspid annuloplasty (group T). Echocardiographic changes between the preoperative and 1-year follow-up periods were compared. Propensity score matching was used to obtain risk-adjusted outcome comparisons (16 pairs). Results In group non-T, there were more operations for aortic stenosis and concomitant coronary artery bypass grafting, and fewer operations for mitral regurgitation. The prevalence of atrial fibrillation was higher in group T. In preoperative echocardiography, there were no significant differences in left ventricular and right ventricular (RV) dimensions and functions. Tricuspid valve annular diameter and TR-related parameters were significantly larger in group T. Left ventricular dimensions and TR-related parameters significantly improved in both groups 1 year after operation. RV diameter was significantly reduced in only group T. In analysis of variance, RV diameter in systole and diastole showed significant interaction, whereas left heart dimensions and function, tricuspid valve tethering height, and RV fractional area change did not show interaction. These results were not attenuated even after propensity-matching analyses. Conclusions Among patients with mild or more TR, RV reverse remodeling was not obtained with left-sided valve surgery alone. Additional use of tricuspid annuloplasty might potentially achieve favorable TR regulation as well as RV reverse remodeling.

Coral and macroalgal communities are threatened by global stressors. However, recently reported community shifts from temperate macroalgae to tropical corals offer conservation potential for corals at the expense of macroalgae under climate warming. Although such community shifts are expanding geographically, our understanding of the driving processes is still limited. Here, we reconstruct long-term climate-driven range shifts in 45 species of macroalgae, corals, and herbivorous fishes from over 60 years of records (mainly 1950–2015), stretching across 3,000 km of the Japanese archipelago from tropical to subarctic zones. Based on a revised coastal version of climate velocity trajectories, we found that prediction models combining the effects of climate and ocean currents consistently explained observed community shifts significantly better than those relying on climate alone. Corals and herbivorous fishes performed better at exploiting opportunities offered by this interaction. The contrasting range dynamics for these taxa suggest that ocean warming is promoting macroalgal-to-coral shifts both directly by increased competition from the expansion of tropical corals into the contracting temperate macroalgae, and indirectly via deforestation by the expansion of tropical herbivorous fish. Beyond individual species’ effects, our results provide evidence on the important role that the interaction between climate warming and external forces conditioning the dispersal of organisms, such as ocean currents, can have in shaping community-level responses, with concomitant changes to ecosystem structure and functioning. Furthermore, we found that community shifts from macroalgae to corals might accelerate with future climate warming, highlighting the complexity of managing these evolving communities under future climate change.

[Purpose] This study evaluated gait parameters and foot pressure in two regions of the feet among older females with different personal care support needs to analyze factors that contribute to higher support requirements. [Subjects and Methods] Thirty-two older females were divided into support-need and care-need level groups. Gait parameters (speed, cadence, step length, step width, gait angle, toe angle, double support phase, swing phase, and stance phase) and foot pressure during a 5-m walk were measured and analyzed in the two groups. [Results] The percentage of the double support phase on both feet and the right stance phase were significantly higher in the care-need level group, while that of the right swing phase was significantly lower than that of the support-need level group. Additionally, the phase showing peak pressure on the left rear foot was significantly delayed and the left forefoot pressure in the terminal stance was significantly lower in the care-need level group than in the support-need level group. [Conclusion] These findings show that the temporal duration parameters and foot pressure on a particular side were significantly different between the two groups and suggest that these differences were associated with a higher care level.