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Surgical antimicrobial prophylaxis (SAP) is one of the major purposes of antimicrobial use.To determine the adherence to the Japanese SAP guidelines in Japanese university hospitals.This was a retrospective cohort study including 15 general hospitals and one dental university hospital. Up to three cases of 18 designated surgeries were evaluated regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as 'appropriate'.In total, 688 cases (22-45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.6% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.9%, 116/688, respectively), compared to the guideline.Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multi-centre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections.

Thermal biology research compares field with laboratory data to elucidate the evolution of temperature-sensitive traits in ectotherms. The hidden challenge of many of these studies is discerning whether animals actively thermoregulate, since motivation is not typically assessed. By studying the behaviours involved in thermoregulation, we can better understand the mechanisms underlying body temperature control. Using an integrative approach, we assessed the thermoregulatory and thermotactic behaviours of two sympatric snake species with contrasting life histories: the generalist Eastern Garter Snake (Thamnophis sirtalis sirtalis ( Linnaeus, 1758 )) and the semi-fossorial Northern Red-bellied Snake (Storeria occipitomaculata occipitomaculata ( Storer, 1839 )). We expected that thermoregulatory behaviours would be optimized based on life history, in that T. s. sirtalis would show higher evidence for thermally oriented behaviours than S. o. occipitomaculata due to its active nature. Thamnophis sirtalis sirtalis actively thermoregulated, had higher thermal preferences (29.4 ± 2.5 vs. 25.3 ± 3.6 °C), and was more active than S. o. occipitomaculata, which showed relatively low evidence for thermotaxis. Our results build on the notion that evaluating movement patterns and rostral orientation towards a heat source can help ascertain whether animals make thermally motivated choices. Our data provide insight into the thermoregulatory strategies used by snakes with different life histories and maximize the information provided by behavioural thermoregulation experiments.

Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide–bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu’s parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of

Background Blood pressure (BP) variability has reportedly been a risk factor for various clinical events. To clarify the influence of BP visit‐to‐visit variability on adverse events in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J‐RHYTHM Registry was performed. Methods and Results Of 7406 outpatients with nonvalvular atrial fibrillation from 158 institutions, 7226 (age, 69.7±9.9 years; men, 70.7%), in whom BP was measured 4 times or more (14.6±5.0 times) during the 2‐year follow‐up period or until occurrence of an event, constituted the study group. SD and coefficient of variation of BP values were calculated as BP variability. Thromboembolism, major hemorrhage, and all‐cause death occurred in 110 (1.5%), 121 (1.7%), and 168 (2.3%) patients, respectively. When patients were divided into quartiles of systolic BP‐SD (P =0.015 for thromboembolism; HR, 2.60, 95% CI, 1.36–4.97, P =0.004 for major hemorrhage; and HR, 1.85, 95% CI, 1.11–3.07, P =0.018 for all‐cause death) after adjusting for components of the CHA 2 DS 2 ‐VASc score, warfarin and antiplatelet use, atrial fibrillation type, BP measurement times, and others. These findings were consistent when BP‐coefficient of variation was used instead of BP‐SD. Conclusions Systolic BP visit‐to‐visit variability was significantly associated with all adverse events in patients with nonvalvular atrial fibrillation. Further studies are needed to clarify the causality between BP variability and adverse outcomes in patients with nonvalvular atrial fibrillation. Registration URL: https://www.umin.ac.jp/ctr/ ; Unique Identifier: UMIN000001569.

We used radio-tracking to investigate movement patterns and habitat use of Fowler’s Toads (Anaxyrus fowleri) during late summer and early fall in a relatively undisturbed lakeshore dune and beach habitat at Long Point, Ontario. Small radio transmitters were fitted to 11 adult toads with an external harness made from fine surgical plastic tubing wrapped around the body behind the front limbs. We located radio-tagged toads morning and evening, for a maximum of 9 days, recording their locations using Global Positioning System units. Initially, the toads were located on the upper beach or in the fore-dunes during the day, either dug in under the sand or hiding beneath debris; in the evening, they were generally active on the lower beach close to the water line. After a storm and the onset of cooler autumn weather, the toads tended to move further from the water line. They also curtailed their nightly activity and retreated deeper into the sand. As this sort of behaviour was not observed during the summer, we interpret it as pre-hibernation movement to more stable sites away from the beach where the animals can burrow deeply into the sand to lie dormant during the winter.

Summary Background The Japanese government adopted a national action plan on antimicrobial resistance, which aims to reduce drug-resistant pathogens and antimicrobial use. A point-prevalence survey (PPS) is a useful surveillance method to gain information about hospital epidemiology; however, no multi-centre PPS has previously been performed in Japan. Aim To investigate general information about hospital epidemiology, healthcare-associated infections (HCAIs), and antimicrobial use in multiple Japanese university hospitals. Methods In July 2016, a multi-centre PPS was conducted using a standardized protocol at four university hospitals in Japan. Findings A total of 3199 patients were included. Median age and duration of hospital stay were 64 years and 10 days, respectively. A total of 246 (7.7%; 95% confidence interval (CI): 6.8–8.7) patients had 256 active HCAIs, and 933 (29.2%; 95% CI: 27.6–30.8) patients received 1318 antimicrobials. Pneumonia and gastrointestinal system infection were the most common HCAIs (N = 42, 16.4%), and Enterobacteriaceae (N = 49, 30.8%) were the predominant causative organisms. Carbapenems (N = 52, 17.8%), anti-MRSA medications, and cephems with antipseudomonal activity were the most frequently prescribed antimicrobials for HCAIs. As surgical prophylaxis, 46 of 278 antimicrobials (16.5%) were administered orally. Proportions of HCAI and antimicrobial use in each hospital ranged from 4.8% to 9.5% and 19.3%–35.0%, respectively. Conclusion This multi-centre PPS recorded detailed HCAI data and distinct antimicrobial use in Japanese university hospitals. Further surveillance is necessary to reduce HCAIs and formulate feasible plans to achieve the national action plan on antimicrobial resistance.

When the Budd-Chiari syndrome (BCS) lesion extends to the inferior vena cava (IVC) or the orifices of the hepatic vein, the thickened IVC and/or hepatic vein wall must be removed and IVC reconstruction is required in living-donor liver transplantation (LDLT). In various reports about IVC resection in LDLT for BCS, there are none about left lobe liver transplantation with reconstruction of the retrohepatic IVC (rhIVC). To overcome removal and reconstruction of the rhIVC in LDLT for BCS, we introduced a composite IVC graft that is applicable to both right and left lobe partial liver grafts for LDLT for BCS. Pathogenic IVC was removed together with the native liver between the lower edge of the right atrium and 5 cm above the renal vein junction with the use of venovenous bypass. The e-polytetrafluoroethylene graft was anastomosed to the suprarenal intact IVC. Then the native part was detached at the level of just above the renal junction. The composite graft was inverted and a half rim of the native part of the graft was anastomosed to the posterior wall of the right atrium. Next, the common venous orifice of the left lobe graft was anastomosed to the wall defect which was composed of the anterior wall of the right atrium and the distal end of the native part of the composite graft. In conclusion, our inverted composite graft technique will overcome the weak points of LDLT for BCS, such as incomplete removal of the pathogenic caval wall and reconstruction of the rhIVC.

Carry-over effects, which occur when an animal's early life experience has lasting effects on its later life, may be manifested in an animal's behavior, growth, and fitness, and are often overlooked as contributing factors to such aspects of animal ecology. Metamorphosis is a process that can produce such effects in animals with complex life histories, due to the significant energetic cost and physical changes undergone during this process. We explored the potential impact of tadpole density after metamorphosis in a pond-breeding amphibian, Anaxyrus fowleri. If larval density induces carry-over effects, then there should be a positive correlation in behavior and/or relative growth rate between pre-metamorphic tadpoles and the same animals as post-metamorphic toadlets. We raised tadpoles at six density levels, ranging from 0.08 tadpoles/L to 1.67 tadpoles/L, designed to produce variation in growth rate and toadlet size, and quantified relative activity by monitoring movement per five-second intervals in ta...

Summary: Background: Periodic point prevalence surveys (PPSs) provide a method for assessing changes in healthcare-associated infections (HAIs) and antimicrobial use over time. Following the introduction of an antimicrobial stewardship programme at Nagoya University Hospital (Aichi, Japan) a five-year PPS study was performed to highlight any epidemiological changes. Methods: One-day PPSs were performed annually in July at Nagoya University Hospital. Data on patient characteristics, medical devices, active HAIs and antimicrobial use were collected using a standard data-collection form. Results: A total of 4339 patients were included. Over the five-year study period the median patient age was 62 years, median duration of hospital admission was nine days, 9% of patients had an HAI and 35.2% received at least one antimicrobial. Overall there were 406 HAIs (95% confidence interval, 369–447) with surgical site infection, pneumonia and febrile neutropenia occurring most frequently. Enterobacterales were the most common pathogens (N = 78, 28.6%) and 32.1% were third-generation cephalosporin-resistant. Meropenem was the most frequently prescribed antimicrobial for HAIs. Surgical antimicrobial prophylaxis changed drastically, with shorter durations and a marked reduction in oral cephalosporin use. However, antimicrobials for medical prophylaxis gradually increased. Conclusions: This five-year PPS study shows consistent data for patient background, HAIs and causative pathogens and highlights changes in antimicrobial use during the era of the National Action Plan on Antimicrobial Resistance. To describe the epidemiology of Japanese hospitals by PPS, multicentre PPSs including in community hospitals should be performed annually.

We examined the effect of body size on locomotor performance and movement behavior in early postmetamorphic toadlets of Fowler's Toad (Anaxyrus fowleri). Dispersal, if strictly density dependent, should be favored among the relatively small toadlets that emerge from crowded growth conditions, but not among the relatively large toadlets that result from low-density conditions; however, smaller toadlets may have less physical capability to disperse than larger toadlets. The net result may thus be that actual dispersal probability is greatest among intermediate-sized toadlets. Using toadlets of various sizes purposefully raised by manipulating their densities as tadpoles, we tested toadlet locomotor jumping endurance in relation to body size. We also compared the animals' initial body size against their overall movements in the wild, determined using capture–recapture methods, over 2 yr as they grew from toadlets to adults. We calculated movement rate and dispersal probability for each individual re...

Introduction The use of information and communication technology (ICT) for sleep testing is mainly aimed at improving the accuracy of out-of-center sleep testing (OCST) by remote monitoring. In this study, as the first achievement in Japan, we report the results of our sleep medical clinic and hospital unit. For the diagnosis of sleep disorders, monitoring polysomnography (PSG) attending sleep technologist is the gold standard and is positioned as Type I. On the other hand, diagnosis using OCST has become acceptable because many patients can be diagnosed quickly and cost can be reduced.When using Type II devices that measure electroencephalogram at home, the measurement accuracy is inevitable, including poor recording, because it is performed in a non-monitoring situation. As an attempt to improve this situation, our clinic and hospital unit have established a remote monitoring PSG system that can be upgraded from Type II to Type I level by remote monitoring by a sleep technologist to ensure recording accuracy. Methods During the period from April 2004 to December 2017, a total of 286 remote monitoring PSGs were performed by dedicated sleep technologists at the Ota Memorial Sleep Center for patients admitted to a private room at Ota General Hospital. Results The breakdown of the reasons for requesting remote monitoring tests is about 30% of patients scheduled to undergo surgerysuch as palatine tonsillectomy or soft palate plastic surgery the next day, and 24% of hospitalized patients with risky complications %, 17% of patients expected to have a high probability of nighttime seizures and abnormal behavior, and 15% were physically disabled or paralyzed. Conclusion Our remote monitoring PSG system is effectively used in the clinic for the general hospital for patients who need nighttime safety management and nursing management. Support non

Introduction In Japan, the many of the patients are not able to access the specialized sleep medical facilities for overnight polysomnography(PSG) due to less availability and cost issues. Purpose of the study is to examine whether combination of video monitoring and other clinical examinations can reliably predict the severity of pediatric OSA compared with PSG. Methods Between April 1, 2012 and March 31, 2019, total of 175 children (3-12 years of age, boy 122, girl 53) with SDB were enrolled in this individual prospective-cohort study. In-laboratory based PSG were performed for all patients and sleep stages and respiratory events were manually scored. Video monitoring was performed during PSG. Modified video-recording test scoring system (based on Sivan et al 1996), were scored by laboratory technicians. Other clinical examinations were extracted from each PSG with ENT examinations, cephalogram, and rhinomanometry for all patient Results Multiple linear regression analyses was performed with a forward stepwise approach in which independent predictors that were significantly related to severity of OSA (AHI: 5/hr and 10/hr). Applying the multiple logistic regression analysis, the independent predictors for AHI 5/hr were ODI 3% >3/hr, rhinomanometry (NR>0.5 Pa/cm3/sec), enlargement of tonsils (Brodsky classification more than 2), two video monitoring items and total score, with an accuracy of predictive statistic model was 88.0% (sensitivity 78.3%, and specificity 93.0%). For the severity above AHI 10/hr, the independent predictors were Cephalogram parameter (Fx>84°), Oximetry (ODI 3% >5/hr) and BMI Conclusion Video monitor scoring parameters contributed to predict both AHI 5/hr and 10/hr with good overall sensitivity, specificity and overall accuracy compare with the combination of objective results alone. Instead of PSG, the combination of video scoring system and multiple clinical examinations could potentially provide reliable diagnostic approach for pediatric OSA with high accuracy. These results will support to establish more efficient diagnostic strategy for both patients and physicians Support N/A

Density-dependent growth has ordinarily been studied in aquatic ecosystems by varying the abundance of animals in mesocosms of equal volume. Aside from the unequal sample sizes involved with using this abundance-limited method, confounding factors potentially associated with levels of social interactions may also be introduced. The alternative, volume-limited method, i.e., varying the volume while maintaining equal numbers of animals, can provide a test for the presence of potentially confounding factors. Using tadpoles of Fowler's Toad, Anaxyrus fowleri, we examined the effect of density on growth rate, timing of metamorphosis, and size at metamorphosis in both abundance-limited and volume-limited experiments. We found no difference in tadpole growth rate or timing of metamorphosis between these two methods, but the metamorphs emerging from abundance-limited low density treatments were significantly smaller when compared to those in volume-limited low density treatments. Because toad tadpoles may natural...

Temperate snakes occupy overwintering sites for most of their annual life cycle. Microhabitat characteristics of the hibernaculum are largely undescribed, yet are paramount in ensuring snake overwintering survival. We hypothesized that snakes survive hibernation within a vertical subterranean space that we termed a “life zone” (LZ), that is aerobic and flood and frost free throughout winter. We studied an isolated, endangered population of Massasaugas (Sistrurus catenatus) inhabiting an anthropogenically altered peatland and monitored the subterranean habitat during a period of environmental stochasticity. Initial radio telemetry confirmed that snakes moved between altered and natural habitats during the active season and showed hibernation-site fidelity to either habitat. We used a grid of groundwater wells and frost tubes installed in each hibernation area to measure LZ characteristics over 11 consecutive winters. The LZ within the impacted area was periodically reduced to zero during a flood–freeze cycle, but the LZ in the natural area was maintained. Model selection analysis revealed that soil depth and flood status best predicted LZ size. Thermal buffering and groundwater dissolved oxygen increased with LZ size, and annual Massasauga encounters were significantly correlated with LZ size. This analysis suggests a population decline occurred when LZ size was reduced by flooding. Our data give support to the importance and maintenance of an LZ for successful snake hibernation. Our methods apply to subterranean hibernation habitats that are at risk of environmental stochasticity, causing flooding, freezing, or hypoxia.

The aim of this study was to investigate the changes in oxygen consumption during liver transplantation and to examine the relationship between intraoperatively elevated systemic oxygen consumption and postoperative liver function.This study was performed in 33 adult patients undergoing liver transplantation between September 2011 and March 2014. We measured intraoperative oxygen consumption through the use of indirect calorimetry, preoperative and intraoperative data, liver function tests, and postoperative complications and outcomes.The mean age of patients was 52 ± 9.7 years; 14 (42%) of them were women. Average Model for End-Stage Liver Disease scores were 20 ± 8.9. Oxygen consumption significantly increased after reperfusion from 172 ± 30 mL/min during the anhepatic phase to 209 ± 30 mL/min (P.0001). We divided patients into 2 groups according to the increase in oxygen consumption after reperfusion (oxygen consumption after reperfusion minus anhepatic phase oxygen consumption: 40 mL/min increase as cutoff). The higher consumption group had a longer cold ischemia time and higher postoperative aspartate aminotransferase and alanine aminotransferase levels as compared with the lower oxygen consumption group. There were no statistically significant differences in major postoperative complications, but the higher oxygen consumption group tended to have shorter hospital stays than the lower consumption group (58 versus 95 days).We have demonstrated that oxygen consumption significantly increased after reperfusion. Furthermore, this increased oxygen consumption was associated with a longer cold ischemia time and shorter hospital stays.

We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials （RCTs） revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.

Background There has been no public structured training program for transplant surgeons in Japan. However, such a program is crucial for optimizing liver transplant surgery and training young professionals in liver transplant surgery. A comprehensive training program was recently developed and the underlying concepts, structure and curriculum, and results of this program are described here. Methods We developed a 3-year training program in 2014 called the Six National University Consortium in Liver Transplant Professionals Training (SNUC-LT) program supported by the Ministry of Education, Culture, Sports, Science, and Technology. This program is based on strong cooperation among 6 national universities (Kumamoto, Okayama, Nagasaki, Kanazawa, Niigata, and Chiba Universities). The program includes various courses to help trainees learn transplant theory and practice as well as to teach surgical skills required to safely perform transplant surgery. Results Three trainees completed the specially designed 3-year curriculum. They attended lectures on transplant theory for an average of 59 hours and participated in an average of 44 liver transplant surgeries and 51 liver resections for transplant practice. Trainees from low-volume centers had sufficient opportunities to attend operations in high-volume centers because of the cooperative agreement among the universities. After finishing the program, the trainees were certified as talent-proven liver transplant surgeons. Conclusions The SNUC-LT program is the first national program in Japan to have strong professional support. Our multicenter program enables young surgeons to have more abundant knowledge, more extensive experience, better surgical skills, and smoother communication skills in the field of liver transplantation.

Background and aims Whether asymptomatic patients with colorectal cancer (CRC) who are treated in hospitals show better outcomes than symptomatic patients with CRC still remains unknown. The aim of this study was to evaluate differences in clinical benefits following treatment in asymptomatic and symptomatic patients with CRC. Methods This study was a retrospective cohort analysis with data obtained from records. A cohort of 145 asymptomatic and 123 symptomatic patients who underwent CRC surgery between January 2009 and December 2011 was enrolled. To reduce bias in comparing outcomes, propensity score (PS) analysis was used for matching of patients in the symptomatic and asymptomatic groups based on clinicopathological factors. Surgical invasiveness, medical costs and oncological outcomes were examined by unadjusted and PS-matched analysis. Results Tumours in the symptomatic group were more often diagnosed in advanced stages compared with tumours in the asymptomatic group. Therefore, fewer symptomatic group patients underwent minimally invasive surgery. Short-term outcomes, including amount of blood loss, duration of postoperative hospital stay and perioperative medical costs, were significantly better in the asymptomatic group. Although overall survival was significantly better in the asymptomatic group, there was no significant difference between the groups when the patients were adjusted on the basis of PS. Conclusions Though this study was limited by the retrospective nature and small sample size, favourable outcomes in asymptomatic patients were due to the higher proportion of patients in this group who were diagnosed with CRC in earlier stages, due to participation in CRC screening programmes.

Body temperature has a major influence on the physiological processes, growth, reproductive output, and overall survival of ectotherms. When a habitat is altered as a result of natural or anthropogenic influences, the available temperatures in the habitat can change, thus affecting an animal's ability to thermoregulate. We studied thermoregulation in response to habitat change in a population of spotted turtles ( Clemmys guttata ) in Southern Ontario, Canada. Historically, the study site was ditched to draw down water levels to facilitate peat mining, and the resulting drainage ditches were the only habitat containing surface water and turtles were restricted to these drains. Recent colonization of the site by beaver ( Castor canadensis ) caused increases in water level and water surface area. We followed spotted turtles ( N =16) outfitted with radio transmitters and iButtons to estimate body temperatures ( T b ) continuously throughout the active season post-flooding. Turtle models outfitted with iButtons ( N =50) were deployed in the nine available habitat types to record environmental temperatures ( T e ). Turtles ( N =13) were tested in a thermal gradient under laboratory conditions to determine preferred body temperature range ( T set ). The T set for the population ranged from 20 °C to 26 °C. In the field, T b was within the T set range 28% of the time from March to October, and 67% of the time from July to August. Efficiency of thermoregulation was calculated to be highest in July and August. The habitat type with the highest thermal quality was the shallow flooded zone created by beaver damming, and the habitat with the lowest thermal quality was the drain bottom, the drains being the only aquatic habitat available prior to flooding. This study confirms that beaver flooding provided a wide variety of preferable thermal opportunities for spotted turtles. Further investigation is needed to determine the effects of flooding on spotted turtle thermoregulation during nesting and hibernation.

Filtering based on blacklists is a major countermeasure against malicious websites. However, blacklists must be updated because malicious URLs tend to be short-lived, and they can be partially mutated to avoid blacklisting. Due to these characteristics, it can be assumed that unknown malicious URLs exist in the neighborhood of known malicious URLs created by the same adversary. The authors propose an effective blacklist URL generation method that discovers URLs in the neighborhood of a malicious URL by using a search engine. This article is part of a special issue on security.

Background To clarify the influence of hypertension and blood pressure ( BP ) control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J‐ RHYTHM Registry was performed. Methods and Results A consecutive series of outpatients with atrial fibrillation was enrolled from 158 institutions. Of 7937 patients, 7406 with nonvalvular atrial fibrillation (70.8% men, 69.8±10.0 years) were followed for 2 years or until an event occurred. Hypertension was defined as a systolic BP ≥140 mm Hg, a diastolic BP ≥90 mm Hg, a history of hypertension, and/or antihypertensive drug use. Hypertension was an independent risk factor for major hemorrhage (hazard ratio 1.52, 95% CI 1.05–2.21, P =0.027) but not for thromboembolism (hazard ratio 1.05, 95% CI 0.73–1.52, P =0.787). When patients were divided into quartiles according to their systolic BP at the time closest to the event or at the end of follow‐up (Q1, CI 1.75–4.74, P CI 1.02–2.53, P =0.041) after adjustment for components of CHA 2 DS 2 ‐ VAS c score, warfarin use, and antiplatelet use. A systolic BP of ≥136 mm Hg was an independent risk factor for thromboembolism and major hemorrhage. Conclusions BP control appears to be more important than a history of hypertension and baseline BP values at preventing thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation. Clinical Trial Registration URL : http://www.umin.ac.jp/ctr . Unique identifier: UMIN 000001569.

Many studies have focused on the effects of anthropogenic habitat alterations on animals, but little attention has been given to the effects of natural changes in habitat. The purpose of our study was to examine the effects of flooding caused by Beaver (Castor canadensis) dams on the spatial ecology of the federally endangered Spotted Turtle (Clemmys guttata), in a bog in Ontario that was historically drained for peat extraction. We hypothesized that home range sizes and daily distances traveled would be greater after flooding and that habitat selection would change because turtles would exploit the increase in aquatic habitats post-flooding. Using 12 years of mark–recapture data, radio telemetry, and GIS software, we compared movements and habitat selection before and after flooding. Distances traveled and home range sizes were larger post-flood compared to pre-flood conditions, indicating that turtles were opportunistically exploring the new aquatic habitat. During pre-flooding, turtles primarily select...

The N2 and O2 pressure broadening coefficients of the pure rotational transitions at 625.66 GHz (NKaKc=101▒9–100▒10, J=10.5–10.5) and 649.70 GHz (NKaKc=102▒9–92▒8, J=9.5–8.5) in the vibronic ground state X2A′ of the perhydroxyl (HO2) radical have been determined by precise laboratory measurements. For the production of HO2, the mercury-photosensitized reaction of the H2 and O2 precursors was used to provide an optimum condition for measurement of the pressure broadening coefficient. The Superconducting Submillimeter-wave Limb Emission Sounder (SMILES) was designed to monitor the volume mixing ratio of trace gases including HO2 in the Earth's upper atmosphere using these transitions. The precise measurement of pressure broadening coefficient γ in terms of the half width at half maximum is required in order to retrieve the atmospheric volume mixing ratio. In this work, γ coefficients of the 625.66 GHz transition were determined for N2 and O2 at room temperature as γ(N2)=4.085±0.049 MHz/Torr and γ(O2)=2.578±0.047 MHz/Torr with 3σ uncertainty. Similarly, the coefficients of the 649.70 GHz transition were determined as γ(N2)=3.489±0.094 MHz/Torr and γ(O2)=2.615±0.099 MHz/Torr. The air broadening coefficients for the 625.66 GHz and 649.70 GHz lines were estimated at γ(air)=3.769±0.067 MHz and 3.298±0.099 MHz respectively, where the uncertainty includes possible systematic errors. The newly determined coefficients are compared with previous results and we discuss the advantage of the mercury-photosensitized reaction for HO2 generation. In comparison with those of other singlet molecules, the pressure broadening coefficients of the HO2 radical are not much affected by the existence of an unpaired electron.

In this paper, we investigated a chromatic dispersion and Brillouin gain spectrum (BGS) control in highly nonlinear fibers (HNLFs). Downsized HNLFs (DS-HNLFs) with specific mechanical properties are effective to realize novel applications using a strain applied to the fibers. We experimentally demonstrated the zero dispersion wavelength (?0) and the BGS tuning of the DS-HNLFs by the strain control technique. In addition, the efficient stimulated Brillouin scattering (SBS) suppression was also demonstrated by the dispersion and BGS managed downsized dispersion-decreasing HNLF. We confirmed that the efficiency of the wavelength conversion was increased drastically by the SBS suppression, and the maximum conversion efficiency of 1.5 dB was realized by a single continuous-wave pump without phase modulation.

The KCNQ1 gene encodes a voltage-dependent potassium ion channel, and mutations in this gene are the most common cause of congenital long QT syndrome (LQTS). In the present study, we investigated the various phenotypic characteristics of vertigo 2 Jackson (C3H/HeJCrl-Kcnq1(vtg-2J)/J) mice with a Kcnq1 mutation. Both heterozygotes (vtg-2J/+) and homozygotes (vtg-2J/vtg-2J) showed prolonged QT intervals in electrocardiograms (ECGs) compared to C3H/HeJ control (+/+) mice. Furthermore, vtg-2J/vtg-2J mice showed gastric achlorhydria associated with elevation of their serum gastrin levels. The serum corticosterone levels were also significantly increased in vtg-2J/vtg-2J mice. In addition, vtg-2J/vtg-2J mice exhibited significantly higher blood pressure. These findings indicate that the Kcnq1 mutation in vtg-2J mice alters various physiological functions in the cardiac, gastric and adrenocortical systems, and suggest that vtg-2J mice may represent a useful model for studying Kcnq1 functions.

The perfect softening of the ferroelectric E u mode has been demonstrated in SrTi 18 O 3 by Raman scattering using a Sandercock-type tandem Fabry-Perot interferometer. The temperature dependence of the E u mode spectrum indicates that the mechanism of the ferroelectric phase transition is concluded as the ideal displacive type related to the Slater-type ferrlelectric mode. The observed result is compared to the previous reported results observed by a hyper-Raman scattering, inelastic neutron scattering, and Raman scattering.

On March 20, 2005, a large M JMA7.0 earthquake occurred in the offshore area, west of Fukuoka prefecture, northern Kyushu, Japan. A series of joint observations were carried out by teams from several universities in Japan with the aim of investigating the aftershock activity. Six online telemetered and 17 offline recording seismic stations were installed on land around the aftershock area immediately followed the occurrence of the mainshock. Because aftershocks were located mainly in offshore regions, we also installed 11 ocean bottom seismometers (OBSs) just above the aftershock region and its vicinity in order to obtain accurate locations of hypocenters. The OBS observation was carried out from March 27 to April 13, 2005. We further conducted temporary GPS observations in which ten GPS receivers were deployed around the aftershock region. The aftershocks were mainly aligned along an approximately 25-km-long NW-SE trend, and the hypocenters of the main aftershock region were distributed on a nearly vertical plane at depths of 2–16 km. The mainshock was located near the central part of the main aftershock region at a depth of approximately 10 km. The largest aftershock of M JMA5.8 occurred near the southeastern edge of the main aftershock region, and the aftershock region subsequently extended about 5 km in the SE direction as defined by secondary aftershock activity. Enlargement of the aftershock region did not occur after the peak in aftershock activity, and the aftershock activity gradually declined. The distribution of hypocenters and seismogenic stress as defined by aftershocks suggest that the 2005 West Off Fukuoka Prefecture Earthquake occurred on the fault that is the NW extension of the Kego fault, which extends NW-SE through the Fukuoka metropolitan area, and that the largest aftershock occurred at the northwestern tip of the Kego fault.

A new heterodyne experiment on the ferroelectric KH 2 PO 4 elucidates the extremely early stage of the excitation process of the ferroelectric relaxation mode. The time dependence of the response function G(t) shows a continuous rising from the time origin where the mode is excited by the ultra-short femtosecond pulses. The limit of the Debye model is overcome by a new phenomenological response function proposed here based on the experimental result.

The low frequency phonon mode in SrTi18O3 has been investigated by highresolution technique, in order to clarify the relationship between the perfect softening of the ferroelectric Eu mode and the acoustic anomaly in the c44 mode reported previously near the phase transition point Tc. The drastic softening and the anomalous increase of intensity were reported as the anomalous behavior of the c44 mode. However, in the present paper the anomaly of the c44 mode has not been observed in the spectra of SrTi18O3 with the 18O isotope concentration of 95%, though the perfect softening of the Eu mode has been confirmed clearly. The obtained result indicates that the anomalous behavior reported in the c44 mode is not intrinsic for the ferroelectric phase transition. The acoustic anomaly might be related to the ferroelectric phase transition through the coupling effects induced by a sample-depending internal stress originated in the structural phase transition at 105 K or the ferroelectric micro regions.