The Southwest Pacific represents an independent biogeographic province for deep-sea hydrothermal vent fauna. Different degrees of genetic connectivity among vent fields in Manus, North Fiji and Lau ...Basins have been reported for various molluscan and crustacean species, presumably reflecting their different levels of dispersal ability as swimming larvae. The present study investigates the population connectivity of the hydrothermal vent limpet Shinkailepas tollmanni (family Phenacolepadidae) in the Southwest Pacific. Our analyses using mitochondrial COI-gene sequences and shell morphometric traits suggest a panmictic population structure throughout its geographic and bathymetric ranges, spanning 4,000 km from the westernmost Manus Basin (151#194;#186;E; 1,300 m deep) to the easternmost Lau Basin (176#194;#186;E; 2,720 m). The measurements of its embryonic and larval shells demonstrate that the species hatches as a planktotrophic veliger larva with an embryonic shell diameter of 170-180 mum and settles at the vent environment with the larval shell diameter of 750-770 mum. This substantial growth as a feeding larva, ca. 80 times in volume, is comparable or even greater than those of confamilial species in the hydrothermal-vent and methane-seep environments in the Northwest Pacific and Atlantic Oceans. Large pigmented eyes in newly settled juveniles are another common feature in this and other phenacolepadids inhabiting the chemosynthetic environments. These results put together suggest that the larvae of S. tollmanni migrate vertically from deep-sea vents to surface waters to take advantages of richer food supplies and faster currents and stay pelagic for an extended period of time (> 1 year), as previously indicated for the confamilial species.
Obesity is a risk factor for coronary artery disease (CAD), but the association between fat distribution, i.e., visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and coronary ...artery plaque morphology remains unclear. This study explored the association between abdominal fat distribution and coronary artery plaques.
We retrospectively evaluated 4327 consecutive patients without CAD history, undergoing coronary computed tomography (CT) angiography. Plaques were assessed using segment stenosis score (SSS) and segment involvement score (SIS). We evaluated abdominal VAT and SAT areas using CT images. Patients were categorized into four groups: low VAT (<median)/low SAT (<median); low VAT/high SAT (≥median); high VAT (≥median)/low SAT; and high VAT/high SAT.
Mean age was 65 years (men, 66.4%). VAT area correlated with SSS (β-coefficient = 0.11, p < 0.001) and SIS (β-coefficient = 0.006, p < 0.001), whereas SAT area was inversely correlated with SSS (β-coefficient = −0.007,p < 0.001) and SIS (β-coefficient = −0.004, p < 0.001). The low VAT/high SAT group had the lowest risk of higher SSS (≥5) and SIS (≥5) (odds ratio OR using low VAT/low SAT group as the reference category, 0.76, 95% confidence interval CI, 0.61–0.95, p < 0.05; OR, 0.68, 95% CI, 0.53–0.88, p < 0.01, respectively) in multivariate analysis adjusted for age, sex, and traditional CAD risk factors. In the obese population (body mass index ≥25, n = 1694), the low VAT/high SAT group had the lowest risk of higher coronary plaque scores.
Higher SAT and lower VAT were inversely correlated with the extent and severity of coronary artery plaques. Fat distribution may be useful for evaluating risk and prognosis of CAD.
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•Abdominal visceral fat area correlated with coronary plaque scores, whereas abdominal subcutaneous fat area inversely correlated with those scores.•Higher SAT and lower VAT were inversely correlated with the extent and severity of coronary artery plaques.•Fat distribution may be a useful tool for evaluating risk and prognosis of coronary artery disease.
The effects of patient age on the efficacy of eradication treatment for Helicobacter pylori (H. pylori) remain unclear. The present study aimed to determine whether age affects eradication therapy ...involving vonoprazan, a novel potassium-competitive acid blocker (PCAB). We reviewed the cases of 3,261 patients who were administered first-line and second-line H. pylori eradication therapy at Toyoshima Endoscopy Clinic. The first-line treatment was clarithromycin and amoxicillin combined with a proton pump inhibitor (PPI) or a PCAB. The second-line treatment was metronidazole and amoxicillin combined with a PPI or PCAB. The patients were divided into a young to middle-aged group (age ≤50 years) and an older group (age >50 years) as well as into PPI and PCAB groups. The PPI-clarithromycin-amoxicillin regimen demonstrated a significantly lower H. pylori eradication rate than the PCAB-clarithromycin-amoxicillin regimen (p<0.001). With the PPI-clarithromycin-amoxicillin regimen, the eradication rate in the young to middle-aged group was significantly lower than that in the older group (p<0.001). Lastly, age had no impact on the eradication rate of PCAB-based therapy or metronidazole-based therapy. In conclusion, with clarithromycin-based triple therapy, PCAB is a better choice of antisecretory agent compared to PPIs, especially in young to middle-aged patients.
Undershot cross-flow water turbines are characterized by their being easily applicable to open channels with various widths and depths by changing their blade width and/or the outer diameter of the ...runner. On the other hand, as this water turbine operates in a free-surface flow field, it is expected that when the flow rate changes, the flow field around the runner including the water depth changes dramatically, and that the turbine performance also changes. Thus, the objective of this study is to elucidate the effect of flow rate on the performance and flow field of an undershot cross-flow water turbine. By changing the flow rate, we conduct experiments and free surface flow analysis on the water turbine, as well as torque component analysis. The result showed that, among the torques in the respective flow regions, that torque resulting from the second stage cross-flow was dominant. Furthermore, it was found that among the respective dynamic components of the torque, the most dominant component was the gravitational component for low flow rates and the angular momentum component for medium-to-high flow rates. We expect these results to contribute to the establishment of higher performance design guidelines, such as optimum shapes for the flow rates.
•The undershot cross-flow water turbine is applicable to open channels of various widths and depths.•The effect of flow rate on the performance of the present water turbine were elucidated.•The flow field was elucidated at different flow rates.•The breakdown of the torque into its flow rons and dynamic components were elucidated.
Underwater endoscopic mucosal resection (UEMR) and cold snare polypectomy (CSP) are novel endoscopic procedures for superficial nonampullary duodenal epithelial tumors (SNADET). However, consensus on ...how to use both procedures appropriately has not been established. In this study, we evaluated treatment outcomes of both procedures, including resectability.
In this single-center randomized controlled study conducted between January 2020 and June 2022, patients with SNADET ≤12 mm were randomly allocated to UEMR and CSP groups. The primary end point was sufficient vertical R0 resection (SVR0), which was defined as R0 resection including a sufficient submucosal layer. We compared treatment outcomes including SVR0 rate between groups.
The SVR0 rate was significantly higher in the UEMR group than in the CSP group (65.6% vs 41.5%, P = 0.01). By contrast, the R0 resection rate was not significantly different between study groups (70.3% vs 61.5%, P = 0.29). The submucosal layer thickness was significantly greater in the UEMR group than in the CSP group (median 546 range, 309-833 μm vs 69 0-295 μm, P < 0.01). CSP had a shorter total procedure time (median 12 range, 8-16 min vs 1 1-3 min, P < 0.01) and fewer total bleeding events (9.4% vs 1.5%, P = 0.06).
UEMR has superior vertical resectability compared with CSP, but CSP has a shorter procedure time and fewer bleeding events. Although CSP is preferable for most small SNADET, UEMR should be selected for lesions that cannot be definitively diagnosed as mucosal low-grade neoplasias.
Acute thrombogenicity and re-endothelialization represent clinically relevant end points pertaining to the safety of coronary stents, which have not been compared among biodegradable polymer-based ...drug-eluting metallic stents and fully bioabsorbable scaffolds to date.
We investigated comparative outcomes with respect to acute thrombogenicity and re-endothelialization among thin-strut biodegradable polymer metallic everolimus eluting stents (EES), thick-strut fully bioabsorbable EES, thick-strut biodegradable polymer metallic biolimus-eluting stents and control bare metal stents. An ex-vivo porcine arterio-venous shunt model was used to assess platelet aggregation, whereas a healthy rabbit model of iliofemoral stent implantation was used to assess re-endothelialization and inflammation. Confocal microscopy was used to detect fluorescently labeled antibody staining directed against CD61/CD42b for the identification of aggregated thrombocytes, CD14/PM-1, and RAM-11 for identification of neutrophils and monocytes/macrophages. Endothelial recovery was assessed by scanning electron microscopy, whereas CD31/PECAM-1 was used to confirm endothelial maturity. EES demonstrated significantly less acute thrombogenicity compared with bioabsorbable EES and biolimus-eluting stents. EES showed greater re-endothelialization at 28 days and reduced inflammatory cell adhesion of monocytes/macrophages at 14 days compared with bioabsorbable EES. Only bare metal stents showed complete re-endothelialization at 28 days.
These outcomes indicate differential trends in thrombogenicity and vascular healing among contemporary stents used in clinical practice and suggest a need for long-term adjunct antithrombotic pharmacotherapy for bioabsorbable EES.
Background Surgical gastrojejunostomy is associated with relatively high morbidity and mortality rates. However, current experimental EUS-guided gastrojejunostomy information is limited. Objective To ...evaluate a novel EUS-guided gastrojejunostomy technique using a new enteric balloon and lumen-apposing metal stent. Design Animal experiment. Setting Animal laboratory at a referral center. Subjects and Interventions In 5 pigs, gastrojejunostomies were created under EUS guidance. Fully covered lumen-apposing stents were placed between the stomach and the jejunum. Main Outcome Measurements Technical success and adverse events of EUS-guided gastrojejunostomy. Results All stents, with 1 exception, were successfully deployed without any adverse events. The mean time to stent placement was 44.2 minutes (range 28-64 minutes). All animals showed normal eating behavior without signs of infection for 1 month after the procedure. Endoscopic imaging of the stomach site showed the stent to be patent and stable, without dislodgment, in all of the pigs. Necropsy showed complete adhesion between the stomach and the jejunum wall. Limitations Pilot study. Conclusions Creation of an EUS-guided gastrojejunostomy by using a novel enteric balloon and metal stent appears to be promising as a minimally invasive treatment.
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