Tissue acquisition for comprehensive genomic profiling of gallbladder cancer using a forward-viewing echoendoscope in a patient who underwent Roux-en-Y reconstruction.

A 50-year-old man with a history of total gastrectomy, distal pancreatectomy, splenectomy, and Roux-en-Y reconstruction was admitted to our hospital with a gallbladder tumor that had infiltrated the liver and abdominal wall. Because malignant cells were not collected during the percutaneous biopsy, we planned to perform an endoscopic ultrasound-guided fine-needle biopsy with a 22-G Franseen needle using a forward-viewing echoendoscope. Using intermittent manual compression, the forward-viewing echoendoscope reached the duodenum under fluoroscopic guidance. Endoscopic ultrasound-guided fine-needle biopsy was performed using a 22-G needle and 20-mL syringe and yielded a sufficient specimen with a single puncture. Malignant cells were promptly identified during on-site evaluation. The composition of the specimen (> 20% cancer cells and tissue area exceeding 25 mm2) enabled comprehensive genomic profiling. Subsequently, high-tumor mutational burden was diagnosed based on comprehensive genomic profiling, and pembrolizumab was initiated as a second-line therapy. Even in cases involving Roux-en-Y reconstruction, endoscopic ultrasound-guided fine-needle biopsy using a forward-viewing echoendoscope can result in collection of a high-quality specimen.

Impact of COVID-19 on pediatric surgery cancellations: A retrospective study.

BACKGROUND: Prevalence trends and reasons for pediatric surgery cancellation in Japan during the coronavirus disease 2019 (COVID-19) pandemic have not previously been reported. This study aimed to compare the prevalence and reasons for cancellation of pediatric surgeries in Japan before and during the COVID-19 pandemic. METHODS: This single-center retrospective cohort study reviewed the reasons for surgery cancellations scheduled for patients aged <18 years between the prepandemic period (September 2017-December 2019) and the COVID-19 pandemic period (January 2020-April 2022). The cancellation reasons were classified into four major categories: medical, surgical, patient-related, and administrative. RESULTS: Of the 3395 and 3455 surgeries scheduled before and during the COVID-19 pandemic, 305 (9.0%) and 319 (9.2%) surgeries were canceled (p = 0.737), respectively. The proportion of cancellations due to infections or fever in medical reasons decreased from 67.9% to 56.1% (p = 0.003) and that due to patient-related reasons increased from 6.6% to 15.1% (p = 0.001). Further, the proportion of cancellations due to staff shortages in staff administrative reasons increased from 0.3% to 3.1% (p = 0.011). There was no significant difference in the proportion of surgeries canceled due to surgical reasons between the two periods. CONCLUSIONS: The proportion of cancellations due to infections or fever decreased during the COVID-19 pandemic, while that due to staff shortages increased. Infection prevention is an important measure to address the staff shortages. Implementation of national or regional policies and additional strategic interventions may be required to prepare for disasters like the COVID-19 pandemic.

Sequential estimation of the generated curing heat of composite materials by data assimilation: A numerical study.

The models and parameters related to the generated curing heat in the molding simulation of composite materials are dependent on the type of resin used and the experimental conditions. Therefore, in this study, we estimated the generated curing heat that changes with time by a data assimilation method, which combines the observation values with simulation values, so that the heat curing simulation of carbon fiber reinforced polymers (CFRPs) becomes closer to the experimental conditions. In the data assimilation method, the temperature distribution on the surface of the composite material was used as an observation value, and the generated curing heat was estimated using an ensemble Kalman filter. By optimizing the data assimilation parameters in advance using the response surface method and estimating the generated curing heat by numerical experiments, the generated curing heat could be estimated with an accuracy represented by the time mean error of less than 6%.

Physical frailty predicts the development of social frailty: a prospective cohort study.

BACKGROUND: It has not been clarified whether physical frailty symptoms predict social. frailty. The purpose of this study was to elucidate the effect of physical frailty on social frailty, and to determine which domains of physical frailty predict the development of social frailty. METHODS: We employed a two-year prospective cohort study. A total of 342 socially robust community-dwelling older adults were recruited. We used a modified social frailty screening index consisting of four social domains including financial difficulties, living alone, social activity, and contact with neighbors. Physical frailty status was also assessed at baseline. At the two-year follow-up, we assessed the development of social frailty. Social status was assessed using four social subdomains for the primary analysis. Social status was assessed using the two social subdomains of social activity and contact with neighbors, which would be affected by the physical frailty component, for the secondary analysis. The risk ratios (RR) of physical frailty for the development of social frailty were estimated. RESULTS: Although physical frailty symptoms were not a significant risk factor for future development of social frailty as assessed by four social subdomains (adjusted RR 1.39, 95% CI 0.95-2.15), it became significant when development of social frailty was assessed by the two social subdomains (adjusted RR 1.78, 95% CI 1.10-2.88). An analysis using the physical frailty subdomain showed that slow gait speed (adjusted RR 3.41, 95% CI 1.10-10.53) and weakness (adjusted RR 1.06, 95% CI 1.01-1.12) were independent risk factors for development of social frailty as assessed by two social subdomains. CONCLUSIONS: Physical frailty symptoms predict the development of social frailty. Among physical frailty subdomains, gait speed and muscle strength are critical independent risk factors for future decline in the social aspect. The prevention of physical frailty, especially by maintaining gait ability and muscle strength, may be effective for avoiding social frailty.

Territorial males can sire more offspring in nests with smaller doors in the cichlid Lamprologus lemairii.

To examine how territorial males counter reproductive parasites, we examined the paternity of broods guarded by territorial males using 5 microsatellite loci and factors that determine siring success in a wild population of the Lake Tanganyika cichlid Lamprologus lemairii. Females enter rock holes (nests) and spawn inside, and territorial males release milt over the nest openings. Sneakers attempt to dart into the nests, but territorial males often interrupt the attempt. The body size of territorial males (territorial defense ability) and the size of nest opening (the ability to prevent sneakers from nest intrusions) are predicted to be factors that affect paternity at the premating stage, whereas milt quality traits are factors that affect paternity at the postmating stage. Parentage analyses of 477 offspring revealed that most clutches have few or no cuckolders, and territorial males sired >80% of eggs in 7 of the 10 analyzed clutches. Larger territorial males that spawned in nests with narrower openings had greater siring success. In contrast, none of the milt traits affected the siring success. These suggest that territorial male L. lemairii adopt premating strategies whereby they effectively prevent reproductive parasitism.

Mitochondrial DNA analysis reveals a unique population structure of the amphidromous sculpin Cottus pollux middle-egg type (Teleostei: Cottidae).

In this study, we examined nucleotide sequences from the first half of the mitochondrial control region gene to test for genetic differentiation in an amphidromous sculpin, Cottus pollux middle-egg type (ME) (Cottidae), obtained from 19 localities across its distribution range. Spatial analysis of molecular variance revealed five divergent groups of related haplotypes among this populations. Analysis with Migrate software revealed that gene flow was quite restricted among the groups, although it occurred practically between neighboring groups. It has previously been reported that the population structure among the amphidromous fishes of the various islands is low or non-existent, and is characterized mainly by the duration of the pelagic larval life. However, the present study demonstrated that the various C. pollux ME populations were different both among the islands, and within the island of the Japanese Archipelago. Our finding indicate that the unique population structure of C. pollux ME may be influenced not only by the extent of the pelagic larval phase of the species but also by the seasonal differentiation of its dispersal phase.

Evolutionary history of freshwater sculpins, genus Cottus (Teleostei; Cottidae) and related taxa, as inferred from mitochondrial DNA phylogeny.

The freshwater sculpins, genus Cottus (Teleostei; Cottidae), comprise bottom-dwelling fishes that exhibit various life-history styles, having radiated throughout Northern Hemisphere freshwater habitats. The phylogenetic relationships among Cottus and related taxa were estimated from mitochondrial DNA 12S rRNA and control region (CR) sequences, the freshwater sculpins examined falling into five lineages (A-E). Lineage A consisted of Trachidermus fasciatus and C. kazika, both having a catadromous life-history. The remaining species (lineages B-E) spawn in freshwater habitats regardless of life-history (amphidromous, lacustrine or fluvial), suggesting that the various life-history types post-dated a common ancestor of lineages B-E. Molecular clock estimates suggested a Pliocene-Pleistocene radiation (or Miocene-Pliocene from the alternative clock) of lineages B-E. In eastern Eurasia, speciation with life-history changes to amphidromous or fluvial styles has apparently occurred independently in some lineages, as a general pattern. Mitochondrial DNA CR phylogeny showed the monophyletic Baikalian cottoids (Cottoidei) to be nested within Cottus and Trachidermus, suggesting that the former ecologically and morphologically divergent cottoids may have originated from a single lineage which invaded the ancient lake.