The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis

Background/Aims: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. Methods: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. Results: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). Conclusions: Although elderly ­patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching

Orbital ferromagnetism and anomalous Hall effect in antiferromagnets on distorted fcc lattice

The Berry phase due to the spin wavefunction gives rise to the orbital ferromagnetism and anomalous Hall effect in the non-coplanar antiferromagnetic ordered state on face centered cubic (fcc) lattice once the crystal is distorted perpendicular to (1,1,1) or (1,1,0)- plane. The relevance to the real systems $\gamma$-FeMn and NiS$_2$ is also discussed.Comment: 4 pages, 3 figure

Design and On-Orbit Operation of the Adiabatic Demagnetization Refrigerator on the Hitomi Soft X-Ray Spectrometer Instrument

The Soft X-ray Spectrometer instrument on the Astro-H observatory contains a 6x6 array of x-ray microcalorimeters that is cooled to 50 mK by an adiabatic demagnetization refrigerator (ADR). The ADR consists of three stages in order to provide stable detector cooling using either a 1.2 K superfluid helium bath or a 4.5 K Joule-Thomson (JT) cryocooler as its heat sink. When liquid helium is present, two of the ADR's stages are used to single-shot cool the detectors while rejecting heat to the helium. After the helium is depleted, all three stages are used to continuously cool the helium tank (to about 1.5 K) and single-shot cool the detectors (to 50 mK), using the JT cryocooler as its heat sink. The Astro-H observatory, renamed Hitomi after its successful launch in February 2016, carried approximately 36 liters of helium into orbit. On day 5, the helium had cooled sufficiently (<1.4 K) to allow operation of the ADR. This paper describes the design, operation and on-orbit performance of the ADR, and the use of the ADR's heat rejection as a tool for mass gauging the helium tank

Design and On-Orbit Operation of the Soft X-Ray Spectrometer Adiabatic Demagnetization Refrigerator on the Hitomi Observatory

The Soft X-ray Spectrometer (SXS) instrument that flew on the Astro-H observatory was designed to perform imaging and spectroscopy of x-rays in the energy range of 0.2 to 13 keV with a resolution requirement of 7 eV or better. This was accomplished using a 6x6 array of x-ray microcalorimeters cooled to an operating temperature of 50 mK by an adiabatic demagnetization refrigerator (ADR). The ADR consisted of three stages in order to operate using either a 1.2 K superfluid helium bath or a 4.5 K Joule-Thomson (JT) cryocooler as its heat sink. The design was based on the following operating strategy. After launch, while liquid helium was present (cryogen mode), two of the ADRs stages would be used to single-shot cool the detectors, using the helium as a heat sink. When the helium was eventually depleted (cryogen-free mode), all three ADR stages would be used to continuously cool the helium tank to about 1.5 K, and to single-shot cool the detectors (to 50 mK), using the JT cryocooler as a heat sink. The Astro-H observatory, renamed Hitomi after its successful launch in February 2016, carried approximately 36 liters of helium into orbit. Based on measurements during ground testing, the average heat load on the helium was projected to be 0.66 mW, giving a lifetime of more than 4 years. On day 5, the helium had cooled to <1.4 K and ADR operation began, successfully cooling the detector array to 50 mK. The ADRs hold time steadily increased to 48 hours as the helium cooled to a temperature of 1.12 K. As the commissioning phase progressed, the ADR was recycled (requiring approximately 45 minutes) periodically, either in preparation for science observations or whenever the 50 mK stage approached the end of its hold time. In total, 18 cycles were completed by the time an attitude control anomaly led to an unrecoverable failure of the satellite on day 38. This paper presents the design, operation and on-orbit performance of the ADR in cryogen mode as the foreshortened mission did not provide an opportunity to test cryogen-free mode

Role of Inn1 and its interactions with Hof1 and Cyk3 in promoting cleavage furrow and septum formation in S. cerevisiae

Cytokinesis requires coordination of actomyosin ring (AMR) contraction with rearrangements of the plasma membrane and extracellular matrix. In Saccharomyces cerevisiae, new membrane, the chitin synthase Chs2 (which forms the primary septum [PS]), and the protein Inn1 are all delivered to the division site upon mitotic exit even when the AMR is absent. Inn1 is essential for PS formation but not for Chs2 localization. The Inn1 C-terminal region is necessary for localization, and distinct PXXP motifs in this region mediate functionally important interactions with SH3 domains in the cytokinesis proteins Hof1 (an F-BAR protein) and Cyk3 (whose overexpression can restore PS formation in inn1Δ cells). The Inn1 N terminus resembles C2 domains but does not appear to bind phospholipids; nonetheless, when overexpressed or fused to Hof1, it can provide Inn1 function even in the absence of the AMR. Thus, Inn1 and Cyk3 appear to cooperate in activating Chs2 for PS formation, which allows coordination of AMR contraction with ingression of the cleavage furrow

Hitomi (ASTRO-H) X-ray Astronomy Satellite

The Hitomi (ASTRO-H) mission is the sixth Japanese x-ray astronomy satellite developed by a large international collaboration, including Japan, USA, Canada, and Europe. The mission aimed to provide the highest energy resolution ever achieved at E  >  2  keV, using a microcalorimeter instrument, and to cover a wide energy range spanning four decades in energy from soft x-rays to gamma rays. After a successful launch on February 17, 2016, the spacecraft lost its function on March 26, 2016, but the commissioning phase for about a month provided valuable information on the onboard instruments and the spacecraft system, including astrophysical results obtained from first light observations. The paper describes the Hitomi (ASTRO-H) mission, its capabilities, the initial operation, and the instruments/spacecraft performances confirmed during the commissioning operations for about a month