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The sensitivity of photosynthesis to temperature has been identified as a key uncertainty for projecting the magnitude of the terrestrial carbon cycle response to future climate change. Although thermal acclimation of photosynthesis under rising temperature has been reported in many tree species, whether tropospheric ozone (O3 ) affects the acclimation capacity remains unknown. In this study, temperature responses of photosynthesis (light-saturated rate of photosynthesis (Asat ), maximum rates of RuBP carboxylation (Vcmax ), and electron transport (Jmax ) and dark respiration (Rdark ) of Populus tremula exposed to ambient O3 (AO3 , maximum of 30 ppb) or elevated O3 (EO3 , maximum of 110 ppb) and ambient or elevated temperature (ambient +5°C) were investigated in solardomes. We found that the optimum temperature of Asat (ToptA ) significantly increased in response to warming. However, the thermal acclimation capacity was reduced by O3 exposure, as indicated by decreased ToptA , and temperature optima of Vcmax (ToptV ) and Jmax (ToptJ ) under EO3 . Changes in both stomatal conductance (gs ) and photosynthetic capacity (Vcmax and Jmax ) contributed to the shift of ToptA by warming and EO3 . Neither Rdark measured at 25°C ( R dark 25 ) nor the temperature response of Rdark was affected by warming, EO3 , or their combination. The responses of Asat , Vcmax , and Jmax to warming and EO3 were closely correlated with changes in leaf nitrogen (N) content and N use efficiency. Overall, warming stimulated growth (leaf biomass and tree height), whereas EO3 reduced growth (leaf and woody biomass). The findings indicate that thermal acclimation of Asat may be overestimated if the impact of O3 pollution is not taken into account.

Laparoscopic liver resection (LLR) has been expanded rapidly and has been accepted worldwide; however, the safety assessment of LLR has not been fully conducted with a large-scale cohort. The aim of this study was to assess safety and identify clinical factors associated with postoperative major complications in LLR.

This project study retrospectively collected the data of LLRs performed before October 2015 in Japan. Patient characteristics, details of LLRs, and surgical outcomes were analyzed.

A total of 4122 patients from 66 institutions were enrolled. The main indications were hepatocellular carcinoma (HCC) and colorectal liver metastases. The majority of the procedures were performed for solitary tumor-located liver segment 2, 3, 5, and 6 and the partial resection and left-lateral sectionectomy occupied 77.3%. The rate of conversion, accidental events were 7.1% and 2.1%, respectively. Postoperative major complication occurred in 205 cases (5.0%), and 14 in-hospital deaths were found among HCC patients with chronically diseased liver. Occurrence of postoperative major complication was associated with operation time (≥360minutes), intraoperative blood loss (≥250mL), red blood cell transfusion (yes), and the difficulty score (≥6). The 30- and 90-day mortality was 0.14% and 0.41%, respectively.

Laparoscopic liver resection was performed with an acceptable rate of conversion, accidental events, morbidity, and mortality. The indications for LLR should be cautiously judged considering tumor location, planned operative procedure, and liver function.

Laparoscopic liver resection was performed with an acceptable rate of conversion, accidental events, morbidity, and mortality. The indications for LLR should be cautiously judged considering tumor location, planned operative procedure, and liver function.

The high operative mortality rate after hepatopancreatoduodenectomy (HPD) is still a major issue. The present study explored why operative mortality differs significantly due to hospital volume.

Surgical case data were extracted from the National Clinical Database (NCD) in Japan from 2011 to 2014. Surgical procedures were categorized as major (≥2 sections) and minor (<2 sections) hepatectomy. Hospitals were categorized according to the certification system by the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) based on the number of major hepato-biliary-pancreatic surgeries performed per year. The FTR rate was defined as death in a patient with at least one postoperative complication.

A total of 422 patients who underwent HPD were analyzed. The operative mortality rates in board-certified A training institutions, board-certified B training institutions, and non-certified institution were 7.2%, 11.6%, and 21.4%, respectively. Multiple logistic regression showed that certified A institutions, major hepatectomy, and blood transfusion were the predictors of operative mortality. Failure to rescue rates were lowest in certified A institutions (9.3%, 17.0%, and 33.3% in certified A, certified B, and non-certified, respectively).

To reduce operative mortality after HPD, further centralization of this procedure is desirable. selleck Future studies should clarify specific ways to improve the failure-to-rescue rates in certified institutions.

To reduce operative mortality after HPD, further centralization of this procedure is desirable. Future studies should clarify specific ways to improve the failure-to-rescue rates in certified institutions.

The conventional H category-based classification for colorectal liver metastases (CRLM) was created by equal weighting of tumor number and tumor size; however, our previous nomogram to predict postoperative disease-free survival demonstrated that CRLM ≥5 as a parameter provided 4.5 times greater impact compared with a largest CRLM size >5cm.

A total of 3815 patients newly diagnosed with CRLM between 2005 and 2007, including 2220 resectable cases, were investigated. Six groups were created based on largest lesion size (≤ 5 vs >5cm) and lesion number (1, 2-4, and ≥5).

The novel (n) H1, nH2, and nH3 categories were defined as solitary lesions with a size ≤5cm; lesions other than nH1 or nH3; and ≥5 lesions with any lesion size, respectively. In the resectable cohort, the 5-year cumulative overall survival rates were 64.0%, 53.5%, and 42.6% in the nH1, nH2, and nH3 groups, respectively (P<.001), and no significant differences were observed between the conventional H2 and H3 categories. In the overall cohort, the discrimination ability of the two classifications were comparable.