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As climate changes and anthropogenic pressures increase, marine ecosystem assembly and functioning are altered. High-latitude areas may provide opportunities for some tropical and subtropical organisms to survive. Yet, it is difficult to assess ongoing changes as ecological baselines are often missing. Here, we focus on the rapidly warming region of Jeju Island (South Korea), where thermal changes may have already triggered a poleward expansion of tropical and subtropical taxa and changes in community assembly. In 2012–2014, an island-wide quantitative description of its benthic communities (5 m and 15 m depths) was made, whereas patterns in seawater temperatures were examined from 1981 to 2020. Jeju Island algal assemblage was dominated by the regionally endemic kelp, Ecklonia cava. Turf, encrusting coralline algae, alongside tropical, subtropical, and cosmopolitan macro-algae were also major components of the benthic community. Hermatypic coral cover was higher at the 15 m depth than 5 m depth. Increases in seawater temperatures were highly significant, with differences between the average annual SST [1980–2020] and annual SST reaching up to + 1.61 °C in only 40 yr. The thermal rise was more pronounced in winter than summer, and warming was further accompanied by a major decline in the number of days below 14 °C and 18 °C, which are considered critical thermal thresholds for hermatypic coral survival and reef development, respectively. Warming winter seawater temperatures could ultimately lead to a loss of seasonality and profound modifications of benthic assemblages. This study provides the necessary assessment of benthic community conditions at Jeju Island upon which the ongoing changes in the area can be explicitly demonstrated. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the incidence rate and risk factors of stroke in patients treated with bilateral TKA compared with patients with unilateral TKA. Methods: In this retrospective nationwide cohort study, we compared patients undergoing unilateral TKA or bilateral TKA using data from the Korean National Health Insurance claims database between January 1, 2009 and August 31, 2017 and included patients older than 40 years of age who underwent primary TKA by the index date as documented primary diagnosis and first additional diagnosis without a history of stroke during the preceding 1 year. We used matched Cox regression models to compare the incidence rate and risk factors of newly acquired stroke among patients treated with unilateral TKA or bilateral TKA after propensity score (PS) matching. Results: In the present study, 163,719 patients who received unilateral TKA were matched to 163,719 patients with bilateral TKA based on PS. The risk of stroke during the study period was lower in patients treated with bilateral TKA than in patients with unilateral TKA (adjusted hazard ratio [HR] 0.79). Patients who received bilateral TKA were at decreased risk of stroke when the following variables were present: advanced age (70–79 years, HR 0.76), female sex (HR 0.75), rural area (HR 0.77), small- or medium-sized hospital (HR 0.75), health insurance (HR 0.77), history of hypertension drug use (HR 0.75), congestive heart failure (HR 0.70), connective tissue disease (HR 0.71), diabetes (HR 0.77), and diabetes with complication (HR 0.76). Conclusion: The risk of stroke was lower in patients treated with bilateral TKA than in patients with unilateral TKA. Patients treated with bilateral TKA were at decreased risk of stroke when the following variables were present: age (70–79 years), female sex, health insurance, history of hypertension drug use, and comorbidities, such as congestive heart failure, connective tissue disease, and diabetes. [ABSTRACT FROM AUTHOR]