Maximum proportion of masks worn: Collaborative efforts in Japanese professional football.

Mass gathering events in Japan have gradually mitigated their novel coronavirus disease (COVID-19) control regulations, along with a minimum infection risk. The Japan Professional Football League (J.League) conducted pilot surveys on holding events with chant cheers. In this commentary, we introduce the collaborative efforts based on scientific knowledge among experts, J.League, and their fans. We performed risk assessment in advance, by updating a previously developed model. We further observed the average proportion of masks worn, chant cheering time of participants, and CO2 levels in the stand. The number of new COVID-19 cases in an event with 5,000 chant cheering participants and 35,000 non-chant cheering participants was estimated to be 1.02 times of an event, with 40,000 non-chant cheering participants. The average proportion of masks worn during the game was 98.9 %, for chant cheer participants. The chant cheering participants spent 50.0-51.1 % of their time chant cheering. Monitored average CO2 levels were ≤ 540 ppm, suggesting high ventilation rates in the stand. The high proportion of masks worn represents the willingness of norm-conscious fans to cooperate in regular recovery of the sport. This has proved to be one of the successful models for future mass gathering events.

A rare case of fibrohistiocytic hepatic inflammatory pseudotumor with cholecystocholangitis showing positive IgG4 staining.

Inflammatory pseudotumor (IPT) is a rare benign mass characterized by infiltration of inflammatory cells and proliferation of fibrous tissues. Consistent with increasing knowledge about IgG4-related disease (RD), it has been implicated in the etiology of hepatic IPT, which is pathologically classified into two categories with respect to the proportion of IgG4-positive plasma cells: fibrohistiocytic- and lymphoplasmacytic-type. A 66-year-old man was admitted for treatment of cholecystocholangitis. Incidentally, abdominal computed tomography (CT) revealed an ambiguous low-density mass within segment 4 (S4) of the liver. Magnetic resonance imaging (MRI) showed the typical images of hepatic IPT within S4. Together with CT and MRI imaging, we suspected hepatic IPT, and had the opportunity to biopsy the S4 lesion during surgery for cholecystitis. Histopathological examination of liver tissue showed diffuse fibrous tissues, dense lymphoplasmacytic infiltration, and obliterative phlebitis with no evidence of malignancy. Despite infiltration of IgG4-positive plasma cells, these histological findings corresponded with fibrohistiocytic-type hepatic IPT. Similarly, in the resected gallbladder, relatively abundant IgG4-positive cells were observed, but not entirely consistent with IgG4-RD criteria. Although IgG4 immunostaining can be useful for the classification of hepatic IPT, the present histological tissues were borderline condition defined by IgG4-RD criteria. This rare case of hepatic IPT suggests a future focus on the borderline histological features of IgG4-RD.

Impact of chronological age on efficacy and safety of fluoropyrimidine plus bevacizumab in older non-frail patients with metastatic colorectal cancer: a combined analysis of individual data from two phase II studies of patients aged >75 years.

OBJECTIVE: Many clinical trials for older patients with metastatic colorectal cancer have been conducted, and fluoropyrimidine and bevacizumab are standard treatments. However, the relationship between age and the efficacy and safety of this treatment is unclear in older metastatic colorectal cancer patients. METHODS: Individual data from two phase II studies on older (≥75 years), non-frail patients with metastatic colorectal cancer treated with uracil-tegafur/leucovorin or S-1 combined with bevacizumab were collected. Patient characteristics were evaluated with multiple regression analyses for survival outcomes, using the Cox proportional hazard model and linear regression analyses for the worst grade of adverse events. RESULTS: We enrolled 102 patients with a median age of 80 years (range, 75-88 years). Of the 70 patients who died, seven (10%) died of causes unrelated to disease or treatment. The study treatment was discontinued due to adverse events in 19 patients (18.6%), with 63% aged ≥85 years. The adverse event that most commonly resulted in treatment discontinuation was grade 2 fatigue (21%). Chronological age was not associated with progression-free survival (Hazard ratio, 1.03; P = 0.40) or overall survival (Hazard ratio, 1.02; P = 0.65). Age was weakly associated with non-hematologic adverse events (regression coefficient [R], 0.27; P = 0.007), especially fatigue (R, 0.23; P = 0.02) and nausea (R, 0.19; P = 0.06), but not with hematologic (R, 0.05; P = 0.43) or bevacizumab-related (R, -0.06; P = 0.56) adverse events. CONCLUSIONS: The efficacy of fluoropyrimidine plus bevacizumab was age-independent in patients with metastatic colorectal cancer aged ≥75 years, and attention should be paid to non-hematologic adverse events as age increases.

Effects of chemotherapy on quality of life and night-time sleep of colon cancer patients.

Background : The aim of this study was to investigate quality of life (QOL) and night-time sleep disturbance in colon cancer patients with middle risk chemotherapy for proper antiemetic therapy. Methods : The study enrolled 139 patients with colorectal cancer. All patients received oxaliplatin or irinotecan-based chemotherapy. Patients completed a questionnaire about chemotherapy-induced nausea and vomiting and sleep disturbance. Sleep disturbance was checked, and the relationship between sleep disturbance and nausea was analyzed. Results : The prevalence of nausea was 48.9% (68 / 139). The degree of the nausea was slight / moderate / severe in 51 / 11 / 6 patients, and 12 patients had vomiting. Appetite showed no change / slightly decreased / half / one-fourth / none in 51 / 34 / 33 / 6 / 7 patients. There were significant differences in the mental component summary (MCS) score and the role-social component score (RCS). (MCS : nausea(+) vs nausea(-) 46.4 ±â€…1.1 vs 54.1 ±â€…1.1 p < 0.01 RCS : nausea(+) vs nausea(-) 33.1 ±â€…2.1 vs 41.6 ±â€…2.1 p < 0.01). Using the MCS with a cut-off score of 50, patients were divided into two groups, and nausea was significantly correlated with a low MCS score. Furthermore, patients were divided into two groups using a Pittsburgh Sleep Quality Index cut-off score of 6, and sleep disturbance was correlated with old age and second-line chemotherapy. Conclusions : Nausea affects QOL and night-time sleep of colon cancer patients with middle risk chemotherapy. J. Med. Invest. 67 : 338-342, August, 2020.

Phase II study of S-1 on alternate days plus bevacizumab in patients aged ≥ 75 years with metastatic colorectal cancer (J-SAVER).

BACKGROUND: Alternate-day administration of S-1 is thought to reduce toxicities. This phase II study evaluated S-1 on alternate days combined with bevacizumab as first-line treatment for elderly patients with metastatic colorectal cancer. PATIENTS AND METHODS: Eligible patients had histologically proven colorectal adenocarcinoma, measurable metastatic lesions, age ≥ 75 years, Eastern Cooperative Oncology Group performance status ≤ 1, no previous chemotherapy, and refused oxaliplatin- or irinotecan-containing regimens. Patients received 40 mg, 50 mg, or 60 mg (body surface area ≤ 1.25 m2, > 1.25 to ≤ 1.50 m2, or > 1.50 m2, respectively) of S-1 twice orally on Sunday, Monday, Wednesday, and Friday every week. Bevacizumab (7.5 mg/kg) was administered every 3 weeks. The primary endpoint was progression-free survival. RESULTS: Of 54 enrolled patients, 50 patients were evaluated for efficacy and 53 for safety. The median age was 79 years (range 75-88 years). The median progression-free survival was 8.1 months (95% confidence interval (CI) 6.7-9.5 months). The median overall survival was 23.1 months (95% CI 17.4-28.8 months). The response rate was 44% (95% CI 30.2-57.8%), and the disease control rate was 88% (95% CI 79.0-97.0%). Grade 3 or higher hematologic, non-hematologic, and bevacizumab-related adverse events occurred in 9%, 11%, and 25% of patients, respectively. The most common grade 3 and 4 treatment-related adverse events were hypertension (11%), nausea (6%), fatigue (6%), anemia (6%), and proteinuria (6%). Only 6 patients discontinued treatment due to adverse events. CONCLUSION: S-1 on alternate days combined with bevacizumab showed better tolerability and comparable survival compared with the results of similar studies.

Design of UAV-Embedded Microphone Array System for Sound Source Localization in Outdoor Environments.

In search and rescue activities, unmanned aerial vehicles (UAV) should exploit sound information to compensate for poor visual information. This paper describes the design and implementation of a UAV-embedded microphone array system for sound source localization in outdoor environments. Four critical development problems included water-resistance of the microphone array, efficiency in assembling, reliability of wireless communication, and sufficiency of visualization tools for operators. To solve these problems, we developed a spherical microphone array system (SMAS) consisting of a microphone array, a stable wireless network communication system, and intuitive visualization tools. The performance of SMAS was evaluated with simulated data and a demonstration in the field. Results confirmed that the SMAS provides highly accurate localization, water resistance, prompt assembly, stable wireless communication, and intuitive information for observers and operators.

Propensity score-matched study of laparoscopic and open surgery for colorectal cancer in rural hospitals.

BACKGROUND AND AIM: Various randomized clinical studies have suggested that short- and long-term outcomes of laparoscopic surgery (LAP) for colorectal cancer are comparable with those of open surgery (OP). However, these studies were performed in high-volume hospitals. The aim of the present study was to compare the outcomes of LAP versus OP for colorectal cancer in rural hospitals. METHODS: This was a multicenter retrospective propensity score-matched case-control study of patients who underwent colorectal surgery from January 2004 to April 2009 in 10 hospitals in Japan. All patients underwent curative surgery for pathologically diagnosed stage II or III colorectal cancer. The primary end point was 5-year overall survival (OS). The secondary end points were disease-free survival (DFS) and postoperative complications. RESULTS: In total, 319 patients who underwent LAP and 1020 patients who underwent OP were balanced to 261 pairs. There was no significant difference in the OS and DFS between two groups. The operation time was significantly shorter for OP than for LAP. Blood loss was significantly lower in LAP than in OP. There was no difference in intraoperative morbidity between the two groups. The postoperative morbidity was significantly lower in LAP than in OP. The hospital stay was significantly shorter in LAP than in OP. There was no significant difference in 90-day postoperative mortality. CONCLUSIONS: Laparoscopic surgery may be a feasible option for colorectal cancer in rural hospitals.

[A case of posterior gastric arteriovenous malformation causing massive intraperitoneal hemorrhage].

We report abdominal bleeding caused by arteriovenous malformations (AVM) of the posterior gastric artery. A 38-year-old man visited our hospital complaining of epigastralgia. Enhanced abdominal CT revealed a high density spot in a huge low density mass. Angiographic study showed AVM of the posterior gastric artery. Transcatheter arterial embolization was performed and we successfully treated the AVM which was accompanied by abdominal bleeding.

[Huge unresectable multiple hepatic metastases of rectum cancer responding to combined therapy with FOLFIRI +bevacizumab - a case report].

We report a patient with a huge multiple hepatic metastases of rectal cancer treated by combination of infusional 5-FU, Leucovorin, irinotecan(FOLFIRI), and bevacizumab(BV). The patient was a 60-year-old man with cancer of the rectum, with huge multiple hepatic metastases. The serum carcinoembryonic antigen(CEA)level was 3,979.6 ng/mL, and the carbohy- drate antigen(CA)19-9 level was 66,562.6 U/mL. The patient received combined chemotherapy with FOLFIRI and BV. After completion of 8 courses, abdominal CT scans revealed that those low-density areas of the liver had reduced. The patient was judged to have achieved PR. He received combined therapy for 42 courses, and his response is SD at this point. No grade 2 adverse event occurred throughout chemotherapy. This case suggests that combined therapy with FOLFIRI+BV may be an effective regimen for advanced rectal cancer with huge multiple hepatic metastases.