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Background/aim: The lung immune prognostic index (LIPI), which is determined by assessing the derived neutrophil-to-lymphocyte ratio in conjunction with the level of lactate dehydrogenase, predicts outcomes in various cancers. Its utility as a preoperative biomarker in upper tract urothelial carcinoma (UTUC) patients remains unexplored., Patients and Methods: This is a retrospective study of UTUC patients who underwent radical nephroureterectomy. Patients were stratified into favorable, intermediate, and poor LIPI groups. Non-urothelial tract recurrence-free survival (NUTRFS) was evaluated using Kaplan-Meier analysis, and Cox regression analyses were performed to identify risk factors for NUTRFS., Results: A total of 567 UTUC patients were included, with 46.4% in the favorable, 44.6% in the intermediate, and 9.0% in the poor (9.0%) LIPI groups. The median participant age was 74 years, with a median follow-up of 26 months. Kaplan-Meier curves demonstrated that NUTRFS was significantly worse in patients with poor and intermediate LIPI scores than in those with favorable LIPI scores. Furthermore, combining LIPI status with pathological stages (pT3-4/ypT2-4) and lymph node metastasis status improved postoperative non-urothelial tract recurrence prognosis assessment., Conclusion: The preoperative LIPI is a prognostic indicator for patients with UTUC undergoing nephroureterectomy. Its predictive accuracy improves when combined with advanced pathological stages and lymph node metastasis status., (Copyright © 2025, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: Androgen receptor-signaling inhibitors (ARSIs) have significantly changed the preferred treatments for metastatic castration-sensitive prostate cancer (mCSPC). Despite such advances, the prognostic significance of metastases at specific sites remains unclear. This study evaluated how metastatic site affected the oncological outcomes of mCSPC patients., Methods: This retrospective multicenter study included 716 mCSPC patients receiving androgen- deprivation therapy (ADT) alone, combined androgen blockade (CAB) therapy, or both ARSI and ADT (ARSI doublet) from February 2018 to June 2023. All patients were categorized based on their metastatic sites. The primary endpoint was the time to castration-resistant prostate cancer (CRPC) development; the secondary endpoints were progression-free survival 2 (PFS2), cancer-specific survival (CSS), and overall survival (OS). Kaplan-Meier curves and multivariate Cox's regression models were used to analyze the survival outcomes. We stratified mCSPC patients with bone metastases by the volumes of such metastases and lung metastasis status, and explored the clinical significance of lung metastasis., Results: Patients with lung-only metastases experienced better outcomes than those with other visceral metastases. On multivariate analysis, the bone metastasis volume, but not lung metastasis status, significantly affected CRPC-free survival status. No significant difference in any of CRPC, PFS2, CSS, or OS status was apparent among patients with bone metastases with or without lung metastases. In terms of interaction, lung metastasis did not significantly affect the prognoses of patients with either low- or high-volume bone metastases., Conclusion: In the present era of ARSI doublet therapy, lung-only metastases in mCSPC patients were associated with favorable outcomes. The negative prognostic effects of lung metastases were much lower than was the bone metastasis volume, indicating that treatments targeting low-volume disease may be adequate even when lung metastases are apparent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)

Objectives: Data regarding willingness to pay (WTP) for one quality-adjusted life year (QALY) may need to be updated given rapidly changing modern lifestyles and dynamic shifts of population's values related to healthcare and economic factors as influenced by the COVID-19 pandemic., Study Design: A cross-sectional study using online-based questionnaire surveys., Methods: We conducted an online survey in March 2024 of 2,000 Japanese adults aged 20-69 years to evaluate their individual WTP for one QALY gained. We constructed a case scenario in which participants were asked to answer a series of yes/no questions to evaluate their willingness to pay for a new treatment to prolong a patient's life with a certain health status for one year. The scenario was stratified by the treatment cost per case, the annual number of patients, and the health status of patients. A probit model was implemented to estimate the WTP for one QALY gained and included the total cost, the total QALYs gained, recruitment method, participant's age, sex, household income, and educational background as explanatory variables., Results: WTP per one QALY gained was estimated to be 16.98 [95%CI 14.43-19.91] million Japanese yen. A positive QALY gain (p < 0.001), male sex (p < 0.001), and higher household income (p < 0.001) were positively correlated with having a higher WTP. A higher total cost (p < 0.001), increased age (p = 0.002) and living alone (p < 0.001) were negatively correlated with WTP., Conclusion: Our study showed that the updated WTP threshold for a QALY gained was much larger than previously reported values. This suggests that WTP data should be reviewed and updated regularly., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

A unified view on recovery from supplementary motor area syndrome after glioma resection is lacking. This study retrospectively examined the relationship between motor function, higher brain function, the ability to perform activities of daily living, and social reintegration and the extent of tumor resection in patients who underwent resection of tumors near the supplementary motor area. We assigned 24 consecutive patients into 3 groups according to the depth of tumor resection: resection involving (A) only the supplementary motor area (5 patients); (B) the supplementary motor area and cingulate gyrus (11 patients); and (C) the supplementary motor area, cingulate gyrus, and corpus callosum (8 patients). Motor paralysis, language function, and the ability to perform activities of daily living were evaluated perioperatively and 2 months postoperatively, whereas successful social reintegration was examined retrospectively. In group C, 62% of patients developed severe paralysis after surgery, with slow recovery and delayed ambulation (p = 0.0869). Patients with tumors in the left hemisphere, specifically those extending to the cingulate gyrus and corpus callosum, showed decreased scores for postoperative word recall; however, recovery was observed after 2 months. The Functional Instrumental Measure score, which indicates the activity of daily living ability, showed the largest difference preoperatively and postoperatively in group C. The World Health Organization tumor grade (p = 0.0445) and extent of tumor resection (p = 0.0011) were inversely correlated with social reintegration 6 months postoperatively. Overall, the findings suggest that early social reintegration is influenced by the World Health Organization tumor grade (2021 World Health Organization classification) and the extent of tumor resection.

Objective: We determined the optimal timing for initiating androgen receptor signaling inhibitor (ARSI) therapy in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) and assessed its impact on oncological outcomes., Materials and Methods: This retrospective study included 145 nmCRPC patients who received enzalutamide, apalutamide or darolutamide at the Jikei University Hospital or its affiliated institutions between May 2014 and November 2022. Patients were stratified based on prostate-specific antigen (PSA) doubling time (PSADT) at CRPC diagnosis and PSA levels at ARSI initiation. Oncological outcomes, including progression-free survival (PFS), metastasis-free survival (MFS), cancer-specific survival and overall survival, were assessed using the Kaplan-Meier curve and Cox regression analysis., Results: The median age of the patients was 73 (interquartile range [IQR]: 52-88) years, and the median follow-up duration was 36 (IQR: 2-104) months. The median PSA level at ARSI initiation was 5.4 (IQR: 2.2-48) ng/ml, and 44.8% of patients had a PSADT <3 months. Multivariate analysis revealed that PSADT and PSA levels at ARSI initiation were independent MFS predictors. Patients with a PSADT ≤3 months and a PSA level ≥5.4 ng/ml experienced significantly reduced PFS and MFS. Notably, ARSI initiation at a PSA level ≥5.4 ng/ml was associated with worse outcomes, suggesting the potential benefit of earlier intervention., Conclusions: Patients with rapid PSADT are at increased risk of early disease progression, suggesting that immediate treatment may be warranted. In addition, initiating therapy at a PSA level <5.4 ng/ml may be associated with improved patient outcomes in patients with low PSADT., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To investigate the effect of studying abroad on catch-up vaccination coverage for measles, rubella, mumps, varicella, and tetanus during the pretravel consultation among young adult travelers., Methods: This retrospective cohort study analyzed data from the Japan Pretravel Consultation Registry (J-PRECOR) on individuals aged 18-21 years with childhood vaccination records. Propensity score weighting was used to estimate the average treatment effect on the proportion of participants receiving catch-up vaccination., Results: Among 1091 eligible participants, the catch-up vaccination need was highest for mumps (65.7 %) and varicella (49.0 %) and lowest for measles (9.9 %) and rubella (14.0 %). In the unadjusted analysis, the catch-up vaccination rate was 70.6 % for tetanus, 50.9 % for measles, 47.7 % for rubella, 40.0 % for mumps, and 23.9 % for varicella. In the weighted analysis, the study-abroad group had significantly higher catch-up vaccination rates for measles (54.6 % vs. 29.8 %, P = 0.039), rubella (53.0 % vs. 22.1 %, P < 0.001), and varicella (26.8 % vs. 10.9 %, P = 0.002), whereas the non-study-abroad group had a higher catch-up vaccination rate for tetanus (62.4 % vs. 78.4 %, P = 0.024)., Conclusion: Compared with other travelers, the catch-up vaccination rate among travelers studying abroad was higher for measles, rubella, and varicella, but lower for tetanus. In clients planning to study abroad, vaccinations required for travel should be recommended in addition to those required by the host institution, and vaccination against highly infectious diseases with potential for complications, such as measles, rubella, mumps, and varicella, should be recommended to clients traveling for reasons other than studying abroad., Competing Interests: Competing interests T.Matono has received speaker honoraria from MSD, Pfizer, Gilead, and GSK., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Background: A nationwide survey conducted by the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases in 2020 provided insights into antimicrobial prescription practices among clinic doctors. This study aimed to investigate factors influencing changes in antimicrobial prescriptions post-implementation of the National Action Plan on Antimicrobial Resistance (NAPAR) and doctors' inclination to prescribe antimicrobials for common cold cases., Methods: In September 2020, randomly selected questionnaires were distributed to 3000 community-based medical clinics in Japan. The primary objective was to assess the reduction in antimicrobial prescriptions post-NAPAR implementation. Multivariate linear regression analysis was employed to identify associated factors., Results: Analysis of 632 responses (response rate: 21.1 %) revealed determinants of decreased antimicrobial prescriptions, including familiarity with the Guide to Antimicrobial Stewardship (β = .482, t = 3.177, p = 0.002) and awareness of NAPAR (β = .270, t = 2.301, p = 0.022)., Conclusion: Interventions such as the Guide to Antimicrobial Stewardship may have contributed to the reduction in antimicrobial prescriptions among Japanese physicians. However, targeted strategies are needed to address high-prescription groups. Enhancing awareness and education on appropriate antimicrobial use should be integral components of future initiatives to combat antimicrobial resistance effectively., Competing Interests: Declaration of competing interest Shigefumi Maezaki has received lecture fees from Pfizer Japan Inc., Astellas Pharma Inc., Sumitomo Dainippon Pharma Co. Ltd., Shionogi & Co. Ltd., MSD K.K., KYORIN Pharmaceutical Co. Ltd., and Taisho Toyama Pharmaceutical Co. Ltd. Tetsuya Matsumoto has received lecture fees from MSD K.K., Pfizer Japan Inc., Taisho Toyama Pharmaceutical Co., Ltd., and Meiji Seika Pharma Co., Ltd., as well as research funding from Kewpie Corp. Norio Ohmagari, Yoshiaki Gu, Shinichiro Morioka, Shinya Tsuzuki, Hiroshi Soeda, Chikara Nakahama, Naoki Hasegawa, Yumiko Fujitomo, Masayuki Maeda, and Isao Miyairi have declared no conflicts of interest associated with this manuscript., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Overconsumption of fat contributes to obesity and low adherence to dietary therapy in patients with obesity. The frequency of consuming soup dishes containing "dashi" (Japanese broth), a characteristic element of the Japanese diet, is negatively associated with obesity indicators. The use of dashi is considered one of the reasons why the low-fat Japanese diet is popular; however, whether and how dashi controls the selection and intake of fat is unknown. In this study, we tested the hypothesis that bonito broth, a typical Japanese dashi, affects fat consumption in a mouse model. First, we examined the long-term or short-term intake of corn oil emulsion in adult mice fed bonito broth. No significant effect was observed. Next, mouse dams were fed bonito broth during gestation or lactation and licking of 0.5, 1, 2.5, 5, and 10% corn oil in their adult pups was evaluated in acute tests. Compared to the control group, there were significant decreases in licks for some corn oil concentrations in the gestation and lactation groups. Finally, corn oil licking was tested in pups fed bonito broth after weaning. No significant effect was detected. This study suggests that dams' intake of bonito broth during gestation or lactation reduces the intake of fat by their pups in adulthood., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The social contact data for Japan as of 2022 showed a substantially decreased number of contacts compared with before the COVID-19 pandemic. However, it is unclear whether social contact continues to be depressed following the end of countermeasures against the pandemic. There is also scarce evidence regarding the influence of influenza-like illnesses (ILIs) on social contacts in Japan. Therefore, this study examined whether the reduction in contact frequency during the pandemic was temporary or persists today and assessed the impact of ILIs on social mixing patterns., Methods: We conducted online questionnaire surveys of individuals who experienced symptoms of ILIs periodically from 2022 to 2024 to compare the number of contacts per day during and after their illnesses. Contact matrices were obtained from the survey data. The impacts of the timing of the survey and the ILIs were examined using negative binomial regression analysis., Results: Contact patterns were generally age-assortative, and the average contact numbers gradually increased from March 2022 to June 2024. Most recently, the median number of contacts per day during illness was 3 (interquartile range [IQR] 2-7) and then rose to 4.5 (IQR 2-11) after recovery. The earlier survey and ILIs showed a negative association with the frequency of social contacts., Conclusion: The frequency of social contacts in Japan tended to rise compared with that in 2021 but has not yet reached pre-pandemic levels. Individuals tended to decrease their contacts when they had symptoms caused by ILIs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Co-infection with other pathogens can alter the severity and clinical outcomes of viral infections. However, the information regarding viral co-infections in pediatric coronavirus disease 2019 (COVID-19) cases is still limited., Methods: This is a nationwide, retrospective cohort study using the data from the COVID-19 Registry Japan. The pediatric (<18 years), laboratory confirmed, hospitalized COVID-19 patients in the Omicron variant of concern predominant period (January 2022 to January 2024) were included. Co-infection was investigated by multiplex PCR. We compared clinical characteristics, symptoms, severity, and outcomes between children with and without co-infection., Results: Among 245 hospitalized pediatric COVID-19 patients, 78 (31.8 %) had co-infections. The patient backgrounds of the "co-infection" and "SARS-CoV-2 alone" groups were similar, although age distribution was different, with a lower number of patients over 12 years in the co-infection group (n = 2, 2.6 % vs. n = 29, 17.4 %; P < 0.001). Among the patients with co-infection, the most common pathogen was enterovirus/rhinovirus (51.3 %), followed by parainfluenza virus (23.1 %) and adenovirus (12.8 %). Patients with co-infection more commonly had respiratory symptoms, including SpO 2 < 96 %, shortness of breath, runny nose, and wheezing. Requirement of non-invasive oxygen support was higher in the co-infection group (n = 27, 34.6 % vs. n = 28, 16.8 %, P = 0.006). By multivariable logistic regression analysis, co-infection and presence of any comorbidity were identified as significant risk factors for necessity of oxygen therapy (odds ratio [95 % confidence interval] 2.44 [1.29-4.63] and 3.99 [2.07-7.82], respectively)., Conclusions: Viral co-infection may increase the risk of respiratory distress in pediatric COVID-19 patients., Competing Interests: Declaration of competing interest K. Shoji received payment for lectures from bioMérieux Japan, Nippon Becton Dickinson Company, Ltd., Viatris, Inc., Meiji Seika Pharma Co., Ltd., AstraZeneca K.K., Novartis Pharma Co., Ltd., Kyorin Pharmaceutical Co., Ltd., and Gilead Sciences, Inc. S. Tsuzuki received payment for supervising medical articles from Gilead Sciences, Inc. I. Miyairi received payment for lectures from Astellas Pharma, Sanofi K.K., Pfizer, Inc., Takeda Pharmaceutical Company, Ltd., Biken Group, Shionogi & Company, Ltd., bioMérieux Japan, Gilead Sciences, Inc., Meiji Seika Pharma, KM Biologics, Tanabe-Mitsubishi Pharmaceuticals, and Daiichi Sankyo. The other authors declare that they do not have any conflicts of interest directly associated with the study., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Background: Despite its demonstrated efficacy in prolonging overall survival (OS) and delaying skeletal-related events in the ALSYMPCA trial, the optimal timing of radium-223 initiation remains unclear. This study investigated factors influencing radium-223 treatment outcomes, including completion rates and survival., Methods: This retrospective, multi-institutional study included 164 patients with metastatic castration-resistant prostate cancer (CRPC) who received radium-223 therapy. The primary endpoint was OS following radium-223 initiation. Secondary endpoints included factors associated with incomplete radium-223 treatment (< six cycles) and poor OS. Multivariate Cox regression and multivariate logistic regression analyses were conducted to identify prognostic factors., Results: The median OS times after CRPC diagnosis and radium-223 initiation were 39 and 12.5 months, respectively. Kaplan-Meier analysis showed that the OS of patients who completed six cycles of radium-223 treatment was longer than that of those who did not (18 vs. 5 months; P < .001). Multivariate Cox analysis identified Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥ 1 (hazard ratio [HR] = 1.74, P = .046), PSA > 17 ng/ml (HR = 2.93, P < .001), and radium-223 incompletion (HR = 3.23, P < .001) as independent predictors of poor OS. The radium-223 completion rate was 68.3%, and incompletion was significantly associated with prior docetaxel use (odds ratio [OR] = 5.97, P = .001), bone pain (OR = 2.64, P = .024), and PSA > 17 ng/ml at the start of radium-223 treatment (OR = 3.12, P = .013)., Conclusions: Completion of all six cycles of radium-223 treatment were associated with favorable survival outcomes in metastatic CRPC patients. Prior docetaxel use, bone pain, and elevated PSA levels were significant risk factors for radium-223 incompletion. These findings suggest the importance of initiating radium-223 earlier in the treatment course for patients with favorable clinical profiles to maximize the therapeutic benefits., (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: The JAVELIN Bladder 100 trial demonstrated improved overall survival (OS) with maintenance avelumab in patients with locally advanced or metastatic urothelial carcinoma UC (la/mUC) who achieved disease control following first-line platinum-based chemotherapy (1 L-PBC). However, real-world data on eligibility, utilization, and outcomes of maintenance avelumab therapy remain limited., Methods: This retrospective study included patients with la/mUC who received 1 L-PBC. Eligibility for maintenance avelumab therapy was determined based on the best overall response to 1 L-PBC, with patients who achieved stable disease or a partial or complete response considered eligible. Survival outcomes were analyzed using the Kaplan-Meier method. Multivariate Cox regression analysis was used to identify prognostic factors among patients with la/mUC who received maintenance avelumab., Results: Of 161 prospective patients, 67.1% were eligible for maintenance avelumab therapy, and 46.3% of eligible patients received the treatment. The median progression-free survival (PFS) following avelumab initiation was 10.2 months, whereas the median OS was not reached. Prognostic factors associated with PFS included the presence of liver metastases, elevated C-reactive protein (> 1.0 g/dL), and administration of more than five cycles of 1 L-PBC. Adverse events occurred in 60% of patients treated with avelumab, with 16% experiencing grade 3-4 adverse events., Conclusion: We emphasize the real-world applicability of maintenance avelumab for Japanese patients with la/mUC. Maintenance avelumab demonstrated favorable survival outcomes, consistent with clinical trial data. Identifying prognostic factors and optimizing treatment sequencing are essential strategies for improving outcomes in this patient population., (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)