Tokyo Research Articles

Interpretation of Hybrid Counterfactual Logic into Hybrid Tense Logic: and Comparison of Their Expressive Power on Temporal Sphere Models

Lewis (Noûs 13:455–476, 1979) claimed that branching-time(-like) models can be derived from his sphere models. However, he did not present any specific construction of branching-time(-like) models from his sphere models formally. Meanwhile, Hosokawa (in: Modern logic of modality and its philosophical range: counterfactuals, Gettier problem, and information flow, Tokyo Metropolitan University, 2018) presented a logico-mathematically strict manner in which sphere models can be reconstructed from branching-time models. Subsequently, Hosokawa (J Logic Lang Inf 32:677–706, 2023) presented a proof-theoretically refined version of hybrid tense logic for a certain type of conditionals, which is referred to as hybrid tense logic for temporal conditionals (HTLTC). In this paper, we interpret a hybrid version VHC(@,↓) of Lewis’s counterfactual logic V into HTLTC, and then prove that HTLTC is more expressive than VHC(@,↓) on the class of temporal sphere models, i.e., sphere models derived from a type of branching-time models.

Land Use Characteristics of Commuter Rail Station Areas and Their Impact on Station Ridership: A Case Study of Japan Railways in the Tokyo Metropolitan Area

Exploring the relationship between land use characteristics and ridership in railway station areas provides crucial decision-making support for station area planning. Previous research has mostly focused on subways, with a lack of studies on the land use characteristics and ridership of commuter rail stations, particularly in relation to the differences and impacts across various passenger catchment areas (PCAs). This study employed a multinomial logit model to evaluate the land use characteristics within 1000 m of Japan Railways (JR) stations in four different PCAs of the Tokyo metropolitan area (TMA). Additionally, regression models and a multiscale geographically weighted regression (MGWR) model were used to analyze how land use characteristics in these PCAs affected station ridership. The key findings were as follows: (1) the land use characteristics around commuter rail stations exhibit distinct zonal patterns; within 250 m, public transport stops and public service facilities are the most densely concentrated; the highest residential population density is found between 250 and 750 m; and commercial facilities are mostly clustered in the 500 to 750 m range; (2) the impact of land use factors on ridership varies in intensity across different spatial zones; the density of public transport stops and street network density is most significant within 250 m, whereas commercial facility density is greatest within the 500–750 m PCA; (3) The land use characteristics within 500 m of stations have greater explanatory power for passenger flow, and the goodness of fit of the MGWR model surpasses that of the linear regression model.

A Case of Food Poisoning Caused by Campylobacter jejuni after the Ingestion of Undercooked Chicken Meal with Subsequent Development of Guillain-Barré Syndrome.

Campylobacter jejuni is one of the major bacterial strains that cause diarrhea in humans. It has been associated with many cases of food poisoning in Japan caused by eating raw, undercooked, and/or improperly prepared chicken meat, liver, and grilled chicken (Yakitori). Campylobacter jejuni is also known to be a preceding infectious pathogen of Guillain-Barré syndrome (GBS), which has a considerably negative health impact on humans. In a case of C. jejuni food poisoning that occurred at a restaurant in Tokyo (Japan) in January 2022, 1 of 4 patients with diarrhea developed GBS, which was presumed to have been caused by undercooked chicken, which has emerged as one of the most common causes of food poisoning in Japan. Moreover, C. jejuni isolates from 3 patients, including those with GBS, had the same genotypes (ST22, HS19, and LOS A). This genotype was frequently detected in patients with GBS in the authors' previous study. Findings confirmed that the patient developed GBS due to food poisoning after consuming undercooked chicken.

Are different TOD circles oriented towards sustainability amidst urban shrinkage? Evidence from urban areas to suburbs in the Tokyo metropolitan area

Transit-Oriented Development (TOD) is a prominent urban development approach aimed at maximizing the number of residential, commercial, and walkable spaces within the catchment area of public transportation. Despite its widespread discussion, the definition of the TOD catchment area remains ambiguous. This study expands the research scope of TOD catchment areas by introducing the concept of three TOD circles and examines their relevance within the context of urban shrinkage in the Tokyo Metropolitan Area over time. Focusing on the Den-en-toshi Line, which spans Tokyo and Kanagawa Prefecture, as a case study, we developed a sustainable TOD assessment model based on the node-place-ecology (NPE) framework. This model was used to analyze the dynamic changes in different TOD circles from 2011 to 2019. The results indicate a positive sustainable development trend in the first and second circles, while the third circle shows a slight decline. Moreover, a comparison between urban and suburban areas further supports the notion that the monopolization trend of core stations in Tokyo is intensifying. We believe that the model framework developed in this study has great adaptability and can be widely applied globally to help researchers and urban planners conduct more accurate sustainability assessments of TOD stations.

Possibility of diffusion and challenges of a frailty prevention class hosted by older adults: Efforts by the Saitama Prefecture Silver Human Resources Center Federation Headquarters

Objectives Since 2018, the Saitama Prefecture Silver Human Resources Center (SHRC) Federation Headquarters and Tokyo Metropolitan Institute for Geriatrics and Gerontology has attempted to diffuse a business model in which SHRC members are compensated for operating a frailty prevention class. This activity report clarifies these efforts, examines the feasibility of diffusing this model based on each SHRC's project implementation status, and summarizes the relevant issues.Methods To promote the commercialization of classes, all 58 SHRCs in Saitama Prefecture were offered (1) class programs comprising a multifactorial program (exercise, nutrition, and social interactions) and teaching materials, (2) training courses for frailty prevention supporters who manage the classes (three days × four blocks/year), (3) project information exchange meetings (held once annually), and (4) consultation support for project implementation. A questionnaire survey on the project implementation status was conducted among SHRC employees to evaluate the possibility of project diffusion based on adoption, implementation, and continuation. Furthermore, project implementation issues were categorized using free descriptions as codes to create subcategories based on content and categories based on subcategory similarities.Results Regarding adoption, among the 58 SHRCs, 43 (74.1%) participated in training courses for frailty prevention supporters and 34 (58.6%) implemented the project from 2018 onwards. Regarding implementation, 23 (39.7%) SHRCs provided rewards to frailty prevention supporters (67.6% of the SHRC that implemented the project). Regarding continuation, 21 of the 28 SHRCs (75.0%) that began the project by 2021 continued it for two years or longer. Moreover, implementation challenges related to project initiation, supporters, new entrants, and class management were categorized.Conclusions More than half of the SHRCs implemented the project, 40% of SHRC provided rewards for frailty prevention supporters, and 75% of SHRCs that implemented the project continued working on it. Hence, the model may be extended to other regions. However, four issues have been identified. The model is likely to have a ripple effect, increasing the number of individuals involved in community frailty prevention and creating attractive employment opportunities for the elderly. We intend to address these challenges and disseminate our model further.

Chemotactic activity of products of Elizabethkingia anophelis derived from Aedes albopictus against RAW264 murine macrophage cell line.

Dengue viruses enter dermal macrophages which are derived from other tissues after mosquito bites. We examined chemotactic factors derived from the dengue vector mosquito, Aedes albopictus, toward a RAW264 murine macrophage cell line. We found that Elizabethkingia anophelis that was isolated from mosquitoes exhibited migration-inducing activity toward RAW264 cells. The active substances were extracted using ethyl acetate to induce chemotactic movements. Chemotactic activity was eluted in the several fractions using the reversed-phase chromatography, suggesting that multiple substances were responsible for the activity. We isolated three bacterial colonies from the wild A. albopictus mosquitoes collected in Toyama Park, Tokyo prefecture, Japan. The bacterial 16S rRNA gene sequences were the most similar to those of Lonsdalea quercina. These bacteria also exhibited migration-inducing activity toward RAW264 cells. The migration-inducing activity of mosquito bacteria might be a new aspect of mosquito-mediated viral infections.

Effects of neighbourhood characteristics on the distribution of vacant houses in Toda city, a satellite city of Tokyo metropolis of japan

As Japan faces a growing crisis of vacant housing, this study investigates the underexplored relationship between vacant house distribution and neighbourhood characteristics in Toda City, a satellite city of the Tokyo metropolis located in Saitama Prefecture. We selected 10 community features, including living convenience, housing supply, and policy support, to explore their influence on vacancy rates. Using a comprehensive dataset primarily derived from the PLATEAU data, we employed a two-step method combining global and local Moran’s I analyses to assess the spatial distribution normality of vacant houses. We then compared traditional statistical data analysis with spatial data analysis through multiscale geographically weighted regression to evaluate their effectiveness and identify the factors most closely associated with vacancy rates. Our findings reveal that spatial data analysis provides superior insights compared to traditional statistical methods. Both approaches consistently indicate a significant positive correlation between the supermarket area ratio and vacancy rates, and a significant negative correlation between road adjacency and vacancy rates. This study demonstrates the feasibility of using spatial data to analyse neighbourhood characteristics in the context of declining vacancy rates in satellite cities. The insights gained offer theoretical support for selecting data and methodologies in future research and policymaking that are aimed at mitigating the growth of vacant houses.

Animation of latissimus dorsi flap in breast reconstruction: a retrospective analysis based on 203 cases.

Breast animation is a common postoperative complication of breast reconstruction surgery. This study investigates the factors affecting the onset and degree of animation to suggest an ideal treatment strategy for this complication. This study included patients who underwent latissimus dorsi reconstruction at Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, between 2009 and 2020 and had an outpatient visit after July 2020. Statistical analysis was performed and the patients' background and surgical factors were examined to determine whether they affected the animation incidence rate. The animation incidence rate was 69.6%. There was no significant relationship between animation incidence and any patient background or surgical factors, except for the complete dissection of insertion into the humerus of the latissimus dorsi muscle (p = 0.0039). The rate of uncomfortable animation was 4% and recurrence of animation was observed in one of the two patients who underwent denervation. Prophylactic denervation is not considered necessary and should be offered only for persistent discomfort with animation. Instead, the muscle insertion must be dissected during flap elevation to prevent animation, and the thoracodorsal nerve must be preserved to avoid muscle atrophy.

Frequency and severity of hyponatremia in healthy children with acute illness.

Hyponatremia can occur in the acute phase of any illness through various mechanisms. However, the frequency and severity of hyponatremia are not well known across a broad range of illnesses including medical and surgical diseases and trauma. The present, retrospective chart review was conducted at Tokyo Metropolitan Children's Medical Center from 2018 to 2019. Included were healthy children aged < 16years with an acute illness, who were urgently admitted, and had their serum sodium level measured on arrival. In total, 2717 patients were urgently admitted and had their serum sodium level measured. Of these, 1890 were included. Hyponatremia was found in 260 patients (13.8%). The most common hyponatremic disease was type 1 diabetes mellitus (69%) followed by acute infectious encephalopathy (60%), pyogenic arthritis (60%), and Kawasaki disease (51%). Kawasaki disease, seizure, urinary tract infection, acute appendicitis, lower respiratory tract infection, and acute gastroenteritis were associated with a significantly lower serum sodium value than cases of fracture comprising a control group. Conversely, acute bronchial asthma exacerbation (3%), anaphylaxis (0%), intussusception (0%), acute scrotal disease (0%), head injury (1%), and fracture (0%) were very infrequently associated with hyponatremia. The present study determined the frequency and severity of hyponatremia in various, acute, pediatric illnesses, including medical and surgical diseases and trauma. Despite reports of respiratory distress and pain inducing vasopressin secretion, hyponatremia was rarely observed on arrival in patients with acute bronchial asthma exacerbation, anaphylaxis, intussusception, acute scrotal diseases, head injury, or fracture.

Persistent anti-vaxxers and pandemic-induced new anti-vaxxers

Persistent anti-vaxxers and pandemic-induced new anti-vaxxers Read this analysis of persistent anti-vaxxers and pandemic-induced new anti-vaxxers by Fujio Toriumi, Professor at the University of Tokyo in Japan. During the COVID-19 pandemic caused by the novel coronavirus, anti-vaccine discourses pose a threat to public health by making it challenging to achieve herd immunity. Although studies describing anti-vaxxers’ characteristics have been accumulating, a lack of understanding prevails regarding the “triggers” that lead individuals to become anti-vaxxers.

Persistence of sub-urban agriculture and landowners' behavior in the population declining phase: Case of the preferential tax treatment for rental farmland

With the majority of the world’s population residing in urban areas, particularly in vast suburbs, land use control around the suburbs of large cities is a concern for not only protecting agricultural productivity but also maintaining a decent residential environment. A practical policy measure to address this concern is providing preferential tax treatments to landowners who lease out their farmland, and the Production Green Land (PGL) Act is a typical example, which was extensively revised by the Japanese government in 2018 to conserve farmlands and allow active farmers to use it effectively amid the overall population decrease. Previous studies have extensively focused on identifying factors to encourage persistent agriculture in the urban growing phase. However, the appropriate combinations of specialization, diversification, attributes, and location of farm businesses in the shrinking suburbs, where leasing farmland has become a practical option for farmers. Moreover, multifunctional value is important for ensuring that agriculture continues as a family business. Studies on the attributes of suburban landowners who keep farmland and provide multifunctional value to the community are also limited. Based on the above understanding of the literature, this study explores the specific farm attributes and locations related to the persistence of suburban agriculture. To this end, this study conducts a two-wave survey of suburban farmers, including smallholders in the Tokyo Metropolitan Area. The following key findings are observed. First, the continuity of agriculture in the suburbs is significantly related to farmers’ diversification activities in terms of sales channels and provision of services, with specialization within a business type in terms of agricultural operation also being an advantageous factor. Meanwhile, regarding the location, the probability of continuing agriculture is lowest in moderately populated suburbs. Second, landowners engaged in multifunctional agriculture that is linked with the community tend to hold farmland rather than convert it even when they stop or downscale their agricultural activities. Third, regarding the policy implication, the number of exiting and downsizing farmers was larger compared with expanding farmers, in addition to an unbalanced geographical distribution. Based on the findings, the study recommends that multifunctional agriculture through forming relationships with the community should be encouraged, new entrants to agriculture must be promoted, and active farmers who expand farm size need to be supported.

Asian Bay Areas' Experiences in Promoting Youth's Participation in Social Innovation Asian Bay Areas' Experiences in Promoting Youth's Participation in Social Innovation

This study analyzes the experiences and approaches of Asian bay areas, particularly China's Greater Bay Area and Japan's Tokyo Bay Area, in promoting youth participation in social innovation. Through a literature review and four case studies, the paper explores how social innovation helps young people address modernity challenges, including unemployment and social isolation. The cases include knowledge enhancement programs, breaking social isolation, providing work promotion opportunities, and empowering and inspiring youth to engage in social innovation. These methods not only contribute to solving social issues but also enhance young people's self-efficacy and improve their employability. The findings suggest that social innovation programs targeting youth must be tailored to meet their diverse needs, ranging from personal development and community belonging to professional advancement, all of which play a vital role.

Evaluation of the safety of drainless uniportal video-assisted thoracoscopic surgery for the treatment of primary spontaneous pneumothorax: a two-institution retrospective study.

Uniportal video-assisted thoracoscopic surgery (U-VATS) offers good cosmetic outcomes with minimal pain for the treatment of primary spontaneous pneumothorax (PSP). Moreover, the early removal of postoperative chest drains reduces postoperative pain and hospitalization duration for patients with PSP. We aimed to investigate the safety and feasibility of drainless U-VATS in patients with PSP and compare postoperative outcomes between specialists and residents. We retrospectively analyzed data obtained from the medical records of consecutive patients diagnosed with PSP who underwent surgery at Yamagata Prefectural Central Hospital and Tokyo Metropolitan Bokutoh Hospital between April 2023 and March 2024. Yamagata Prefectural Central Hospital and Tokyo Metropolitan Bokutoh Hospital initiated the drainless protocol in April and July 2023, respectively. All surgeries were performed using the U-VATS approach with a 1.8-2.0-cm incision. We retrospectively reviewed the medical records of 54 patients who underwent U-VATS according to the protocol. Postoperative repeated drainage was not required for any patient. The median postoperative length of hospital stay was 1 day. No multiport conversions were required. The specialists performed significantly better than the residents based on operative time; however, the other perioperative outcomes were not significantly different. Protocol-compliant drainless surgery for PSP is safe and feasible. The results from the two institutions suggest that residents can adequately perform U-VATS for spontaneous pneumothorax with perioperative outcomes comparable to those of specialists.

Feasibility of vehicle-to-grid (V2G) implementation in Japan: A regional analysis of the electricity supply and demand adjustment market

Vehicle-to-Grid (V2G) technology forms a critical bridge between electric vehicles (EVs) and renewable energy, playing a transformative role in the global shift towards a low-carbon future. Despite its promise, the impact of regional differences on V2G potential, particularly within specific application scenarios, remains largely unexplored. This study employs an agent-based modeling approach to evaluate V2G potential across Japan's 47 prefectures, with a focus on its integration into an energy reserve service business model. Our analysis reveals that EV ownership is the dominant factor influencing regional variability, with the Tokyo Metropolitan Area, Aichi, and Kanagawa emerging as top candidates for V2G deployment. Interestingly, when EV ownership is excluded from consideration, regions like Okinawa, Kagoshima, and Ibaraki show leadership in V2G potential. These findings highlight the existence of regional priorities for V2G application. Moreover, a ‘High Demand Disparity’ is observed in the power supply and demand adjustment market, where V2G systems are often either underutilized or overwhelmed, leaving many idle. The study underscores the need for region-specific strategies and the integration of diverse business models to fully capitalize on V2G's potential in various demand adjustment scenarios.

Can Avatar Robots Assist Older People and Care Professionals? Evaluation of an Intervention Study in Eight Nursing Homes in Tokyo

Abstract Background Securing human resources to meet increasing demand for older people's care is challenging, particularly in Japan, where the pace of ageing is accelerating. Central and local government have been seeking partial solutions in assistive technologies such as robotics. Against such a background, the study was conducted in 8 nursing care homes in Tokyo, where avatar robots were tested to examine whether and how these robot interventions can affect the daily life of older people and care professionals. Methods Four different types of avatar robot (ORIHIME, NEWME, Piyokame and BOCCO) were introduced to and used in eight nursing care facilities, in order to create conversational opportunities over 12 weeks. Before–after studies were conducted, and a variety of data was collected (interpersonal communication, self-care and depressive tendencies using the International Classification of Functioning, Disability and Health (ICF) and InterRAI assessments). System usability scores (SUS) were collected from care professionals, who also performed a time-on-task analysis. Results Study participants who consented to taking part were 136 older adults (88.4±6.6 years old, 18 men and 118 women) and 63 care professionals. Participants with a high degree of dependency accounted for 31 percent. In total, 136 avatar robots were used. There was an overall, yet marginal, improvement for older people. While the SUS scores were poor, the majority (90 percent) responded that such devices would prove useful in the future. The time-on-task analysis indicates that more time can be secured for ‘person-to-person’ care. Conclusion Positive impacts of avatar robots (to increase the level of social interaction and communication) were observed. However, the results are inconclusive, and more needs to be done with regard to technology skills, competence enhancement and data collection methods for this type of research. The study was funded in part by the Tokyo Metropolitan Government.

The “vegetables first” dietary habit correlates with higher-level functional capacity in older adults with diabetes

BackgroundSome studies suggest that the habit of eating vegetables may initially be correlated with maintenance of a higher-level functional capacity; however, such a correlation has not been demonstrated. This study aimed to correlate the habit of eating vegetables first and higher-level functional capacity in older adults with diabetes.MethodsPatients aged ≥ 60 years who were treated at Japanese Red Cross Ise Hospital on an ambulatory basis were included in this study. A self-administered questionnaire using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate higher-level functional capacity. Participants were instructed to answer the questionnaire regarding the order in which they consumed the mentioned food types, and based on their answers, they were classified into “no order of eating,” “carbohydrates first,” “protein first,” and “vegetables first” groups. Multiple regression analyses with the TMIG-IC score as a dependent variable and the order of eating as explanatory variables were used to determine the partial regression coefficients of the “vegetables first” dietary habit with higher-level functional capacity.ResultsThis study included 346 patients. The adjusted partial regression coefficients of the “carbohydrates first,” “protein first,” and “vegetables first” dietary habits with the TMIG-IC score were 0.27 (95% confidence interval [CI], − 0.29 to 0.84), 0.17 (95% CI, − 0.54 to 0.90), and 0.77 (95% CI, 0.23 to 1.31), respectively.ConclusionsThe habit of eating vegetables first was correlated with higher-level functional capacity in older adults with diabetes.

LAND SURFACE TEMPERATURE FORECASTING IN THE CONTEXT OF THE DEVELOPMENT OF SUSTAINABLE CITIES AND COMMUNITIES

The article examines the aspects of land surface temperature forecasting for effective planning and development of sustainable cities and communities. The relevance of the research lies in the need to develop effective approaches to the analysis and forecasting of climate data, for the timely determination of existing problems and ways to solve them, in accordance with civilizational challenges. The trends of changes in the land surface temperature from the middle of the 20th to the beginning of the 21st century were analyzed, using the example of five megacities located in different regions: Tokyo (Japan), Lagos (Nigeria), Berlin (Germany), Singapore (Singapore) and Belo Horizonte (Brazil). The results of the analysis of changes in average monthly and average annual temperatures are presented. The factors affecting the formation of the temperature regime of each of the cities are determined. The role of urbanization as a key factor in the development of the city is described, the main challenges caused by it are considered. An overview of megacities from the point of view of sustainable development was carried out. Prospects for urban development and measures aimed at reducing the urban heat island effect are considered. The role of modern technologies, in particular machine learning for predicting the land surface temperature, is described. The expediency of land surface temperature forecasting, in order to implement strategies for mitigating negative consequences and achieving the goals of sustainable development, is substantiated. The conducted research makes it possible to be convinced of the need for a responsible approach to the design and development of sustainable cities and communities. The temperature of the earth’s surface is one of the key indicators that allows you to monitor the main trends of urban life and can be an indicator of the effectiveness of strategies used to increase comfort and sustainable development.

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain. This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education. The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019. After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively. These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Frontline evaluation: Atezolizumab-bevacizumab versus lenvatinib for BCLC stage B hepatocellular carcinoma exceeding the up-to-seven criteria.

This study aimed to evaluate the efficacy and safety of atezolizumab combined with bevacizumab (Atez/Bev) compared to lenvatinib (LEN) as first-line systemic therapy for patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) exceeding the up-to-seven criteria threshold, who are typically unsuitable for transarterial chemoembolization (TACE). A retrospective analysis was conducted on 49 consecutive patients with HCC treated at Tokyo Metropolitan Komagome Hospital between May 2018 and October 2023. The patients were divided into two groups: the Atez/Bev group (21 patients) and the LEN group (28 patients). Eligibility criteria included Child-Pugh A classification, no prior systemic therapy, and ineligibility for resection, ablation, or transplantation. Treatment outcomes were assessed through periodic imaging and laboratory tests, evaluating OS, PFS, ORR, and disease control rate (DCR). Both groups demonstrated comparable baseline characteristics, with a median follow-up of 15.4 months. No significant difference was observed in OS between the Atez/Bev and LEN groups (median OS: 19.80 vs. 22.20 months, p = 0.763). The median PFS was 10.23 months for Atez/Bev and 7.20 months for LEN (p = 0.343). There were no statistically significant differences in ORR or DCR between the two groups. Common adverse events included elevated AST and ALT levels, with no significant difference in the overall rate of adverse events between the groups. Atez/Bev and LEN demonstrated comparable efficacy and safety as first-line systemic treatments for patients with BCLC stage B HCC exceeding the up-to-seven criteria. Both therapeutic options are viable for this population, though further large-scale prospective studies are required to confirm these findings.

A retrospective single institutional analysis of outpatient chemotherapy in patients with cancer during the COVID-19 pandemic.

Providing treatment to patients with cancer, even during the coronavirus disease (COVID-19) pandemic, is essential. In collaboration with infectious disease specialists, we established guidelines for the management of patients with cancer receiving ambulatory treatment during the pandemic on April 8, 2020. This study examined the practice and management of ambulatory chemotherapy under emergency conditions. Following the guidelines, our Breast and Medical oncology department developed a chemotherapy strategy for the phases. Additionally, to distinguish fever during chemotherapy, we developed a flow chart for fever. As part of a fact-finding survey, the status of outpatient chemotherapy was investigated: (1) whether there was any change in the number of chemotherapies before and after the declaration of a state of emergency by the Tokyo Metropolitan Government and (2) the frequency and severity of febrile neutropenia (FN) cases. Compared to before the first declaration of the state of emergency, the number of chemotherapies decreased except after the declaration, but no decrease was observed during the rest of the period; no difference was observed in the frequency or severity of FN outbreaks or in the use of pegfilgrastim for primary prevention before and after the epidemic. With appropriate treatment guidelines, routine chemotherapy can be performed in an outpatient setting during an outbreak.