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Conversion therapy for gastric cancer (GC) has been the subject of much recent attention. It is defined as a surgical treatment aiming at an R0 resection after chemotherapy for tumors that were originally unresectable or marginally resectable for technical and/or oncological reasons. However, the indications for resection remain to be clarified. In the present review, we focus on the biology and heterogeneous characteristics of stage IV GC and propose new categories of classification. Stage IV GC patients can be divided based on the absence (categories 1 and 2) or presence (categories 3 and 4) of macroscopically detectable peritoneal dissemination, which has a different biological outcome compared to hematological metastasis. Category 1 is defined oncologically as stage IV but the metastasis is technically resectable. Category 2 includes a marginally resectable metastasis or patients for whom the operation would not necessarily be the best choice. Category 3 includes a potentially unresectable metastasis of peritoneal dissemination that is only macroscopically detectable. Category 4 includes noncurable metastasis with peritoneal and other organ metastasis. The indications for conversion therapy might include the patients from category 2, some patients from category 3 and a very small number of patients from category 4. The longer survival can be expected for patients corresponding to categories 1, 2 and, to a lesser extent, 3, while the treatment of other patients focuses on “care.” The provision of conversion therapy for stage IV GC patients might be one of the main roles of surgical oncologists in the near future.

Breast cancer (BC) is the most common cancer worldwide among women. In Japan, the incidence of BC gradually increased. The recent number of adolescent and young adult (AYA)-BC patients is approximately 4,000–5,000 every year, accounting for 5% of all BC cases. BC in young people has been attracting attention since Japan's third basic plan to promote cancer control programs incorporated cancer control measures for pediatric (age ≤ 14 years) and adolescent and young adult (AYA)-generation (age 15–39 years) cancers in 2018. Attention is needed to detect AYA-BC because of the presence of dense breasts. AYA-BC patients are clinically characterized by larger tumor size, more lymph node metastases, advanced stages, and a higher rate of aggressive phenotypes, such as triple-negative or HER2-positive subtypes, and are strongly associated with family history and genetic germline alterations, including hereditary breast and ovarian cancers. Given that AYA-BC patients show a poorer prognosis than older BC patients, they often require intensive therapies, including surgery, radiation, chemotherapy, and endocrine therapy. We must solve many survivorship-associated problems in AYA-BC patients, including fertility preservation, comorbidity after treatment, and long-term follow-up. Under these circumstances, national and local governments and various academic societies have started addressing these problems by formulating laws and guidelines, establishing medical systems, and offering financial support to conquer cancer and maintain a better quality of life. This review summarizes the current trends of AYA-BC worldwide and in Japan. Further Japan-specific data on AYA-BC are required to clarify its characteristics and improve prognosis and survivorship.

Lewin, in his article: “It is time to fix the low financing trap: public spending on education revisited”, reveals, when low- and lower middle-income countries are grouped according to their level of public education spending, that individual country's education spending largely remained unchanged at the same and insufficient level since the 1990s, pointing the existence of a “low financing trap” and “only the highest band countries are likely to be able to finance the ambitions of SDG 4 with domestic revenue.” Malenya & Ohba's article, “Equity Issues in the Provision of Online Learning during the Covid-19 Pandemic in Kenya”, similarly found that the government's approach to providing equitable and inclusive online learning rather aggravated gaps in educational opportunities, leaving students living in remote areas and urban informal settlements, girls and learners from low-socioeconomic households further behind. [...]some girls lost protective space of the school environment, resulting in the increased incidence of early pregnancy. In education, conventional major players, such as UNESCO, World Bank and Global Partnership for Education, as well as other international and bilateral organizations, have constituted mechanisms to work more closely [1], and efforts are underway to mobilize increased resources to be made available to educational development.

NH 3 -SCR (selective catalytic reduction) is important process for removal of NOx. However, water vapor included in exhaust gases critically inhibits the reaction in a low temperature range. Here, we report bulk W-substituted vanadium oxide catalysts for NH 3 -SCR at a low temperature (100–150 °C) and in the presence of water (~20 vol%). The 3.5 mol% W-substituted vanadium oxide shows >99% (dry) and ~93% (wet, 5–20 vol% water) NO conversion at 150 °C (250 ppm NO, 250 ppm NH 3 , 4% O 2 , SV = 40000 mL h −1 g cat −1 ). Lewis acid sites of W-substituted vanadium oxide are converted to Brønsted acid sites under a wet condition while the distribution of Brønsted and Lewis acid sites does not change without tungsten. NH 4 + species adsorbed on Brønsted acid sites react with NO accompanied by the reduction of V 5+ sites at 150 °C. The high redox ability and reactivity of Brønsted acid sites are observed for bulk W-substituted vanadium oxide at a low temperature in the presence of water, and thus the catalytic cycle is less affected by water vapor. NH 3 selective catalytic reduction is an important technique for NOx removal but water vapor critically inhibits the reaction at a low temperature. Here the authors show bulk W-substituted VOx exhibits higher NOx removal ability than the TiO 2 supported vanadia catalyst in the presence of water.

BackgroundIt is important to determine the effect of clinical factors on several domains (symptoms, living status, and quality of life [QOL]) after gastrectomy to establish individualized therapeutic strategies. This study was designed to determine the factors—particularly surgical method—that influence certain domains after gastrectomy for proximal gastric cancer by using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire.MethodsWe conducted a nationwide study of PGSAS-45 questionnaire responses retrieved from 1950 (82.5%) patients from 70 institutions who had undergone gastrectomy for gastric cancer. Of these, 1,538 responses for proximal gastric cancer (1020 total gastrectomies and 518 proximal gastrectomies [PGs]) were examined.ResultsPG significantly and favorably affected four main outcome measures (MOMs): elderly affected 10 MOMs, male sex affected 4 MOMs, longer postoperative period affected 8 MOMs, preservation of the vagus nerve affected 1 MOM, adjuvant chemotherapy affected 1 MOM, clinical stage affected 2 MOMs, and more extensive lymph node dissection affected 2 MOMs. However, the laparoscopic approach had an adverse effect on MOMs and combined resection of other organs had no favorable effect on any MOMs.ConclusionsThis PGSAS NEXT study showed that it is better to perform PG for proximal gastric cancer, even for patients with advanced cancer, to obtain favorable postoperative QOL if oncological safety is guaranteed. Because the MOMs of PGSAS-45 are positively and negatively influenced by various background factors, it also is necessary to provide personalized care for each patient to prevent deterioration and further improve symptoms, living status, and QOL postoperatively.

Hand, foot, and mouth disease (HFMD) is a common febrile illness caused by enteroviruses in the Picornaviridae family. The major symptoms of HFMD are fever and a vesicular rash on the hand, foot, or oral mucosa. Acute meningitis and encephalitis are observed in rare cases. HFMD epidemics occur annually in Japan, usually in the summer season. Relatively large-scale outbreaks have occurred every two years since 2011. In this study, the epidemic patterns of HFMD in Japan are predicted four weeks in advance using a deep learning method. The time-series data were analyzed by a long short-term memory (LSTM) approach called a Recurrent Neural Network. The LSTM model was trained on the numbers of weekly HFMD cases in each prefecture. These data are reported in the Infectious Diseases Weekly Report, which compiles the national surveillance data from web sites at the National Institute of Infectious Diseases, Japan, under the Infectious Diseases Control Law. Consequently, our trained LSTM model distinguishes between relatively large-scale and small-scale epidemics. The trained model predicted the HFMD epidemics in 2018 and 2019, indicating that the LSTM approach can estimate the future epidemic patterns of HFMD in Japan.

Tumor associated macrophages (TAMs) play a critical role in biology of various cancers, including breast cancer. In the current study, we defined “M1” macrophage and “M1”/“M2” ratio by transcriptomic signatures using xCell. We investigated the association between high level of “M1” macrophage or “M1”/“M2” ratio and the tumor immune microenvironment by analyzing the transcriptome of publicly available cohorts, TCGA and METABRIC. We found that “M1” high tumors were not associated with prolonged survival compared with “M1” low tumors, or with the response to neoadjuvant chemotherapy. “M1” high tumors were associated with clinically aggressive features and “M1” high tumors enriched the cell proliferation and cell cycle related gene sets in GSEA. At the same time, “M1” high tumors were associated with high immune activity and favorable tumor immune microenvironment, as well as high expression of immune check point molecules. Strikingly, all these results were mirrored in “M1”/“M2” ratio high tumors. In conclusion, transcriptomically defined “M1” or “M1”/“M2” high tumors were associated with aggressive cancer biology and favorable tumor immune microenvironment but not with survival benefit, which resembled only part of their conventional clinical characteristics.

Heavy metals in the environment cause adverse effects on living organisms. Agro-wastes have the potential to remove heavy metals from aqueous solutions. In this study, the orange peel cellulose (OPC) beads were utilized as adsorbents to remove metals from wastewater. The surface of the adsorbent was studied by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy coupled with energy dispersive x-ray spectroscopy (SEM-EDS). The concentrations of the metals before and after adsorption were measured using inductively coupled plasma mass spectrometry. The removal of the metal ions (i.e., Cr6+, Cd2+, and Pb2+) using the OPC was investigated by varying the pH, contact time, and adsorbent dosages parameters. The maximum removal efficiency obtained for the metal ions occurred at pHs 4–8. The use of the Langmuir isotherm and Freundlich isotherm models demonstrated the statistical significance of the heavy metal adsorption processes (R2 > 0.96). At a neutral pH, the OPC adsorption order was Pb2+ > Cd2+ > Cr6+ with % removal values of 98.33, 93.91, and 33.50, respectively. The adsorption equilibrium for Cr6+ was reached after 36 h. For Cd2+ and Pb2+, equilibrium was reached after 8 and 12 h, respectively. The FT-IR and SEM-EDS confirmed the presence of many functional groups and elements on the adsorbent. The adsorption of heavy metals using the OPC is a low-cost, eco-friendly, and innovative method for the removal of metals in aquatic environments. The findings of this study will be highly significant for the public in the affected areas worldwide that have credible health concerns due to water contamination with heavy metals.

Rat sarcoma (RAS) is a well‐known oncogene that plays important roles in cancer proliferation, cell survival and cell invasion. RAS exists as three major isoforms, Kirsten rat sarcoma (KRAS), Harvey rat sarcoma (HRAS) and neuroblastoma rat sarcoma (NRAS). Mutations of these genes account for approximately 30% of all cancers. Among them, KRAS mutations are the most common, responsible for 85%, followed by NRAS (12%) and HRAS (3%). Although the development of RAS inhibitors has been explored for over the past decade, so far, no effective inhibitor has been found. MicroRNA (miRNA) are a class of small non–coding RNA that control the gene expression of pleural target genes at the post–transcriptional level. MiRNA play critical roles in the physiological and pathological processes at work in cancers, such as cell proliferation, cell death, cell invasion and metastasis. MicroRNA‐143 (MIR143) is known to function as a tumor suppressor in a variety of cancers. One of its known mechanisms is suppression of RAS expression and its effector signaling pathways, such as PI3K/AKT and MAPK/ERK. Within the last five years, we developed a potent chemically modified MIR143‐3p that enabled us to elucidate the details of the KRAS signaling networks at play in colon and other cancer cells. In this review, we will discuss the role of MIR143‐3p in those RAS signaling networks that are related to various biological processes of cancer cells. In addition, we will discuss the possibility of the use of MIR143 as a therapeutic drug for targeting RAS signaling networks. In this review, we will discuss the role of MIR143 in those Rat sarcoma (RAS) signaling networks that are related to various biological processes of cancer cells. In addition, we will discuss the possibility of the use of MIR143 as a therapeutic drug for targeting RAS signaling networks.

BackgroundAlthough laparoscopic total gastrectomy (LTG) is considered a technically demanding procedure with safety issues, it has been performed in several hospitals in Japan. Data from a nationwide web-based data entry system for surgical procedures (NCD) that started enrollment in 2011 are now available for analysis.MethodsA retrospective cohort study was conducted using data from 32,144 patients who underwent total gastrectomy and were registered in the NCD database between January 2012 and December 2013. Mortality and morbidities were compared between patients who received LTG and those who underwent open total gastrectomy (OTG) in the propensity score-matched Stage I cohort and Stage II–IV cohort.ResultsThere was no significant difference in mortality rate between LTG and OTG in both cohorts. Operating time was significantly longer in LTG while the blood loss was smaller. In the Stage I cohort, LTG, performed in 33.6% of the patients, was associated with significantly shorter hospital stay but significantly higher incidence of readmission, reoperation, and anastomotic leakage (5.4% vs. 3.6%, p < 0.01). In the Stage II–IV cohort, LTG was performed in only 8.8% of the patients and was associated with significantly higher incidence of leakage (5.7% vs. 3.6%, p < 0.02) although the hospital stay was shorter (15 days vs. 17 days, p < 0.001).ConclusionLTG was more discreetly introduced than distal gastrectomy, but remained a technically demanding procedure as of 2013. This procedure should be performed only among the well-trained and informed laparoscopic team.