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Infection with hookworm and are serious health problems among children and adolescents in Laos. In this study, we demonstrated the factors related to hookworm and infection, including primary school health programs, among secondary school students in Vientiane city of Laos. A cross-sectional survey and stool examination were conducted among secondary school students in Vientiane. One stool sample from each participant was examined using two Kato-Katz smears. Data of 164 participants were analyzed and the associations among parasitic infections, sociodemographic characteristics, and the school health program in primary school were assessed in a univariate logistic regression analysis. Predictors with <0.25 were retained in a multivariate logistic regression model. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. The significance level was set at <0.05. The infection rates of and hookworm were 39.0% and 36.0%, respectively. Older students (OR=1.55, 95% CI: 1.01-2.37, =0.046) and those whose father had irregular income (OR=0.47, 95% CI: 0.13-0.93, =0.036) had a higher risk for hookworm infection. Students whose mother had irregular income (OR=0.30, 95% CI: 0.13-0.69, =0.005) had a higher risk for infection. Higher primary school health program scores were associated with a lower risk for hookworm infection in the univariate model but not in the multivariate model. Sociodemographic factors have a strong influence on infections with both hookworm and . Current school health programs in Laos may be insufficient to reduce infections. Other approaches, such as supporting parents in finding employment with regular income, may be needed.

In the Lao People's Democratic Republic (Laos), health education is clearly a core aspect of the health service and is vital in improving people's lives through good health. However, there are many obstacles to conducting effective health education. The development of effective educational media is one solution to these problems. In Laos, traditional folk songs (lam) are preserved as part of the local communication media, and recently this communication medium has been used for health education. The aim of this study is to evaluate the effectiveness of educational media using lam. For this purpose, we conducted focus group discussions with 48 participants. The reactions of the participants towards a lam, developed for preventing HIV/AIDS, were analysed using the KJ (Kawakita Jim) method. The analysis showed there were eight areas of concern: (1) interest in a lam talking about HIV/AIDS; (2) knowledge and perception related to HIV infection routes; (3) expressing a willingness for preventing HIV/AIDS; (4) togetherness with people living with HIV/AIDS; (5) HIV/AIDS education for children; (6) improving educational methods; (7) characteristics and effectiveness of the lam and (8) song preferences. The reactions of the participants, such as gaining knowledge and expressing individual attitudes and community actions for preventing HIV/AIDS, were promoted by the characteristics and effectiveness of the lam such as oral tradition, artistry and cultural values. In particular, the oral tradition represented by lam is useful for the Lao people in memorizing and communicating information.

We devised a single-batch fermentation system to simulate human colonic microbiota from fecal samples, enabling the complex mixture of microorganisms to achieve densities of up to 1011 cells/mL in 24 h. 16S rRNA gene sequence analysis of bacteria grown in the system revealed that representatives of the major phyla, including Bacteroidetes, Firmicutes, and Actinobacteria, as well as overall species diversity, were consistent with those of the original feces. On the earlier stages of fermentation (up to 9 h), trace mixtures of acetate, lactate, and succinate were detectable; on the later stages (after 24 h), larger amounts of acetate accumulated along with some of propionate and butyrate. These patterns were similar to those observed in the original feces. Thus, this system could serve as a simple model to simulate the diversity as well as the metabolism of human colonic microbiota. Supplementation of the system with several prebiotic oligosaccharides (including fructo-, galacto-, isomalto-, and xylo-oligosaccharides; lactulose; and lactosucrose) resulted in an increased population in genus Bifidobacterium, concomitant with significant increases in acetate production. The results suggested that this fermentation system may be useful for in vitro, pre-clinical evaluation of the effects of prebiotics prior to testing in humans.

Background Carbon-ion radiotherapy (CIRT) for prostate cancer was initiated at Kanagawa Cancer Center in 2015. The present study analyzed the preliminary clinical outcomes of CIRT for prostate cancer. Methods The clinical outcomes of 253 patients with prostate cancer who were treated with CIRT delivered using the spot scanning method between December 2015 and December 2017 were retrospectively analyzed. The irradiation dose was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. Biochemical relapse was defined using the Phoenix definition. Toxicities were assessed according to CTCAE version 4.0. Results: The median patient age was 70 (47–86) years. The median follow-up duration was 35.3 (4.1–52.9) months. According to the D’Amico classification system, 8, 88, and 157 patients were classified as having low, intermediate, and high risks, respectively. Androgen deprivation therapy was administered in 244 patients. The biochemical relapse-free rate in the low-, intermediate-, and high-risk groups at 3 years was 87.5, 88.0, and 97.5%, respectively ( P  = 0.036). Grade 2 acute urinary toxicity was observed in 12 (4.7%) patients. Grade 2 acute rectal toxicity was not observed. Grade 2 late urinary toxicity and grade 2 late rectal toxicity were observed in 17 (6.7%) and 3 patients (1.2%), respectively. Previous transurethral resection of the prostate was significantly associated with late grade 2 toxicity in univariate analysis. The predictive factor for late rectal toxicity was not detected. Conclusion The present study demonstrated that CIRT using the spot scanning method for prostate cancer produces favorable outcomes.

Abstract From August 2019 to August 2020, we inserted polyglycolic acid (PGA) spacers and administered carbon ion radiotherapy (CIRT) to three cases of retroperitoneal sarcoma at our hospital. We aimed to investigate its utility and safety for retroperitoneal sarcoma. We analyzed changes in PGA spacer volume and corresponding computed tomography (CT) values in addition to the dose distribution using in-room CT images that were obtained during treatment. We assessed adverse events and investigated the suitability, safety and effectivity of PGA spacer insertion. During treatment, changes in PGA spacer volumes and CT values were confirmed. Volumes increased in patients with a folded PGA spacer, and it increased 1.6-fold by the end of irradiation compared with planning CT. The CT values decreased by 20–50 Hounsfield units at the end of irradiation compared to the planning CT. Dose distribution evaluation showed that the dose to the gastrointestinal tract adjacent to the tumor was maintained below the tolerable dose, and a sufficient dose was delivered to the target by PGA spacer insertion. One case of subileus caused during abdominal surgery for PGA spacer insertion occurred. No other adverse events, such as digestive disorders, were observed. CIRT with PGA spacer insertion for retroperitoneal sarcomas is safe and effective. For cases in which there is no option but to perform irradiation using a PGA spacer, precautionary measures such as verification of dose distributions using CT images are necessary.

BackgroundThe U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have published guidelines on the use of cancer treatments in young people of reproductive potential. However, no such guideline is available in Japan. Therefore, this project aimed to gather relevant data and draft a respective guidance paper.MethodsFrom April 2019 to March 2021, the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential at the Japan Agency for Medical Research and Development gathered opinions from experts in reproductive medicine, toxicology, and drug safety measures. The group considered these opinions, the FDA and EMA guidelines, and relevant Japanese guidelines and prepared a guidance paper, which they sent to 19 related organizations for comment.ResultsBy November 2020, the draft guidance paper was completed and sent to the related organizations, 17 of which provided a total of 156 comments. The study group finalized the guidance paper in March 2021.ConclusionsThe “Guidance on the Need for Contraception Related to Use of Pharmaceuticals” (The report of the Study Group for Providing Information on the Proper Use of Pharmaceuticals in Patients with Reproductive Potential, Research on Regulatory Science of Pharmaceuticals and Medical Devices, Japan Agency for Medical Research and Development: JP20mk0101139) is expected to help Japanese healthcare professionals provide fertility-related care and advice to adolescents, and young adults with cancer and their families.

Background/Aim: The purpose of this study was to compare the dose distribution between scanning carbon-ion radiotherapy (sCIRT) and volumetric-modulated arc therapy with stereotactic body radiation therapy (VMAT-SBRT) for stage I non-small cell lung cancer (NSCLC). Patients and Methods: Fifteen patients with early-stage NSCLC who underwent sCIRT at Kanagawa Cancer Center between 2018-2020 were enrolled. Dose-volume histogram parameters of the planned target volume and normal organs for sCIRT and VMAT-SBRT were evaluated. Results: The homogeneity index of the target volume of sCIRT was significantly lower than that of VMAT-SBRT. The dose of sCIRT was significantly lower than that of VMAT-SBRT at low volumes in the lung, heart, spinal cord, and esophagus. Conclusion: The dose distribution of sCIRT for early-stage NSCLC was better than that of VMAT-SBRT.

This study aimed to explain the dynamics of prostate-specific antigen (PSA) levels in patients with prostate cancer who were treated with carbon ion radiotherapy (CIRT) and neoadjuvant androgen-deprivation therapy (ADT). Eighty-five patients with intermediate-risk prostate cancer who received CIRT and neoadjuvant ADT from December 2015 to December 2017 were analyzed in the present study. The total dose of CIRT was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. The PSA bounce was defined as a ≥0.4 ng/ml increase of PSA levels from the nadir, followed by any decrease. PSA failure was defined using the Phoenix criteria. The median patient age was 68 (range, 48-81) years. The median follow-up duration was 33 (range, 20-48) months. The clinical T stage was T1c, T2a, and T2b in 27, 44, and 14 patients, respectively. The Gleason score was 6 in 3 patients and 7 in 82 patients. The median pretreatment PSA level was 7.37 (range, 3.33-19.0) ng/ml. All patients received neoadjuvant ADT for a median of 6 (range, 2-117) months. PSA bounces were observed in 39 patients (45.9%), occurring a median of 12 (range, 6-30) months after CIRT. PSA failure was observed in eight patients (9.4%), occurring a median of 21 (range, 15-33) months after CIRT. The 3-year PSA failure-free survival rate was 88.5%. No clinical recurrence was observed during the follow-up period. Younger age and lower T stage were significant predictors of PSA bounce. Younger age was a significant predictor of PSA failure. In this study, we identified the significant predictors of the occurrence of PSA bounce and failure. Further follow-up is needed to reveal the clinical significance of PSA dynamics.

This study focused on the hybrid-volumetric modulated arc therapy (hVMAT) for stage I esophageal cancer and compared the effects on dose distribution induced by changes in the ratio of three-dimensional conformal radiotherapy (3DCRT) to VMAT. Fifteen patients who underwent 3DCRT for cT1bN0M0 esophageal cancer at Kanagawa Cancer Center from January 2014 to April 2019 were included in the study. The dose-volume histogram (DVH) parameters of the target volume and normal organs were evaluated in the 3DCRT, hVMAT, and VMAT treatment plans. The homogeneity index of the target volume was significantly lower for hVMAT. In hVMAT, as the ratio of VMAT increased, the volume of low-dose region in the heart and lung increased, whereas the volume of the middle- to high-dose region decreased. As the ratio of VMAT increased, the mean dose in the heart decreased, whereas the mean dose in the lung increased. Favorable dose concentration was obtained for the target volume in hVMAT for stage I esophageal cancer. Altering the ratio of VMAT significantly changed the DVH parameters in normal organs.

Background/Aim: Carbon-ion radiotherapy (CIRT) has been reported to obtain favorable results in the treatment of bone and soft tissue malignancies; however, studies on CIRT for soft tissue sarcomas (STS) of the extremities are limited. Here, we have retrospectively evaluated the therapeutic efficacy and adverse events associated with scanning CIRT (sCIRT) for STS of the extremities at our institution. Patients and Methods: Thirteen consecutive patients with STS who underwent sCIRT between January 2017 and January 2020 were included in the study. The total dose of sCIRT was set at 67.2-70.4 Gy (RBE), which was provided in 16 fractions. Overall survival (OS), progression-free survival (PFS), and local control (LC) were estimated using the Kaplan–Meier method. Toxicity was evaluated using Common Terminology Criteria for Adverse Events v5.0. Results: The cohort consisted of 10 males and 3 females with a median age of 69 years (range=38-95 years). Median duration of observation was 31.8 months (range=7.4-56.4 months). Tumors were localized to the upper extremity in 2 cases and to the lower extremity in 11 cases. Median maximum tumor diameter was 11.7 cm (range=3.0-36.6 cm), while 3-year OS, PFS, and LC were 61.5%, 44.9%, and 79.1%, respectively. Acute toxicity of grade 3 or higher was not observed. Late toxicity included grade 3 peripheral nerve palsy and decreased range of motion in 1 and 1 patient each. Late toxicity of Grade 4 or higher was not observed. Conclusion: sCIRT for STS of the extremities demonstrates favorable therapeutic results with acceptable toxicity.