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Background: Esophageal carcinosarcoma (ECS) is a relatively rare malignancy, accounting for < 1% of all esophageal cancers. Its etiopathogenesis remains unknown. This study analyzed the genomic abnormalities in sarcomatous tumors from two patients undergoing subtotal esophagectomy using whole genome sequencing to elucidate the key characteristics of ECS., Case Presentation: We identified TP53 driver mutations, copy number gains in 11q13 (including CCND1), and Apolipoprotein B mRNA editing enzyme catalytic polypeptide (APOBEC) signature enrichment in both ECS patients. Along with common genetic abnormalities, we identified CDKN2A driver mutations in case 1 and RAC1, NOTCH1, and TTC28 as novel fusion gene partners of MECOM in case 2. Notably, we detected germline pathogenic variant in Fanconi anemia (FA) complementation group I (FANCI) and group G (FANCG), which are involved in repairing DNA double-strand breaks by homologous recombination, for the first time, in ECS blood samples. These germline variants were truncating-type, Lys1221fs of FANCI (rs1567179036) for case 1 and Gln365Ter of FANCG (rs121434426) for case 2. We also identified somatic changes in cancer-associated pathways, such as PI3K/Akt/mTOR, cell cycle, and NOTCH signaling pathways, and structural chromosomal defects such as chromosome doubling., Conclusions: Our findings indicate that therapeutic drugs targeting the activation signal or FA pathway might be effective in treating ECS, however, their therapeutic significance should be elucidated in future studies., (© 2024. The Author(s).)

The fan cooling vest is coming into very common use by Japanese outdoor manual workers. We examined that to what extent using this vest reduces thermal strain and perception during outdoor exercise in the heat on a sunny summer day. Ten male baseball players in high school conducted two baseball training sessions for 2-h with (VEST) or without (CON) a commercially available fan cooling vest on a baseball uniform. These sessions commenced at 10 a.m. on separate days in early August. The fan airflow rate attached the vest was 62 L·s -1 . Neither ambient temperature (Mean ± SD: VEST 31.9 ± 0.2°C; CON 31.8 ± 0.7°C), wet-bulb globe temperature (VEST 31.2 ± 0.4°C; CON 31.4 ± 0.5°C) nor solar radiation (VEST 1008 ± 136 W·m -2 ; CON 1042 ± 66 W·m -2 ) was different between trials. Mean skin temperature (VEST 34.5 ± 1.1°C; CON 35.1 ± 1.4°C), infrared tympanic temperature (VEST 38.9 ± 0.9°C; CON 39.2 ± 1.2°C), heart rate (VEST 127 ± 31 bpm; CON 139 ± 33 bpm), body heat storage (VEST 140 ± 34 W·m -2 ; CON 160 ± 22 W·m -2 ), thermal sensation (- 4-4: VEST 0 ± 2; CON 3 ± 1) and rating of perceived exertion (6-20: VEST 11 ± 2; CON 14 ± 2) were lower in VEST than CON (all P < 0.05). Total distance measured with a global positioning system (VEST 3704 ± 293 m; CON 3936 ± 501 m) and body fluid variables were not different between trials. This study indicates that the fan cooling vest use can reduce thermal strain and perception during outdoor exercise in the heat on a sunny summer day. Cooling with this vest would be effective to mitigate thermal risks and perceptual stress in athletes and sports participants under such settings., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Background: The gold standard for resectable, locally advanced esophageal squamous cell carcinoma (ESCC) is surgery-based treatment; however, it is unclear whether esophagectomy or chemoradiotherapy is suitable for older patients. This retrospective study aimed to identify the treatment outcomes of surgery-based therapy versus definitive chemoradiotherapy (dCRT) as an initial treatment for older patients with resectable, locally advanced ESCC., Methods: Data from 434 patients who received radical treatment for resectable, locally advanced ESCC were collected from January 2011 to December 2020. Of the patients >75 years of age, 49 underwent radical esophagectomy and 26 received dCRT. Survival was compared between the surgery and dCRT groups., Results: The mean ages of the surgery and chemoradiotherapy groups were 77.3 and 78.8 years, respectively. Differences in overall survival (OS) between the two groups were not statistically significant (3-year OS: surgery 66.2%, dCRT 55.7%, p = 0.236). Multivariate analysis for OS showed a hazard ratio of 1.229 for dCRT versus surgery (90% confidence interval 0.681-2.217). OS did not differ between the groups in any of the performance statuses. For patients who were able to receive chemotherapy using fluorouracil and cisplatin, OS tended to be better in the surgery group, but the difference was not statistically significant (3-year OS: surgery 68.1%, dCRT 51.8%, p = 0.117)., Conclusions: There was no clear difference in survival outcome between surgery-based therapy and dCRT as an initial treatment for esophageal cancer in older patients. Either treatment may be an option for older patients., (© 2024 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd.)

Introduction: There are no reports examining the time-of-day effect on team training sessions in the gym without airflow and air conditioning on thermal strain in the summer heat. We investigated this effect during badminton training sessions on a clear summer day., Methods: Nine male high school badminton players (Mean ± SD; age 17.1 ± 0.6 y, height 171 ± 4 cm, body mass 59 ± 7 kg) completed two 2.5-h badminton training sessions in the gym without airflow and air conditioning. The training sessions were started at 0900 h (AM) and 1600 h (PM) on separate days in August. Skin temperatures (chest, triceps, thigh, calf), infrared tympanic temperature, heart rate, thermal sensation and rating of perceived exertion were recorded at rest and at regular intervals during the sessions., Results: Indoor and outdoor environmental heat stress progressively increased in AM and decreased in PM during the sessions. Ambient temperature (AM 30.1 ± 0.9°C; PM 33.2 ± 1.0°C: P  < 0.001) and wet-bulb globe temperature (AM 28.1 ± 0.5°C; PM 30.0 ± 0.9°C: P  = 0.001) during the sessions in the gym were higher in PM than AM. Mean skin temperature (AM 34.2 ± 1.0°C; PM 34.7 ± 0.7°C: P  < 0.001), infrared tympanic temperature (AM 37.8 ± 0.5°C; PM 38.1 ± 0.4°C: P  = 0.001) and thermal sensation (AM 2.7 ± 1.4; PM 3.3 ± 1.0: P  < 0.001) during the sessions were higher in PM than AM. Body heat storage (AM 159 ± 30 W·m -2 ; PM 193 ± 30 W·m -2 : P  < 0.05) was greater in PM than AM. There were no time-of-day differences in the average heart rate (AM 75 ± 4% age-predicted maximal heart rate; PM 76 ± 5 age-predicted maximal heart rate: P  = 0.534), body mass loss (AM 0.6 ± 0.3 kg; PM 0.8 ± 0.2°C: P  = 0.079), the volume of water ingested (AM 1.5 ± 0.1 L; PM 1.6 ± 0.3 L: P  = 0.447) and rating of perceived exertion (AM 16 ± 2; PM 16 ± 3: P  = 0.281)., Conclusions: This study indicates greater thermal strain in PM trial than in AM trial during team training sessions in the gym without airflow and air conditioning on a clear summer day. Therefore, athletes and coaches of indoor sports should perceive that athletes may be exposed to a greater risk for thermal strain in the late afternoon from 1600 h than in the morning from 0900 h during the sessions in the gym under these conditions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Otani, Goto, Kobayashi, Goto, Shirato, Hosokawa, Tokizawa and Kaya.)

The present study examined the effect of wearing a water-soaked inner t-shirt with a ventilation garment on thermal and cardiovascular strain in eight young (26 ± 4 years) and eight older (67 ± 3 years) men undertaking moderate-intensity work (metabolic rate: 200-230 W m -2 ) in a hot environment (37°C, 50% RH, 2.8 kPa). While intermittent walking in hot conditions for 60 min, as a control (CON), the subject wore a dry inner t-shirt (long-sleeved) without fanning of a ventilation jacket (single-layered cotton, 0.21 clo). On separate days, under a fanned ventilation jacket, the subject wore a dry inner t-shirt (DRY) or an inner t-shirt soaked with 350 mL of tap water (WET). In the young group, increases in rectal temperature from pre-exercise baseline in the WET trial (0.7°C ± 0.2°C) were lower than in the CON (1.3°C ± 0.3°C) and DRY (1.1°C ± 0.2°C) (both p < 0.05) trials during exercise in hot conditions. In the older group, the increases were also attenuated in WET (0.7°C ± 0.4°C) compared with CON (1.3°C ± 0.4°C) and DRY (1.1°C ± 0.4°C) (both p < 0.05) without differences between age groups. Heart rate and whole-body sweat loss were lowest in the WET, followed by DRY, and then CON conditions in both groups (all p < 0.05). These findings demonstrate that wearing a water-soaked inner t-shirt while using a ventilation garment is an effective and practical cooling strategy to mitigate thermal and cardiovascular strains in young and older individuals during moderate-intensity work in hot conditions., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tokizawa.)

Objectives: We surveyed how home-working conditions, specifically furniture and computer use, affected self-reported musculoskeletal problems and work performance., Methods: Questionnaires from 4112 homeworkers were analyzed. The relationship between subjective musculoskeletal problems or work performance and working conditions were determined by logistic regression analyses., Results: More than half the homeworkers used a work desk, work chair, and laptop computer. However, approximately 20% of homeworkers used a low table, floor chair/floor cushion, or other furniture that was different from the office setup. Using a table of disproportionate size and height, sofa, floor cushion, and floor chair were associated with neck/shoulder pain or low back pain. Disproportionate table and chair, floor cushion, and tablet computer were associated with poor work performance., Conclusions: Disproportionate desk and chair, floor cushion/chair, and computer with small screen may affect musculoskeletal problems and home-working performance., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

This study aimed to evaluate the reliability of a patch-type sensor on the upper chest region that uses a dual-heat-flux method to estimate core temperature under various heat conditions. The participants' esophageal and rectal temperatures (T eso and T rec ) were measured with real-time monitoring of predicted core temperature (T pre ) using the patch. Twenty-one volunteers wearing work clothes and nine volunteers wearing protective clothing walked (5.0 km/h) for an hour at 35 °C. During exercise, T eso increased to 37.9 ± 0.3 °C and 38.2 ± 0.2 °C for each group, respectively. The root mean squared errors (RMSEs) were 0.18 ± 0.05 °C and 0.25 ± 0.08 °C between T eso and T pre and were 0.31 ± 0.10 °C and 0.34 ± 0.11 °C between T rec and T pre in each clothing condition, respectively. In addition, 11 volunteers walked for an hour at 30 °C or 40 °C. The T eso during exercise increased to 37.7 ± 0.3 °C and 38.2 ± 0.3 °C, respectively. The RMSEs were 0.23 ± 0.10 °C and 0.18 ± 0.05 °C between T eso and T pre in each ambient temperature condition, respectively. Furthermore, eight volunteers performed an arm-cranking exercise (60 W) for 30 min at 35 °C. The T eso increased to 37.9 ± 0.2 °C during exercise. The RMSEs were 0.22 ± 0.07 °C between T eso and T pre . The proportions of all paired measurements differing by less than the predefined threshold for validity of ≤ 0.3 °C were 85 ± 18% between T eso and T pre . These data indicate that the patch is capable of providing a moderate estimate of core temperature during low-intensity and acute exercise under heat conditions., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This study focused on everyday furniture and computers used in work from home and aimed to investigate how improper postures increase the risk of musculoskeletal disorders using different combinations of tables, chairs, and computers. Twenty-one healthy participants were asked to perform a visual display terminal task for 30 minutes in a laboratory modeled on the work from home concept. Seven experimental conditions were set up according to the different combinations of desks, chairs, and computers. Three-dimensional body posture was measured using a magnetic tracking device. The results showed that when using a low table, floor chair, and laptop computer, the body posture above the hip was similar to that when using a dining table, chair, and desktop computer. When using a sofa, and tablet computers, or laptop computer, severe neck flexion, which is stressful to the neck, was observed. Moreover, excessive low back flexion was observed when using a floor cushion and laptop computer. We suggest that computer work while sitting on a sofa or floor cushion without a backrest is harmful to the neck and low back.