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For patients with head and neck cancer (HNC), radiotherapy (RT) is a one of the options for curative treatment. Evidence-based guidelines concerning locally advanced HNC patients in the elderly are lacking, and accurate patient selection for optimal care management is challenging. Recently the Geriatric 8 (G8) screening tool has been attracting attention in the oncology field. In this study, we aimed to clarify the association of the G8 Score with deciding the treatment strategy, overall survival (OS) and safety of RT for HNC in the elderly. Forty-one advanced HNC patients aged ≥65 years who received definitive RT from December 2018 to 2022. The G8 screening tool was performed at the first visit to the radiation oncology department. The treatment strategy was decided by a conference between the radiation oncologist and otolaryngologist, and the G8 score was not used to determine the treatment strategy. Standard treatment (standard CRT) was set as RT:70 Gy/35fr with concurrent chemotherapy, which was cisplatin at 100mg/m2 every 3 weeks. The dose reduction or change to other drugs was defined as reduced CRT. We used the Kaplan - Meier method for estimating OS. For evaluating acute toxicity, the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 was used. The Mann-Whitney-U test was used for the statistics, and the significance level was set at p<0.05. The Receiver Operating Characteristic (ROC) curve was used to determine the cutoff value. The Median follow-up time was 25 months (range = 0-59) for survivors. The primary sites were 33 pharyngeal (3 naso-, 8 oro- and 22 hypo-pharyngeal) cancers and 6 oral cancers and 2 laryngeal cancers. The mean G8 score by treatment strategy were 14.4 (range = 11-17) for standard CRT group (n = 11), 13.8 (range = 10-17) for reduced CRT group (n = 22), and 9.9 (range = 8-15) for RT alone group (n = 8). The G8 score was significantly higher in standard and reduced CRT group than RT alone group (p<0.01), while there were no significant differences between standard and reduced CRT group. The cut-off value of the G8 score calculated by the ROC curve was 12.5 points, indicating the use of chemotherapy. The 2-year OS rates for standard CRT, reduced CRT and RT alone group were 100%, 70% and 47%, respectively, and significantly lower in RT alone group than other groups (p<0.01). For acute toxicities, higher G8 scores were correlated with ≥ grade 3 acute mucositis. However, 4 patients (36%) in standard CRT, 4 (18%) in reduced CRT and none in RT alone had grade 3 mucositis. No patient had ≥ grade 4 toxicities. Our results suggest that the G8 screening tool may be useful in determining the treatment strategy of definitive RT for HNC in the elderly, taking into account safety considerations. The use of chemotherapy is highly dependent on prognosis, and future development of concomitant chemotherapy and new treatment for the frail condition is expected. [ABSTRACT FROM AUTHOR]

The computational approach for designing optimization of an outer-rotor type permanent magnet synchronous motor is discussed. The optimization approach reduces CPU time by 80 percent and increases the overall optimization speed.

Bordetella pertussis is the aetiologic agent of whooping cough, a common cause of severe respiratory illness in children and prolonged mild cough in adults. To understand some of the reasons for differences in clinical symptoms between adults and children, we measured B. pertussis DNA loads in nasopharyngeal swabs (NPS) from 19 adults and 40 children (including 14 infants) by quantitative IS481 realtime PCR. All cases had been pre-diagnosed with the B. pertussis-specific loop-mediated isothermal amplification method. The mean PCR threshold cycles for adult and child NPS were 34.9 and 27.1, respectively, indicating a significantly lower B. pertussis DNA load in adults than in children (p <0.001). Moreover, adults had very low DNA loads during both early and later stages of the disease. When corresponding bacterial loads in NPS were calculated for B. pertussis Tohama cells using a standard curve, the mean number of bacterial cells taken with a rayon-tipped swab from an adult, older child and infant was estimated to be 320 (95% CI 120-910), 2.1 × 104 (95% CI 5.3 × 103 to 8.3 × 104) and 1.1 × 106 cells (95% CI 1.2 × 105 to 8.9 × 106), respectively. This indicates that the B. pertussis load in NPS is closely correlated with patient age. Our observations suggest that adult pertussis is characterized by a lower bacterial load in the nasopharynx, resulting in milder symptoms and negative cultures. [ABSTRACT FROM AUTHOR]

To examine body conditioning requirements during foreign expeditions with prolonged air travel, we investigated the changes in condition that accompany long flights among top Japanese athletes. Athletes from the Japanese delegation who participated in the 14th Asian Games (2002/Busan) were surveyed using a questionnaire on their foreign travel in 2002, regarding the experiences of change in their condition and the influence on performance in the competition, and activities performed in the air plane during the flight. We collected effective data from five hundred and twenty-nine (529)athletes. Countries most frequently visited were China, followed by France, the United States of America, Australia, and Canada. Two hundred and fifty (250)athletes experienced swelling of the crus and lower back and crus pain in the past. One hundred and forty-one athletes also noted deterioration in their condition due to prolonged travel. In forty-one (41)athletes, the deterioration of their condition influenced their performance in the competition. About three hundred and ninety (390)to four hundred (450)athletes did not organize the timing or content of breakfast, dinner or sleep in the days before travel or on the day of travel, in consideration of the time difference. The most frequently performed activities in the airplane were sleeping, reading books, listening to music, and watching movies. However, exercises such as stretching, massage, flexibility exercises, and easy training were less frequent. Many athletes drunk beverages such as tea, coffee, water, or alcohol, and took care over keeping their bodies warm and preventing dry nose and/or throat. As the drinks mentioned are diuretics thus causing dehydration, athletes should be advised to take isotonic drinks with minerals. These findings suggest that prolonged air travel that accompanies foreign expeditions influenced the condition of top Japanese athletes, which was related to performance in competitions. We concluded that fluid intake to prevent dehydration, gentle exercise to facilitate peripheral blood circulation, and attention to timing and volume of sleep and meals before and during travel were required to prevent condition deterioration in top Japanese athletes. Then, circadian rhythm disorder related to jet-lag characterized by fatigue, depression and sleep problems was discussed and resynchronization with the local time recommended. Consequently, subliminal problems during foreign travel were clarified to improve the conditioning of representative athletes. Coaches should educate athletes on the importance of conditioning during prolonged air travel. [ABSTRACT FROM AUTHOR]

A 1998-1999 outbreak of measles in Kawasaki City was studied to provide an up-to-date epidemiological understanding of the disease in Japan. 21 of the 69 total patients (30.4%) seen at the hospital were under 1 y of age. None of the 69 patients had received measles vaccine. 43 out of 50 nasopharyngeal swabs subjected to polymerase chain reaction assay (86%) were positive for the hemagglutinin (H) gene. The measles strain isolated from patients was classified as a D3 genotype. Such outbreaks are important epidemiologically, and these findings shed light on vaccination and immunity patterns in this urban population. [ABSTRACT FROM AUTHOR]