Intensive endoscopic resection for downstaging of polyp burden in patients with familial adenomatous polyposis (J-FAPP Study III) : a multicenter prospective interventional study

Background Total colectomy is the standard treatment for familial adenomatous polyposis (FAP). Recently, an increasing number of young patients with FAP have requested the postponement of surgery or have refused to undergo surgery. We aimed to evaluate the effectiveness of intensive endoscopic removal for downstaging of polyp burden (IDP) in FAP. Method A single-arm intervention study was conducted at 22 facilities. Participants were patients with FAP, aged ≥ 16 years, who had not undergone colectomy or who had undergone colectomy but had ≥ 10 cm of large intestine remaining. For IDP, colorectal polyps of ≥ 10 mm were removed, followed by polyps of ≥ 5 mm. The primary end point was the presence/absence of colectomy during a 5-year intervention period. Results 222 patients were eligible, of whom 166 had not undergone colectomy, 46 had undergone subtotal colectomy with ileorectal anastomosis, and 10 had undergone partial resection of the large intestine. During the intervention period, five patients (2.3 %, 95 % confidence interval [CI] 0.74 %–5.18 %) underwent colectomy, and three patients died. Completion of the 5-year intervention period without colectomy was confirmed in 150 /166 patients who had not undergone colectomy (90.4 %, 95 %CI 84.8 %–94.4 %) and in 47 /56 patients who had previously undergone colectomy (83.9 %, 95 %CI 71.7 %–92.4 %). Conclusion IDP in patients with mild-to-moderate FAP could have the potential to be a useful means of preventing colorectal cancer without implementing colectomy. However, if the IDP protocol was proposed during a much longer term, it may not preclude the possibility that a large proportion of colectomies may still need to be performed

Updating source term and atmospheric dispersion simulations for the dose reconstruction in Fukushima Daiichi Nuclear Power Station Accident

In order to assess the radiological dose to the public resulting from the Fukushima Daiichi Nuclear Power Station (FDNPS) accident in Japan, especially for the early phase of the accident when no measured data are available for that purpose, the spatial and temporal distribution of radioactive materials in the environment are reconstructed by computer simulations. In this study, by refining the source term of radioactive materials discharged into the atmosphere and modifying the atmospheric transport, dispersion and deposition model (ATDM), the atmospheric dispersion simulation of radioactive materials is improved. Then, a database of spatiotemporal distribution of radioactive materials in the air and on the ground surface is developed from the output of the simulation. This database is used in other studies for the dose assessment by coupling with the behavioral pattern of evacuees from the FDNPS accident. By the improvement of the ATDM simulation to use a new meteorological model and sophisticated deposition scheme, the ATDM simulations reproduced well the 137Cs and 131I deposition patterns. For the better reproducibility of dispersion processes, further refinement of the source term was carried out by optimizing it to the improved ATDM simulation by using new monitoring data

Evaluating Opt-In Vaginal Human Papillomavirus Self-Sampling: Participation Rates and Detection of High-Grade Lesions (CIN2+) among Unscreened Japanese Women Aged 30–39

Cervical cancer incidence is increasing among Japanese women, which is partly attributed to low screening rates. This study examined the implementation of opt-in human papillomavirus (HPV) self-sampling among Japanese women aged 30–39 years who had not undergone cervical cancer screening, focusing on those requiring preconception care. The responses to the opt-in approach and effectiveness in detecting cervical squamous intraepithelial neoplasia 2 or worse (CIN2+) were evaluated. Participants used the Evalyn® Brush for self-sampling, with HPV testing conducted using the Cobas 4800 system (version 2.2.0). Out of 3489 eligible, unscreened women from four municipalities in Fukui Prefecture, only 10.6% (370/3489) requested the self-sampling kit. Of these, 77.3% (286/370) returned the kit (HPV testing rate: 8.2% (286/3489)). The HPV positivity rate was 13.7% (39/285), yet only 61.5% (24/39) of those with positive HPV results proceeded to cytology testing. Subsequently, three cases of CIN2+ were detected (10.5/1000). While this study demonstrated a reasonable kit return rate and indicated the capability of opt-in HPV self-sampling to detect CIN2+ cases in unscreened women, the low ordering rate of kits and suboptimal compliance for follow-up cytology testing highlight significant challenges. The findings suggest the need for more effective strategies to enhance participation in cervical cancer screening programs

The complete mitochondrial genome sequence of the medicinal fungus Inonotus obliquus (Hymenochaetaceae, Basidiomycota)

Inonotus obliquus is a medicinal fungus in the family Hymenochaetaceae and commonly known as chaga. The sclerotium of this fungus has been used as a traditional medicine for long time. In this study, we present the mitochondrial genome sequence of I. obliquus. The mitochondrial DNA (mtDNA) is 119,110 base pairs in length and contained genes for 58 Open reading frames, 2 ribosomal RNAs, and 30 transfer RNAs. Consequently performed phylogenetic analysis indicates that this fungus is closely related to Sanghuangporus sanghuang which belongs to the same family Hymenochaetaceae. We first reported about the complete mitochondrial genome of fungi belonging to the genus Inonotus