Objective: The delivery of medicines by the postal service from pharmacies to patients' homes has increased to address medicine supply shortages. However, owing to recent abnormal weather conditions, medicines may be delivered in harsh environments exceeding 40℃. Therefore, this study aimed to measure the temperature at which medicines were mailed in the summer and investigate whether the interview form contained evidence that could guarantee the quality of the medicines mailed under those temperature conditions.Methods: Between August 5 and September 11, 2024, medicines were mailed from 15 postbox locations using a service provided by the Japan Post. The mailing environment was assessed via mean kinetic temperature (MKT) with reference to the United States Pharmacopeia (USP). The medicines in shortage were identified based on information published by the Japan Pharmaceutical Manufacturers Association.Results: Approximately 87.5% of the medicines mailed had an MKT above 25℃ (maximum 28.0℃), which deviates from the USP standard. Some medicines temporarily reached a maximum temperature of 47.5℃. Moreover, the results of the stress tests at temperatures above 40℃ were not listed in the interview form for 78.3% of the medicines that were likely to be mailed due to inventory shortages.Conclusion: To guarantee the medicines quality when mailed in the summer, it is important to consider appropriate measures to protect medicines from excessive heat, even medicines stored at room temperature. Furthermore, it is important to assess the medicine stability by referring to the stress tests (50℃) results listed on the interview forms for the product in question and the original and longlisted drugs. To resolve dissatisfaction between pharmacies and patients due to supply instability, it is necessary to actively publish the results of stress tests on interview forms and make appropriate efforts.

Objective: To investigate an association between the gut microbiome and efficacy of poly(ADP-ribose) polymerase inhibitors (PARPi) in ovarian cancer. Methods: This study conducted fecal microbiome analysis (16S rRNA gene sequencing) and circulating tumor DNA (ctDNA) profiling for ovarian cancer patients who underwent PARPi maintenance therapy. Fecal and blood samples were collected at the baseline and the progressive disease (PD) or last follow-up. The relative abundance of gut microbes and progression-free survival (PFS) were analyzed using linear discriminant analysis of effect size and the Cox proportional hazard model according to BRCA1/2 mutation (BRCA1/2mut) status detected by ctDNA sequencing. Results: Baseline samples were available from 23 BRCA1/2mut-positive patients and 33 BRCA1/2mut-negative patients. The microbes enriched in the baseline samples with long PFS were Bifidobacterium, Roseburia, Dialister, Butyricicoccus, and Bilophila for BRCA1/2mut-positive patients and Phascolarctobacterium for BRCA1/2mut-negative patients. In multivariate analyses dividing patients by the median values of relative abundances, no bacteria were associated with PFS in BRCA1/2mut-positive patients, whereas high Phascolarctobacterium abundances (≥1.11%) was significantly associated with longer PFS in BRCA1/2mut-negative patients (median 14.0 vs. 5.9 months, hazard ratio=0.28; 95% confidence interval=0.11–0.69; p=0.014). In the last samples, the relative abundances of Phascolarctobacterium were significantly higher in patients without PD (n=5) than those with PD (n=15) (median 1.25% vs. 0.06%; p=0.016). Conclusion High fecal composition of Phascolarctobacterium was associated with prolonged PFS in patients with BRCA1/2mut-negative ovarian cancer receiving PARPi therapy. Our results would provide new insights for future research.

This study investigated the characteristics of emergency patients, including walk-in patients and those brought in by ambulance, who visited Akita Kousei Medical Center in the 6 months from April 2019, and the clinical features of elderly patients with heart failure. Elderly patients above 70 years of age accounted for 38.7% of emergency cases and up to 61.7% of ambulance cases. The most common diseases and disorders were orthopedic, digestive, otorhinolaryngeal, respiratory, neurological, dermatological, and cardiovascular disease, in that order. In total, 56 patients with heart failure were admitted during this period (age 83.5±8.3 years, male: female ratio, 1:1.67). Hospitalization from homes accounted for 66.1% of admissions, with the remainder from nursing homes. After treatment, 35.7% of patients moved to nursing homes and 19.6% died despite in-hospital care. Because heart failure is one of the most common conditions in elderly patients, it is pertinent to recognize the importance of quality of outpatient care to prevent hospitalization and also to preserve quality of life by focusing on alleviating overall pain and discomfort.

Ascariasis in Japan was epidemiologically studied through clarifying the relationship between the trends of the percentages of positive ova in feces in the whole country, prefecture, city town and village, and social and environmental factors such as economic level, agricultural conditions, and hygienic index. Concerning colonies and households, relationship between ascariasis and several environmental conditions was studied and the following results were obtained.

Recently our intensive attention has been drawn to the effects of the air pollution on the respiratory organs. The authers have studied the vital capacity and timed vital capacity of the adults and children living in the Spa (hydrogen sulfide containing acid Spring Kusatsu) and the sulfur mine where the atomospheric air contains a small quantity of H₂S under 2ppm in spa and SO₂ under 1ppm in spa, and following results were obtained;
1. There was no significant difference in height and body weight among the children in the mine, the spa and the control district.
2. In the mine, many children complained of subjective symptoms concerning the respiratory organs.
3. Elevated vital capacity was found in the mine children.
4. There was no significant difference in the timed vital capacity between the control and the spa children.
5. In the control and the spa, the height showed the highest correlation to the vital capacity with men and the body weight to the vital capacity with women.
Concerning the partial correlation except the age factor, there was a higher correlation between the vital capacity and body weight than between the vital capacity and the height both with boys and girls.
6. Our results supported the Hewlett-Jackson's fomula in regression equation which can be used to predict the vital capacity.
7. There was no significant difference in the vital capacity of the residents between the two mines, which have different environmental and occupational conditions each other.
8. Concerning the timed vital capacity, there was no significant difference between these mines, but it was lower in the mine workers than in the office workers of the mine.
9. No significant difference in the timed vital capacity was proved between the smoker and non-smoker in the mine.

In the five communities of Urakawa, Sakuma-machi, Shizuoka Prefecture, we have taken measures to Prevent and exterminate ascaris infection, and at the same time studied the causes of infection chiefly from the point of view of environmental conditions. The percentages of ascaris egg-carriers showed a significant difference between 1) farmers and non-farmers; 2) families with and without night-soil; 3) amounts of detergent used for cleaning vegetables; 4) persons with and without experience of anthelmintic treatment.
The group of families that showed extremely high rate of positivity were the farmers not provided with night-soil stores, and the farmers provided with such stores showed about the same rate of positivity as non farmers a fact evidences the appreciatng effect of night-soil stores. On the other hand, the rate of positivity among familis that have no night-soil stores but are in the habit of cleaning vegetables with detergent showed no significant difference as compared with the families provided with night-soil storesa positive evidence of the good effect of detergent.