Purpose: We identified the risk factors for remnant gastric cancer (RGC) based on remnant gastric mucosal characteristics and gastritis morphology in patients undergoing distal gastrectomy. Materials and Methods: This multicenter retrospective study included 100 patients with RGC after distal gastrectomy and 550 patients without RGC treated between 2013 and 2020.Endoscopic findings, including anastomotic redness, red streaks, enlarged folds, bile reflux as anastomotic findings, as well as disappearance of the regular arrangement of collecting venules (RAC), atrophic gastritis, and intestinal metaplasia as background gastric mucosal findings, were evaluated. Disease risk score matching (1:1) was adjusted for baseline characteristics. Logistic regression analysis was used to develop a risk score model to stratify RGC risk into low, moderate, and high categories. Results: After matching, 96 patients with RGC and 96 controls were analyzed. Anastomotic redness and red streaks, as well as the disappearance of RAC and atrophic gastritis, were significantly more frequent in the RGC group than in the control group, whereas enlarged folds and bile reflux showed no significant differences. Risk scores were assigned as follows:anastomotic redness, 2; red streaks, 3; disappearance of RAC, 7; and atrophic gastritis, 3. The total score stratified patients into high (≥15), moderate (7–14), and low risk (≤6). The positive and negative predictive values were 67.7% and 83.3%, respectively. Conclusions The endoscopic findings of anastomotic redness, red streaks, RAC disappearance, and atrophic gastritis were significantly associated with RGC development.The proposed risk-scoring model could serve as a stratification tool for RGC surveillance.

Objective: This study aimed to clarify the current practices of occupational therapy (OT) in addressing the employment aspirations of individuals with advanced or terminal cancer. Methods: A web-based questionnaire survey was administered to occupational therapists (OTs) working at designated cancer care hospitals across Japan. Data were analyzed using descriptive statistics and a qualitative descriptive approach. Results: A total of 278 OTs responded to the survey, of whom 119 (43%) had experience supporting employment in this patient population. The purposes of employment aspirations were categorized as financial reasons, social roles and responsibility to others, and self-realization or self-fulfillment. Agreed-upon goals included full-time return to work (32 cases, 27%) and part-time or reduced-hours return to work (38 cases, 32%). In addition, some goals did not lead to actual employment but reflected patients’ wishes, such as life review (7 cases, 6%) and simulated activities (7 cases, 6%). Conclusion: Employment aspirations in patients with advanced or terminal cancer are rooted in diverse psychosocial factors beyond economic motivations. OTs play a vital role in supporting these patients by respecting their wishes and helping set realistic goals that enhance quality of life.

Background: This study investigates factors influencing cane use among older adults and identifies most significant determinants. Methods: This study is a cross-sectional study. A total of 160 community-dwelling older adults (mean age, 79±7 years) were included in the analysis. Binomial logistic regression analysis was conducted using the presence or absence of cane use as the dependent variable, and the associated factors were investigated. Results: There were 108 participants (mean age, 77±7 years) in the cane-non-using group and 52 (mean age, 83±6 years) in the cane-using group. Factors associated with the presence or absence of cane use were open-eyed one-leg standing time (odds ratio [OR]=0.81; 95% confidence interval [CI], 0.70–0.93; p=0.003) and depressed mood (OR=2.78; 95% CI, 1.31–5.91; p=0.008). Conclusion Older adults with reduced balance ability and depressive mood need to use a cane. This highlights the need to assess balance ability and depressed mood in prescribing a cane to older adults. Appropriate prescription of canes has the potential to enrich the lives of older adults by contributing to their safe range of activities.

Background: This study investigates factors influencing cane use among older adults and identifies most significant determinants. Methods: This study is a cross-sectional study. A total of 160 community-dwelling older adults (mean age, 79±7 years) were included in the analysis. Binomial logistic regression analysis was conducted using the presence or absence of cane use as the dependent variable, and the associated factors were investigated. Results: There were 108 participants (mean age, 77±7 years) in the cane-non-using group and 52 (mean age, 83±6 years) in the cane-using group. Factors associated with the presence or absence of cane use were open-eyed one-leg standing time (odds ratio [OR]=0.81; 95% confidence interval [CI], 0.70–0.93; p=0.003) and depressed mood (OR=2.78; 95% CI, 1.31–5.91; p=0.008). Conclusion Older adults with reduced balance ability and depressive mood need to use a cane. This highlights the need to assess balance ability and depressed mood in prescribing a cane to older adults. Appropriate prescription of canes has the potential to enrich the lives of older adults by contributing to their safe range of activities.

Background: This study investigates factors influencing cane use among older adults and identifies most significant determinants. Methods: This study is a cross-sectional study. A total of 160 community-dwelling older adults (mean age, 79±7 years) were included in the analysis. Binomial logistic regression analysis was conducted using the presence or absence of cane use as the dependent variable, and the associated factors were investigated. Results: There were 108 participants (mean age, 77±7 years) in the cane-non-using group and 52 (mean age, 83±6 years) in the cane-using group. Factors associated with the presence or absence of cane use were open-eyed one-leg standing time (odds ratio [OR]=0.81; 95% confidence interval [CI], 0.70–0.93; p=0.003) and depressed mood (OR=2.78; 95% CI, 1.31–5.91; p=0.008). Conclusion Older adults with reduced balance ability and depressive mood need to use a cane. This highlights the need to assess balance ability and depressed mood in prescribing a cane to older adults. Appropriate prescription of canes has the potential to enrich the lives of older adults by contributing to their safe range of activities.

Objective: In Japan, perioperative prophylaxis of pulmonary embolism (PE) in gynecologic cancer patients with preoperative asymptomatic venous thromboembolism (VTE) has not been well established yet. The GOTIC-VTE trial was a prospective, multi-center, single-arm clinical trial to investigate the prevention of postoperative symptomatic PE onset by seamless anticoagulant therapy from the preoperative period to 4 weeks after surgery instead of using intermittent pneumatic compression. Methods: Anticoagulant therapy was started immediately after asymptomatic VTE diagnosis and stopped preoperatively according to the rules of each institution. Unfractionated heparin administration was resumed within 12 hours postoperatively, and this was followed by the switch to low-molecular-weight heparin and subsequently, edoxaban; this cycle was continued for 28 days. Primary outcome was the occurrence of symptomatic PE in 28 days postoperatively. Secondary outcomes were the incidence of VTE-related events in 28 days and 6 months postoperatively and protocol-related adverse events. Results: Between February 2018 and September 2020, 99 patients were enrolled; of these, 82patients were assessed as the full analysis set, including 58 for ovarian cancer, fallopian tube, or peritoneal cancer; 21 for endometrial cancer; and 3 for cervical cancer. No symptomatic PE was observed within 28 days postoperatively; two patients had bleeding events (major bleeding and clinically relevant nonmajor bleeding) and three had grade 3 adverse events (increased alanine transaminase, aspartate aminotransferase, or gamma-glutamyl transferase). Conclusion The multifaceted perioperative management for gynecologic malignancies with asymptomatic VTE effectively prevented postoperative symptomatic PE.Trial Registration: JRCT Identifier: jRCTs031180124