[Objective]To investigate the effects of acupuncture on sports activities of athletes[Methods]A total of 1,804 athletes were targeted. The method used was a collective survey. Questionnaires were administered after obtaining consent from the participants; online questionnaires were also provided. The questionnaire evaluated profile (sex, age); sensation immediately after acupuncture treatment, duration of stimulus sensation, stimulus intensity, stimulus sensation, and therapeutic effect; timing of acupuncture treatment; and questions related to acupuncture as to whether the acupuncture caused any adverse effects on play (movement) or showed any positive effects.[Results]In total, 1,525 (84.5%) valid responses were obtained. The survey analyzed 841 subjects (55.1%) who underwent acupuncture. The most common response after acupuncture treatment was that the subjects felt lighter and were able to move more easily; 43.9% of subjects gave this response. In addition, 10.6% of respondents said that they continued to feel pain similar to the sensation during acupuncture treatment and 7.7% said they felt weak. The most common response at 59.8% was that the sensation felt during acupuncture disappeared quickly after treatment was ended, 58.6% of subjects said that the sensation felt after acupuncture was optimal, and 48.3% responded that the sensation from treatment remained and a positive effect was observed. The most common timing for receiving acupuncture for 21.8% of subjects was after practice or a match: [Discussion and Conclusion]Acupuncture for athletes should be performed according to the guidelines, taking into account the competition schedule and type of competition and the appropriate amount of acupuncture stimulation, thereby preventing problems during competition.

[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.

Background and aims:Lenvatinib(LEN)is a newly developed tyrosine kinase inhibitor,and is approved as a first-line treatment for advanced hepatocellular carcinoma(HCC)in Japan.This retrospective multi-center study investigated the effect of the relative dose intensity(RDI)of LEN on response rate,progression-free survival(PFS),and overall survival(OS). Methods:This retrospective study enrolled 123 patients with advanced HCC who were treated with LEN at six hospitals in Japan between March 2018 and December 2019.These patients were divided into two groups:RDI ≥70％(RDI 70 group,N=70)or RDI＜70％(control group,N=53)in the first 30 days.The following data were compared between groups:patient backgrounds,adverse events,treatment out-comes,PFS,and OS.PFS and OS were analyzed using the Kaplan-Meier method,followed by the log-rank test.To identify significant factors that contributed to response,PFS,and OS,multivariate analysis was performed using factors for which P-values were ＜0.10 in univariate analysis. Results:The proportion of patients with Child-Pugh class 5A was significantly greater in the RDI 70 group than that in the control group(64.3％ vs. 28.3％,P＜0.01).Dose interruption due to adverse events was significantly more common in the control group.The response rate was significantly higher in the RDI 70 group than that in the control group(35.7％ vs. 11.3％,P＜0.01).Median PFS was significantly longer in the RDI 70 group(9.4 vs.4.7 months,P＜0.01).Multivariate analysis showed that RDI ≥70％(hazard ratio(HR)=0.55,P=0.025),hypertension grade ≥2(HR=0.47,P=0.019),and response(HR=0.52,P=0.033)were independently associated with improved PFS.Median OS was also significantly longer in the RDI 70 group(20.0 vs.13.3 months,P=0.045).Multivariate analysis showed that female sex(HR=0.33,P=0.034)and disease control(HR=0.31,P＜0.01)were independently associated with improved OS.RDI ≥70％ was not statistically significant in multivariate analysis. Conclusions:Our study revealed the importance of achieving RDI ≥70％ in the first 30 days of treatment to maximize the effects of LEN.