Anti-programmed cell death-1 (PD-1) antibodies are regarded as a risk factor for insulindependent diabetes mellitus as a side-effect. While a small number of cases have been reported, evidence remains limited. This is the first report of an Asian patient developing insulin-dependent diabetes during anti-PD-1 therapy. A 55-year-old euglycemic woman receiving nivolumab for malignant melanoma showed abrupt onset of ketonuria, and elevated levels of plasma glucose (580 mg/dL) and hemoglobin A1c (7.0%). Over the next 2 weeks, serum C-peptide levels fell below the limit of detection. Islet autoantibodies were negative, and the patient showed a human leukocyte antigen haplotype associated with type 1 diabetes. Anti-PD-1 therapy can cause rapid onset of insulin-dependent diabetes, possibly because of inappropriate activation of T cells. Human leukocyte antigen haplotypes might be related to the onset of this disease. Physicians should be aware of this serious adverse event and carry out routine blood glucose testing during anti-PD-1 therapy.

Large-eddy simulation (LES) is conducted to investigate the mechanism of pollutant removal from a two-dimensional street canyon with a building-height to streetwidth (aspect) ratio of 1. A pollutant is released as a ground-level line source at the centre of the canyon floor. The mean velocities, turbulent fluctuations, and mean pollutant concentration estimated by LES are in good agreement with those obtained by wind-tunnel experiments. Pollutant removal from the canyon is mainly determined by turbulent motions, except in the adjacent area to the windward wall. The turbulent motions are composed of small vortices and small-scale coherent structures of low-momentum fluid generated close to the plane of the roof. Although both small vortices and small-scale coherent structures affect pollutant removal, the pollutant is largely emitted from the canyon by ejection of low-momentum fluid when the small-scale coherent structures appear just above the canyon where the pollutant is retained. Large-scale coherent structures also develop above the canyon, but they do not always affect pollutant removal.

This is the first report on dissemination of the USA300 clone and PVL-positive MRSA in multiple Japanese hospitals. Our data strongly suggest that the USA300 clone may become epidemic in Japanese hospitals.

In 2019, influenza A(H3N2) viruses carrying an I38T substitution in the polymerase acidic gene, which confers reduced susceptibility to baloxavir, were detected in Japan in an infant without baloxavir exposure and a baloxavir-treated sibling. These viruses’ whole-genome sequences were identical, indicating human-to-human transmission. Influenza virus isolates should be monitored for baloxavir susceptibility.

A randomized controlled trial is being conducted in Japan to compare hepatectomy alone with hepatectomy followed by adjuvant chemotherapy as treatment in patients with curatively resected liver metastases from colorectal cancer to improve survival with intensive chemotherapy. Between 42 and 70 days after liver resection, patients are randomly assigned to either hepatectomy alone or hepatectomy followed by 12 cycles of modified FOLFOX6 (mFOLFOX6) regimen. A total of 300 patients (including 78 patients in Phase II) will be accrued from 38 institutions within 3 years. The primary endpoint is treatment compliance at nine courses of mFOLFOX6 regimen in Phase II and disease-free survival in Phase III. The secondary endpoints are overall survival, incidence of adverse events and patterns of recurrence.