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In Tokyo, qualifier Alex Michelsen picked up his first Top 20 win since May. On the receiving end Thursday, a promising start at the Ariake Tennis Park for Stefanos Tsitsipas wasn't enough to avoid another early exit.

The fourth seed looked to be in command early, taking five of the first six games. But soon everything flipped in Michelsen’s favor. Tsitsipas, looking unwell as the match reached the latter stages—stopping play at one point during the fifth game of the third set for a medical timeout—dropped all five break points against his serve.

Michelsen served out the two-time major finalist to complete a 4-6, 6-1, 6-2 victory. Tsitsipas has now lost six of his last seven matches on outdoor hard courts.

Michelsen awaits the winner of Tomas Martin Etcheverry and Christopher O'Connell.

Michelsen awaits the winner of Tomas Martin Etcheverry and Christopher O'Connell.

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Playing his first event since falling to eventual champion Jannik Sinner in the second round of the US Open, Michelsen improved to 25-24 on the season. The 20-year-old has finished runner-up twice this season at the 250 level in Newport and Winston-Salem.

Earlier, countryman Tommy Paul brushed aside Matteo Arnaldi, 6-3, 6-2.  The No. 5 seed did not face a break point, thanks in part to his tremendous 15 for 17 success rate on his second serve.

Paul is one of several contenders competing this week looking to make up ground in the ATP Finals race. He began this tournament ranked No. 11, and while he can’t catch Alex de Minaur for the eighth spot here, a title would get Paul within 70 points heading into the Rolex Shanghai Masters.

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Yoshihito Nishioka gave home fans a thrilling win to celebrate when he outlasted Felix Auger-Aliassime.

The wild card prevailed, 7-6 (5), 3-6, 7-6 (5), but only after saving two match points on his serve at 5-6 in the pair’s decider. Nishioka erased the first with a volley winner, though the Canadian had a great look at converting the second before a lengthy rally was ended by his missed crosscourt backhand.

Fellow lefty Jack Draper was also victorious. The US Open semifinalist beat Mattia Bellucci, 6-4, 6-2, to line up a second-round encounter with second-seeded Hubert Hurkacz.