Impact of COVID-19 pandemic on oral and maxillofacial surgery in Japan: A report from a questionnaire survey during the different phases of the pandemic

COVID-19 pandemic has provided a new challenge to healthcare systems and medical care providers. In the current study, we describe the challenges faced and actions taken to provide optimum healthcare in Japan during the COVID-19 pandemic based on the results of a questionnaire survey that was conducted by oral and maxillofacial surgeons. A total of 24 Japanese institutions participated in the study. The first survey was conducted between June 22, 2020 and June 26, 2020, and the second survey was conducted between October 23, 2020 and November 8, 2020. The questionnaire focused on the practical situation in the respondent's hospital, personal protective equipment (PPE) availability, and what alterations had occurred compared to the situation before the COVID-19 pandemic. The commonest reported duration of restrictions to the outpatient clinic was 1-2 months. All of the institutions had lifted their restrictions on outpatient services by September 2020. Surgical procedures in the operating room were restricted in 74% of hospitals in the first wave of the pandemic;however, 88% lifted their restrictions and restarted their regular surgical services by November 2020. Although, non-urgent or elective procedures were delayed, surgeries for malignant tumors, maxillofacial infections, and trauma were performed at almost all hospitals during the pandemic. Health care institutions will require a new approach to maintain patient volume and recover from the pandemic. Going forward, it is also necessary to minimize the risk of exposure and transmission to health care personnel as well as patients.Copyright © 2021 The Authors

EFFORTS OF 'S-1 GRAND PRIX', A DELICIOUS LESS SALT RECIPE CONTEST AIMED AT PREVENTING CARDIOVASCULAR DISEASES

Purpose: As the average salt intake of Japanese people is as high as 10 gram per day, it is necessary to reduce the salt intake for the prevention and treatment of cardiovascular diseases. We held a less salt recipe contest to promote delicious less salt recipes among society and examined the potentiality of 'deliciously less salt meals'. Method: National Cerebral and Cardiovascular Center (NCVC) held the 'The 5th S-1 Grand Prix', a contest to develop delicious and less salt bento recipes on a nationwide scale. The contest named after its goal of reducing the salt intake by 1 gram in each meal. Under the theme of a delicious and attractive less salt bento meeting to the nutritional value standards (such as less than 2 gram of salt equivalent per meal), NCVC called for the bento recipe ideas from the 10th of May to 26th of July 2021. All the applied recipes are evaluated and tasted by NCVC contest board members, then the best one was decided for a 'Grand-Prix' award. Contest was held on-line due to the COVID-19, the video presentation made by the applicants were evaluated for the final selection. Result: A total of 67 teams (25 teams in the general category, 15 teams in the student category, 27 teams in the disaster nutrition category) were applied to this contest. We encouraged governments, hospitals, dietitian training schools, and convention-related companies and organizations nationwide to apply the contest. Compared to the 4th tournament, the number of applicants were increased by 16 teams. More than half of the applicants were from 'educational institutions such as universities'. Although the 5th tournament was held online, we were able to hold a recipe contest in a new format, such as using applicants' video presentation for the final selection. Discussion: In the disaster nutrition category, many recipes for the delicious, preserved foods and cooking methods under the disaster were gathered, so that these less salt recipes can be widely adopted in the disaster foods. Through this attempt, we created an opportunity to make a delicious less salt meals, and motivated participants to cook 'deliciously less salt meals'. In the future, more people will participate in this contest in order to get them to participate, we will consider the conditions of the recipe and the recruitment method.

INITIAL ANALYSIS ACTIVITY OF HAYABUSA2-RETURNED SAMPLES FROM C-TYPE NEAREARTH ASTEROID (162173) RYUGU

Introduction: The JAXA's asteroid explorer Hayabusa2 investigated Cb-type near-Earth asteroid (162173) Ryugu from June 2018 to November 2019 [e.g., 1-3], during which the spacecraft made two touchdown operations onto the asteroid surface for sample collection with projectile shooting [4-8]. The spacecraft returned its reentry capsule to the Earth on December 6, 2020 [8, 9]. The mass of the returned samples was ~5 grams in total;~3 grams from the first touchdown site and ~2 grams from the second touchdown site [9]. At Institute of Space and Astronautical Science (ISAS), JAXA, particles larger than ~1 mm in size were individually photographed, weighed, and investigated spectroscopically inside the nitrogen-filled chamber system. Particles < 1mm were inspected in a sample dish as bulk aggregates. The initial characterization phase of the returned sample shows that it well represents the finding from spacecraft investigation of the asteroid surface [8-10]. Initial Analysis: After the first six-month of initial description at ISAS, ~300 mg of returned samples (~6 % of total mass) were allocated to the Hayabusa2 initial analysis team in June 2021 for one-year priority analysis led by the Hayabusa2 mission [11]. The number of allocated particles larger than 1 mm were 11 from the first touchdown site (Chamber A grains) and 11 from the second touchdown site (Chamber C grains). Ten sets of aggregate samples, consisting of particles smaller than 1 mm, were also allocated (5 from Chamber A and 5 from Chamber C). To characterize the Ryugu sample and to maximize the science output of the Hayabusa2 mission, the initial analysis team consisted of six sub-teams: Chemistry [12], Mineralogy and Petrology for coarse grains [13], Mineralogy and Petrology for fine grains [14], Volatiles [15], Macromolecular Organics [16], and Soluble Organic Matter [17]. The overall analysis activity went smoothly thanks to the dedication and hard work of the team in spite of challenges presented by a lack of in-person communication during the COVID-19 pandemic. What is Ryugu? All the results from the initial analysis are interpreted to support the hypothesis that Ryugu comes from a parent body of the most chemically primitive CI chondrites (least fractionated from the Sun's elemental abundance) [12-17]. Ryugu's volatile and organic contents are highest compared to the meteorites in our collections except for micrometeorites and interplanetary dust particles [15-17]. Because C-type asteroids are a major group of asteroids, the close relation of Ryugu to the rarest type of chondrites (CI) suggests that the Earth's atmosphere works an effective filter for the influx of fragile meteorites, resulting in a biased sampling of meteorites on the ground. A notable mineralogical difference of Ryugu samples from CI chondrites [12-14] indicates that all CI chondrites recovered on Earth experienced significant terrestrial weathering since their fall. The Hayabusa spacecraft retuned surface particles from S-type asteroid (25143) Itokawa in 2010, which was found to be a parent body of equilibrated LL ordinary chondrites [18, 19]. Therefore S-type asteroids and C-type asteroids are likely to be composed of the non-carbonaceous (NC) and carbonaceous chondrite (CC) group materials, representing isotopically dichotomous components in the early Solar System [20]. Coexistence of S- and C-type asteroids in the present main belt thus requires small body migration in the (early) Solar System, likely caused by migration of giant planets [21]. Comparison of Ryugu samples with the sample from B-type asteroid (101955) Bennu [22] will further constrain the dynamical and chemical evolution of small bodies and the (early) Solar System. [ FROM AUTHOR] Copyright of Meteoritics & Planetary Science is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Diet and Lifestyle Guidelines for Immunomodulation with Reference to Corona Virus Pandemic: A Scientific Statement of the International College of Nutrition

The immune system is comprised of lymph glands, lymph nodes, thymus gland, spleen, bone marrow, lymphocytes, and molecules such as antibodies and cytokines. It has a vast array of functionally different cells such as T and B lymphocytes, macrophages, neutrophils and mast cells. The ontogenesis of the immune system is comprised of the innate immune cells and the adaptive immune cells, where innate immune cells are the first defense mechanisms to respond to pathogenic environmental factors. There are multiple components of the adaptive immune cells, including immunoglobulins (Igs), T-cell receptors (TCR), and major histocompatibility complex (MHC) responsible for adaptive immunity. However, many elements of both the innate and adaptive immune systems are conserved in our bodies. The adaptive immunity is a type of immunity that develops when a person’s immune cells respond to a pathogen such as microorganism or vaccination. Environmental factors such as pathogenic bacteria or viruses, solar exposure, age, exercise, stress, diet, sleep quality and air pollutants can influence the immune system. There may be marked decline in the immune function due to attack of COVID-19. Most patients with mild COVID-19 develop an appropriate immune response that culminates with viral clearance. However, severe disease manifestations have been linked to lymphopenia and immune hyper-responsiveness leading to cytokine storm. It has been observed that in COVID-19, alveolar macrophages are epigenetically altered after inflammation, leading to long-term lung immune-paralysis. Western diets are known to have adverse effects on the immune function. However, Mediterranean-type diets rich in short-and long-chain polyunsaturated fatty acids (PUFA), vegetables, nuts and fruits, dairy products and fish and red wine, due to high content of vitamins, minerals and flavonoids may be useful in boosting immunity. Moderate physical activity may also cause an extensive increase in numerous and varied lipid super-pathway metabolites, including oxidized derivatives called oxylipins. Emerging evidence suggests that dietary supplements containing flavonoids, carotenoids, coenzyme Q10 (CoQ10), vitamins, minerals and antioxidants modulate gene and protein expression and thereby modify endogenous metabolic pathways, and consequently enhance the immunity. Mediterranean-type diet and multiple bioactive nutrients, fatty acids, amino acids, vitamins and minerals as well as moderate physical activity may be crucial for enhancing immunomodulation.

A biopsy-confirmed case of iga nephropathy flare-up with gross hematuria and AKI following SARS-CoV-2 vaccination successfully treated with steroid therapy

Introduction: The flare of immune-mediated disease (IMDs) following SARSCoV-2 vaccination is a rare adverse event following immunization (AEFI). A few cases of suspected IgA nephropathy (IgAN) flare-up, causing gross hematuria without an increase in Cr, have been reported, and they all resolved without treatment. Here we report a biopsy-confirmed case of IgAN flare-up with AKI following mRNA-1273 vaccination, which was successfully treated with steroid therapy. Case Description: A 54-year-old female with history of IgAN after strep throat infection that was diagnosed with renal biopsy in 2006. Other significant co-morbidity includes obesity (BMI 31.6), hypertension, and GERD. No prior documented infection with COVID-19. She was on enalapril 20mg daily, hydrochlorothiazide 12.5mg daily, and propranolol 120mg daily. Her baseline creatinine level was 1.2. Urinalysis was positive for 2+ protein, 3+ blood, and RBC 15 /HPF. The total urine protein to Cr ratio was 1.03. Two days after receiving the second Moderna mRNA-1273 vaccine, she developed gross hematuria, which resolved in 2 days. Follow-up Cr increased to 3.04 one week after receiving the second dose of vaccine. The urinalysis showed 1+ protein, 3+ blood, RBC 50/ HPF. The total urine protein to Cr ratio was 0.67. The renal ultrasound was unremarkable. Repeat kidney biopsy showed IgA mesangial deposition, focal segmental and focal global glomerulosclerosis, mild interstitial fibrosis and tubular atrophy, and mild arteriolar hyalinosis. The patient was started on prednisone 60mg daily. Shortly after she was started on prednisone, Cr level started getting better. In 3 weeks Cr level was down to 1.7. Discussion: This is the first reported case of biopsy-proven IgAN flare-up after SARS-CoV-2 vaccination that caused AKI. Corticosteroid is an effective treatment, promptly improving Cr. IgAN exacerbation after SARs-Cov-2 vaccination should be closely monitored for frequency and consequence to further elucidate AEFI of the novel vaccine.

Unexpected Aggressive Histological Component in Subsolid Lung Adenocarcinoma: Priority for Resection Without Delay

Introduction: Ground glass opacity (GGO)-containing small-sized adenocarcinoma of the lung can generally be expected to have a fair prognosis after resection. However, some of such tumors might contain a histological aggressive component that is related to poor prognosis. This study aimed to identify the predictors for the aggressive histological component in GGO-containing small-sized lung adenocarcinoma to screen the patients who should undergo resection without delay in the era of COVID-19. Methods: Of the 2,350 patients who underwent pulmonary resection for lung cancer at our institute between 2017 and 2020, we collected data of 501 patients with GGO-containing lung adenocarcinoma with a total diameter of ≤ 2 cm. Multivariable analysis was conducted to identify predictors for the presence of histological aggressive components. Results: Using a historical cohort, lymphovascular invasion and predominant micropapillary or solid patterns were identified as histological aggressive components that were related to poor prognosis in stage IA adenocarcinoma. Of the included 501 cases, 36 (7.2%) had at least one histological aggressive component. A multivariable analysis showed that consolidation/tumor ratio on high-resolution computed tomography > 0.5 (odds ratio [OR], 6.08;p < 0.01), maximum standardized uptake value (SUVmax) on positron emission tomography ≥ 1.5 (OR, 3.56;p < 0.01), and smoking index > 20 pack-years (OR, 2.69;p = 0.03) were predictors for the presence of histological aggressive component, with the sensitivity of 94.4%. Conclusion: Consolidation/tumor ratio > 0.5, SUVmax ≥ 1.5, and smoking history > 20 pack-years were predictors for the presence of a histological aggressive component in GGO-containing small-sized adenocarcinoma. These predictors may be useful for screening patients with a potentially high risk for poor prognosis and for setting priorities for resection in the era of COVID-19. Keywords: ground-glass opacity, consolidation/tumor ratio, prognosis

Stress-, anxiety-, and cellphone use-induced sleep deficits and psychological conditions during the pandemic and a potential remedy

Stress-induced sleep and psychological problems are common in modern life. The rapid spread of COVID-19 and implementation of social isolation has diminished social activities, leading to major changes in daily lifestyles.Unprecedented changes, coupled with the fear induced by the pandemic, have added stress and anxiety for a large segment of the population. Interestingly, within this timeframe, there has been a significant increase in cellphone dependence, which may be linked to social isolation. These events could result in a disruption in sleep patterns and increase in psychological challenges. In this study, we surveyed 288 volunteers to gain insight into how stress, anxiety, and time spent on cellphones affected sleep and mood. In addition, we developed an herbal compound preparation, “Smarto-One”, which is rich in flavonoids that play a role in GABAA receptor modulation. We tested its therapeutic effects on these conditions presumably linked to social isolation. We found 1) a negative linear correlation between sleep duration vs stress level and time on cellphone. 2) a negative correlation between wake-up mood/symptoms vs stress. 3) volunteers taking Smarto-One showed substantial improvements in stress levels, hours of sleep, cellphone dependence, and wake-up mood/symptoms as compared to taking placebo. Overall, this work illustrates the value of Smarto-One as an alternative remedy for improving overall mental health and wellbeing. (Int J Biomed Sci 2021;17 (3): 40-49).