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Background: The coronavirus disease 2019 (COVID-19) pandemic had resulted in either failure to provide required medical resources or delayed treatment for gastric cancer patients. This study aimed to investigate the impact of COVID-19 on the incidence of postoperative complications using a nationwide Japanese database of patients undergoing distal gastrectomy for gastric cancer. Method(s): We collected the data of patients who underwent distal gastrectomy from January 2018 to December 2021 from the National Clinical Database (NCD), a web-based surgical registration system in Japan. The number of surgical cases, the use of intensive care units, and the incidence of morbidity per month were analyzed. We also calculated the standardized mortality ratio (SMR), defined as the ratio of the number of observed patients to the expected number of patients calculated using the risk calculator established in the NCD, for several morbidities, including pneumonia, sepsis, 30-day mortality, and surgical mortality. Result(s): A decrease of 568 gastrectomies was observed from April 2020 to May 2020. Although the absolute number of patients admitted to intensive care units had declined since 2020, the proportion of patients admitted to the ICU did not change before and after the pandemic. Mortality and critical morbidity (such as pneumonia and sepsis) rates were not worse during the pandemic compared to pre-pandemic periods per the SMR. Conclusion(s): Surgical management was conducted adequately through the organized efforts of the entire surgery department in our country even in a pandemic during which medical resources and staff may have been limited.Copyright © 2023 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
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Lung transplant recipients (LTRs) are at the greatest risk for mortality of COVID-19 among recipients of solid organ transplantation. However, LTRs have been shown to have impaired humoral response (0-40%) to the two doses of mRNA SARS-CoV-2 vaccine. In this study, we aimed to assess the humoral response to a third and fourth dose of SARS-CoV-2 mRNA vaccines in LTRs. This was a prospective observational study of 45 LTRs without a history of SARS-CoV-2 infection, who received two or more doses of the BNT162b2 or mRNA-1273 vaccines between April and October 2022. Among these, 11, 26 and 8 LTRs received 2, 3 and 4 doses of the vaccine, respectively. The levels of antibodies to SARS-CoV-2 spike protein were tested by quantitative immunochromatographic assay. LTRs with antibody titers of 250 AU/mL or higher were defined as responders, which corresponds to two-fold the LD50 concentration level in vitro. The median age of the LTRs was 50 years (interquartile range [IQR], 34-59), and 77% of the LTRs were female. The median time from transplantation to anti-SARS-CoV-2 IgG test was 82 months (IQR, 35-124), and the median time from the last dose to anti-SARS-CoV-2 IgG test was 101 days (IGR, 60-158). The maintenance immunosuppression included calcineurin inhibitors (100%), mycophenolate mofetil (95%), and corticosteroids (100%). The humoral responses were detected in 0%, 31%, and 50% of LTRs and the median titers of anti-SARS-CoV-2 IgG were 0.01 AU/ml (IQR, 0.01-0.01), 0.01 AU/ml (IQR, 0.01-335.25), and 1429.48 AU/mL (IQR, 32.06-8195.91) after the second, third and fourth vaccination, respectively. The response rate and the levels of antibodies significantly increased with the numbers of vaccinations (p = 0.027). No patient had acute rejection or serious adverse events within the study period. Augmented humoral response was achieved in the LTRs after the third and fourth vaccine dose. Repeated vaccination may be beneficial to enhance humoral immunity even in the LTRs. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. 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.)
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Background. Nelfinavir, an orally administered inhibitor of human immunodeficiency virus protease, inhibited the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro. To evaluate the efficacy and safety of nelfinavir, we conducted a randomized controlled trial. Methods. Adult patients testing positive for SARS-CoV-2 infection within 3 days were eligible for the study if they had no or mild symptoms of coronavirus disease 2019. Exclusion criteria included the followings: onset of symptoms >= 8 days before enrollment;oxygen saturation of 95% or less on room air;and vaccinated patients. Patients were randomly assigned (1:1) to receive oral nelfinavir 750 mg (x3 times daily) combined with standard-of-care or standard-of-care alone. The primary endpoint was the time to clearance of SARS-CoV-2. Saliva was collected every day and viral load was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Nelfinavir was administered for 14 days. However, the treatment could be discontinued by the decision of investigator, if patients had 2 consecutive negative test results by qRT-PCR. Clinical course and safety information were collected through day 28. The study is registered with the Japan Registry of Clinical Trials (number, jRCT2071200023). Results. Between July 2020 and October 2021, 123 patients (63 in the nelfinavir group and 60 in the control group) were enrolled into the study and included in the analysis. The median time to viral clearance was 8.0 (95% confidence interval [CI] 7.0 to 12.0) days in the nelfinavir group and 8.0 (95% CI 7.0 to 10.0) days in the control group without statistically significant difference between the treatment group (hazard ratio 0.815, 95% CI 0.563 to 1.182;P = 0.1870). Adverse events were reported in 47 (74.6%) patients in the nelfinavir group and 20 (33.3%) in the control group. The most common adverse events in the nelfinavir group were diarrhea (49.2%) and nausea (6.3%). Conclusion. Nelfinavir did not reduce the time to viral clearance in this setting.
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Objectives: The COVID-19 global pandemic has caused children and adolescents to face substantial challenges in their daily lives, but as the pandemic restrictions are lifted, children and adolescents have varying opinions about returning to a prepandemic lifestyle. This study investigates the impact of the transition out of a virtual lifestyle to an in-person lifestyle on the mental health of children and adolescents with psychiatric conditions. Method(s): A retrospective review of medical records was conducted on individuals who were treated in an inpatient or outpatient setting at the UCLA Department of Child and Adolescent Psychiatry following the pandemic. Subjects completed a questionnaire that collected both subjective and objective data on mental health, social and family functioning, academics, daily time spent, and more. The Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and UCLA Loneliness Scale scores were used to measure depression, anxiety, and loneliness, respectively. Result(s): A total of 93 subjects under the age of 21 years were enrolled in the study (Mage= 14.2;49 females, 24 males;20 transgender/nonbinary). Using the subject's subjective response regarding the transition from a virtual to in-person lifestyle, subjects were categorized by having positive, negative, and ambivalent feedback. Each feedback group was then compared using a single-factor ANOVA, which found that mental health scores for all 3 groups in all 3 measures had significant differences. There was a significant decline in depression scores (PHQ-9) with a decline in positivity toward the transition (p <.05). Subjects in the feedback groups experienced the same trend in symptoms of anxiety (GAD-7) (p <.05) and Loneliness Scale scores (p <.05). Conclusion(s): Online learning and returning to an in-person lifestyle has made significant impacts on the overall mental health of pediatric psychiatric patients. These results show that there are many different experiences within this transition, and that subjective data is a good indicator of mental health scores. Further research can be done to investigate the specific trends or implications of various diagnoses on the transition from a virtual to in-person lifestyle. ADOL, AD, DDD Copyright © 2022
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In recent years, an IoT (Internet of Things) system that supports human activities based on various types of real-world data (e.g., temperature, location, etc.) has been attracting attention in various fields. The operation of an IoT system is determined based on the real-world data measured and collected by sensor devices placed in various locations in the real world. If the real-world data is tampered within the process of measurement, collection and analysis, the reliability of the IoT system cannot be guaranteed. Therefore, we propose a new blockchain-based service delivery platform to support the development of IoT systems that can guarantee the reliability of both the real-world data and the procedure for analyzing the data. Furthermore, we design and prototype an IoT system based on the proposed platform for evaluating the effectiveness. The prototype system monitors the environmental information of offices and other facilities and analyzes the real-world data to identify risk of coronavirus infection. In the prototype system, the proposed platform provides the user with the function for validating that the analytical result is derived by applying the correct process to the real-world data. © 2022 IEEE.