Appropriate information provision about covid-19 and sars-cov-2 vaccine improves vaccination anxiety in patients with autoimmune liver disease.

The coronavirus disease 2019 (COVID-19) rapidly spread worldwide. Although several vaccines have been developed to control the spread of the disease, the safety and efficacy of the vaccine to patients with autoimmune liver disease are uncertain. However, subjects need to decide whether to receive the vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study found that 29 of 40 patients with autoimmune liver disease experienced anxiety to receive the SARS-CoV-2 vaccine. After providing information about COVID-19 and the vaccines, the number of patients with vaccination anxiety was reduced from 40 to 14 (p=0.000685). Appropriate provision of the information of COVID-19 and the vaccine improved vaccine anxiety in patients with autoimmune liver disease.Copyright © 2021 The Japan Society of Hepatology.

Evaluation of lung cell populations in severe COVID-19 pneumonia

Introduction/Aim: Coronavirus disease 2019 (COVID-19) is a novel viral infection that can cause severe pneumonia and acute respiratory failure;however, the mechanism of disease progression is still unclear. The aim of this study is to evaluate inflammatory cells in the lung by analysing cell populations of bronchial aspirates of COVID-19 pneumonia. Method(s): Eligible cases were diagnosed as COVID-19, confirmed by SARS-CoV-2 PCR. All cases had developed severe COVID-19 pneumonia and undergone invasive positive pressure ventilation for the treatment of respiratory failure. Bronchial aspirates were collected during endotracheal intubation, and SARS-CoV-2 PCR was done. The populations of obtained cells from bronchial aspirates were examined by Giemsa staining and immunohistochemical staining of CD3, CD4, CD8, CD20 and CD68 antigens. Bronchial aspirates were cultured to confirm respiratory bacterial co-infections. Result(s): A total of 14 cases (median age 70;eleven male and three female) were enrolled in this study. Their bronchial aspirates were all positive for SARS-CoV-2 PCR. Bacterial co-infections were developed in 10 cases, including 6 cases of pneumonia/respiratory tract infection, 2 cases of sepsis, and 2 cases of urinary tract infection. Cell populations of bronchial aspirates with or without bacterial co-infections were as follows: neutrophils 33.0% vs. 21.5%;CD3+ mononuclear cells (MNCs) 2.5% vs. 5.8%;CD4+ MNCs 4.6% vs. 3.4%;CD8+ MNCs 3.5% vs. 5.2%;CD20+ MNCs 0.2% vs. 0.1%;CD68+ MNCs 39.7% vs. 38.8%, respectively. Conclusion(s): CD68 antigen is mainly expressed in monocytes/macrophages. CD68+ MNCs were dominant in bronchial aspirates of the cases with severe COVID-19 pneumonia. Our data suggests that CD68+ MNCs, presumably macrophages, would play an essential role during the innate immune response to acute SARS-CoV-2 infection in the lung.

A Case of Iga Vasculitis That Developed Gross Hematuria and Lower-Limb Purpura Following Covid-19 Vaccines

Introduction: There have been some reports on flare-ups of kidney diseases following COVID-19 vaccines such as IgA nephropathy and minimal change disease. However, there have been few reports on those of IgA vasculitis following the vaccines yet. We report a case of IgA vasculitis with a flare-up of gross hematuria and lower-limb purpura following Moderna COVID-19 vaccines. Method(s): The patient is a 16-year-old female with no previous history of abnormal results of urinalyses before April in 2021. She had developed microscopic hematuria, proteinuria and purpura on both of her lower limbs that emerged and then disappeared repeatedly since then. She received Moderna COVID-19 vaccines in August and September in 2021, both of which were followed by gross hematuria lasting for around 10 days. The lower-limb purpura reemerged at the same time as the hematuria. Microscopic hematuria of around 30-49 RBC/HPF, glomerular hematuria of moderate degree and urine protein-to-creatinine ratio (UPCR) of around 0.8 g/gCr had continuously been detected. Skin and kidney biopsies were performed in December in 2021 and in February in 2022 respectively. Result(s): The skin tissue showed formation of leukocytoclastic vasculitis, and the kidney tissue showed that of cellular and fibrocellular crescents and endocapillary hypercellularity. Immunofluorescence staining of both tissues showed deposition of galactose-deficient IgA1(Gd-IgA1) and C3, and she was diagnosed as IgA vasculitis. She received steroid pulse therapy followed by tonsillectomy. The lower-limb purpura has disappeared after she received three courses of the steroid pulse therapy, but microscopic hematuria and UPCR of around 0.8 g/gCr have still continued. Conclusion(s): IgA vasculitis is leukocytoclastic vasculitis characterized by deposition of Gd-IgA1 on microvessel walls in skin and on glomerular capillaries in kidneys. The detailed mechanism of IgA vasculitis has not been fully elucidated yet. Gross hematuria following an upper respiratory infection is considered as a characteristic clinical symptom of IgA vasculitis as well as IgA nephropathy. Post-vaccination gross hematuria of patients with IgA nephropathy has been reported, and it is believed that innate immunity is related to its mechanism. Moderna COVID-19 vaccines, which the patient received, are mRNA vaccines. We estimate that exposure to the mRNA vaccine triggered excess glomerular deposition of Gd-IgA1-containing immune complexes and subsequent gross hematuria by overactivation of innate immunity such as Toll-like receptors that detect RNA. This case suggests that such immune activation by a mRNA vaccine might be related not only to the mechanism of IgA nephropathy but also to that of IgA vasculitis. No conflict of interestCopyright © 2023

GROSS HEMATURIA AFTER COVID-19 mRNA VACCINATION: A PROSPECTIVE COHORT STUDY

Introduction: The effective control of coronavirus disease 2019 (COVID-19) can be achieved by implementing a global vaccination strategy. After millions of mRNA vaccines targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been administered worldwide, several reports have shown the cases with gross hematuria (GH) following the mRNA vaccine against SARS-CoV2 in patients with glomerulonephritis, especially immunoglobulin A nephropathy (IgAN). A total of 22 articles including 36 cases of GH after COVID-19 vaccination as on July 31, 2022, were found in PubMed and Google Scholar databases. The most cases which had performed kidney biopsy were IgAN or IgA vasculitis. So, it suggested that GH after COVID-19 vaccination is rerated IgAN. Although there are many reported cases of IgAN after COVID-19 vaccination, the detailed clinical characteristics and outcome have not determined in these patients. Moreover, it remains unclear whether COVID-19 vaccination causes the new onset of nephritis or exacerbates pre-existing nephritis. To address this, herein, we conducted a prospective cohort study over a six-month period. Method(s): We analyzed 82 patients who presented with GH after COVID-19 vaccination and conducted a 6-month observational study. Patients, 18 years or older, who presented to the hospital with GH after COVID-19 vaccination were recruited. All the patients visited either Juntendo University Hospital or Juntendo University Urayasu Hospital between May 11, 2021, and July 31, 2022. Result(s): During the study period, a total of 82 individuals who presented with GH after COVID-19 vaccination were enrolled. The median age of the patients was 38 years;58 cases (70.7%) were females. All the patients received an mRNA COVID-19 vaccine. Most patients showed GH within three days after the second or third dose. Among the 82 patients, 22 had been already diagnosed with IgAN or IgA vasculitis (IgAV) before vaccination, and 45 of the 60 undiagnosed patients had a history of abnormal urinary findings. We performed kidney biopsies on 42 of the 60 undiagnosed patients, who were then diagnosed with IgAN (N=41) or IgAV (N=1). Pathological findings demonstrated that chronic inflammation of glomeruli, such as the expansion of mesangial matrix and glomerular sclerosis, is similarly observed in these newly diagnosed patients compared to patients with IgAN unrelated to vaccination. Finally, we evaluated the levels of biomarkers known to be elevated in IgAN at diagnosis during the course of the study and found that they did not increase. Notably, only few cases showed a slight increase in the level of serum creatinine, and no patients progressed to severe renal dysfunction. Conclusion(s): Present prospective study with 82 cases with GH after COVID-19 vaccination have identified their clinical characteristics and outcome. Furthermore, the acute manifestation of vaccine-induced GH may have highlighted the high prevalence of undiagnosed or preclinical IgAN in Japan. No conflict of interestCopyright © 2023

Shielding device for endoscopic procedures during lower gastrointestinal endoscopy

OBJECTIVES: The coronavirus pandemic significantly impacted endoscopic practice. During lower gastrointestinal endoscopy, infectious substances disseminate;therefore, we developed an infection control device (STEP-L) for lower gastrointestinal endoscopy and examined its usefulness. METHODS: STEP-L wraps around the patient's buttocks and covers the endoscope. Using lower endoscopy training models, three endoscopists performed 18 colonoscopies with STEP-L (group S) and without (group C). Endoscopic insertion time and pigmented areas of ​​gloves and diapers after the examination were compared between both groups. RESULTS: Insertion of the endoscope up to the cecum was possible in all 18 examinations. The insertion time to the cecum was 52.4 ± 19.0 s in group S and 53.9 ± 13.3 s in group C. The pigmented areas of the ​​gloves measured 39,108.0 ± 16,155.3 pixels in group C, but were significantly reduced to 2610.5 ± 4333.8 pixels in group S (p < 0.05). The pigmented areas of the diapers measured 2280.9 ± 3285.2 pixels in group C, but were significantly reduced to 138.0 ± 82.9 pixels in group S (p < 0.05). CONCLUSIONS: Using STEP-L does not change the insertion time, and is technically feasible. STEP-L significantly reduces the adhesion of virtual pollutants to the surroundings, suggesting that this device is useful for infection control during lower gastrointestinal endoscopy.

Peripartum Outcomes Associated With COVID-19 Vaccination during Pregnancy: A Systematic Review and Meta-analysis

Background. The risk and benefits of coronavirus disease 2019 (COVID-19) vaccination during pregnancy are under investigation. Pooled evidence regarding neonatal and maternal outcomes in relation to COVID-19 vaccination during pregnancy is scarce. Methods. We searched PubMed and EMBASE databases in April 2022 without language restrictions. We included Prospective trials and observational studies comparing the women who received at least one COVID-19 vaccination during pregnancy with those who did not and reporting neonatal outcomes. Two independent investigators extracted relevant data from each study. Odds ratios (ORs) were calculated using random-effects models. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The primary outcomes were the neonatal outcomes, including preterm birth, small-for-gestational-age (SGA), low Apgar score (< 7 at 5 min), neonatal intensive care units (NICU) admission, and intrauterine fetal death (IFD). The secondary outcomes were maternal outcomes, including maternal SARS-CoV-2 infection, cesarean delivery, postpartum hemorrhage, and chorioamnionitis. Results. Nine observational studies involving 81,349 vaccinated (mean age, 32.0 +/-4.6 years) and 255,346 unvaccinated women during pregnancy (mean age, 30.5+/-5.1 years) were included. COVID-19 vaccination during pregnancy was associated with lower risk of NICU admission (OR, 0.88;95% confidence intervals [CI], 0.80-0.97) and IFD (OR, 0.73;95% CI, 0.57-0.94), whereas it was not associated with preterm birth (OR, 0.89;95% CI, 0.76-1.04), SGA (OR, 0.99;95% CI, 0.94-1.04), and low Apgar score (OR, 0.94;95% CI, 0.87-1.02). COVID-19 vaccination during pregnancy was associated with a lower risk of maternal SARS-CoV-2 infection (OR, 0.46;95% CI, 0.22-0.93), but not associated with increased risk of cesarean delivery (OR, 1.05;95% CI, 0.93-1.20), postpartum hemorrhage (OR, 0.95;95% CI, 0.83-1.07), and chorioamnionitis (OR, 0.95;95% CI, 0.83-1.07). Flowchart of study selection Forest plots showing the odds ratio of neonatal outcomes a: neonatal intensive care units admission, b: intrauterine fetal death, c: preterm birth, d: small for gestational age, e: low Apgar score Forest plots showing the odds ratio of maternal outcomes a: maternal SARS-CoV-2 infection, b: cesarean delivery, c: postpartum hemorrhage, d: chorioamnionitis Conclusion. COVID-19 vaccination during pregnancy did not increase the risk of peripartum outcomes but decreased the risk of NICU admission, IFD, and maternal COVID-19 infection. COVID-19 vaccination should be encouraged for pregnant women.

Changes in Physical Activity, Physical Function, and Depressive Symptoms Associated With the Coronavirus Disease 2019 Pandemic in Japanese Patients Undergoing Hemodialysis

Background: There are concerns about the impact of the coronavirus disease 2019 (COVID-19) pandemic on physical and mental health. This study aimed to investigate changes in physical activity, physical function, and depressive symptoms during the COVID-19 pandemic in Japanese hemodialysis patients. Method(s): This retrospective longitudinal study included 159 clinically stable outpatients (mean age, 66.8+/-10.9 years;men, 62.2%;median hemodialysis vintage, 8 years) who underwent maintenance hemodialysis at two Japanese dialysis centers between April 2019 and March 2021. Participants' physical activity (steps taken per non-dialysis day), physical function (walking speed and leg strength), and depressive symptoms (Center for Epidemiologic Studies Depression [CES-D] score) before and during the COVID-19 pandemic were compared. Result(s): The steps on non-dialysis day was significantly lower during than before the COVID-19 pandemic (P < 0.01). On the other hand, there were no significant differences in walking speed, leg strength, and CES-D score before and during the COVID-19 pandemic (Figure). Conclusion(s): Although a decline in physical activity during the COVID-19 pandemic was not prevented, no negative impacts of declining physical activity on physical function and depressive symptoms were observed. This is likely because we have implemented a long-term disease management program, such as regularly assessing the physical function and mental status of the patients. Our findings may provide insight into disease management in hemodialysis patients after the COVID-19 pandemic.

Innovative Disinfection System Using Gas Phase Nucleic Acid Digestion Technology to Support Laboratory Animal Management in Geriatrics Research

Sterilization of animal testing facilities is performed not only on articles (breeding equipment, instruments, and laboratory equipment) but also on breeding rooms and laboratories to prevent the development of pathogenic microorganisms. Formaldehyde gas, hydrogen peroxide, and chlorine dioxide gas are used for nonheatresistant sterilization. Some sterilization methods have been reported to caus corrosion and the accumulation of residues on breeding equipment (rubber products, gloves, etc.) and electronic equipment. Our facility has kept many naturally aged mice used in gerontology and geriatric research. Since the animals are kept for a long period of time, it is necessary to maintain a clean and appropriate rearing environment. Therefore, we evaluated a new system of combined gas equipment containing formaldehyde gas components with methanol as raw material, which allows decontamination with no corrosion and no residue. The method was performed in 2 facilities of different sizes: the disinfection room (DR, 10 m3) and the Infectious Diseases Laboratory (IL, 50 m3). The decontamination devices used were a gas generator and a gas decomposition device. To evaluate the sterilization of each room, chemical indicators (CI) (F-Sign) and biological indicators (BI) (Bacillus atrophaeus (ATCC #9372) incubated for 7 d) were placed in 4 locations in the DR and 8 locations in the IL. Gas decontamination was performed for 4.5 h in the DR and 7 h. in the IL. Different equipment and electronic devices were decontaminated in both rooms. CI results showed effective sterilization in both rooms. In addition, BI was negative from day 1 to day 7 (spores SAL<10-6). These results confirmed the adequate decontamination of both rooms. Furthermore, no residues or corrosion of instrumentation, electronic devices or experimental equipment were observed. Gas phase nucleic acid digestion method is effective for complete DNA degradation, and therefore for disinfection of COVID-19 (SARS-CoV-2) research laboratories and is expected to become a next generation sterilization solution.

Factors Associated with Injuries and Gender Differences in Japanese Adolescent Athletes Returning to Sports Following the COVID-19 Restriction

Background: Because the worldwide spread of coronavirus disease 2019 has forced a moratorium on student sports activity in Japan, reports on its impact on sports injuries are limited given its novelty. This study aimed to determine the characteristics and gender differences of injuries in adolescent athletes after returning to sport following restriction of club activities due to the coronavirus pandemic. Methods: An online retrospective questionnaire was distributed to 500 adolescent athletes who belong to school sports clubs in Japan from March 1–19, 2021. An anonymous questionnaire was created before and after the restriction of sports activities following the declaration of the first state of emergency of the COVID-19 pandemic in Japan. Subsequently, 258 valid responses were obtained, and injury-related characteristics were compared between injured and non-injured athletes after returning to sports and between genders for injured athletes. There were no differences in the body areas of sports injuries between males and females. Result: We found that injury experience before club activity restriction was significantly associated with injury after returning to sports (p < 0.001). Moreover, practice time increased before and after the restriction in the injury group (p = 0.038). The injury rate was higher in females (p < 0.024), and the trauma rate was higher among males (p = 0.016). There were no differences in the body areas of sports injuries between males and females. Conclusions: Our results provide gender-differentiated ideas and suggestions as they relate to injury prevention once in adolescent athletes returning to sports after the coronavirus disease 2019 induced restriction of club activities. We show the need for injury rehabilitation and practice time control in adolescent athletes in the coronavirus disease 2019 setting.

DUV-LED packaging using high density TSV in silicon cavity and laser-glass-frit-bonded UV transmitting glass cap

This paper reports an improved deep ultraviolet LED (DUV-LED) packaging based on Si Micro-Electro-Mechanical Systems (MEMS) process technology. The Si package (Si-PKG) consists of a cavity formed by Si crystalline anisotropic wet etching and through-silicon vias (TSVs) filled with electroplated Cu. The Si-PKG is hermetically sealed by laser local heating of screen-printed glass frit. This technology allows for the use of a DUV-transparent glass substrate, which has an unmatched coefficient of thermal expansion (CTE). Using a high-density array of TSV capped with AuSn solder bumps, the cooling performance of the DUV-LED has been greatly improved. And the contribution by the Si (111) side reflection of Si-PKG to the total light output was confirmed 13 %. As a result, an optical output of 114 % (50 mW) and a volumetric light power density of 380 % (14 mW/mm3) were recorded compared with the conventional AlN-packaged device. The developed compact low-cost Si-PKG is promising for wider applications of the DUV-LED including the disinfection of the new coronaviruses. © 2022 Elsevier B.V.

Japanese dictionary for sentiment analysis of counselling text

Chat-based counselling has become increasingly popular in the era of telecommunication. The need for accessible therapy has been exacerbated by the COVID-19 pandemic. Given its text-based nature, chat-based counselling provides an opportunity for machine-based analysis. It even has the potential to provide machine-based counselling services. However, the informational resources for machine-based analysis and interaction are rather scarce especially in a Japanese-language context. We created a Japanese dictionary for sentiment analysis, using a technique via machine-based text analysis, tailored for counselling related text. It includes 2389 words that were frequently used in chat-based counselling corpora. The following attributes were included for each word: (1) valence rating by the general public, (2) valence rating by clinical psychologists, (3) emotionality, and (4) body-relatedness. © 2021 Owner/Author.

The impact of COVID-19 on Islamic banks in Bangladesh: a perspective of Marxian “circuit of merchant’s capital”

Purpose: This paper aims to assess the probable impact of COVID-19 on the Islamic banking system in Bangladesh. More specifically, it attempts to test the hypothesis that Islamic banks are exposed to increased risk because of their role as a provider of “merchant capital” including financing for trade, commerce and working capital, which are believed to be severely disrupted by the COVID-19. Design/methodology/approach: The paper draws upon the Marxian tradition on the identification of the circuit of “merchant capital” separated from the circuit of “interest-bearing capital.” Moreover, the research adopts the balance sheet approach to trace the sectoral distribution of investment as well as sources of income of Islamic banks. Findings: The research supports the hypothesis that the investment pattern of Islamic banks is skewed toward the trade and merchant’s financing. More than two-third of Islamic banks’ investment, and income thereof, is concentrated on working capital and trade finance. As these sectors are largely vulnerable to the economic shock resulting from COVID-19, Islamic banks in Bangladesh are likely to be affected through this channel. Research limitations/implications: The research focuses only on Islamic banks in Bangladesh. Further study can assess the impact of COVID-19 on conventional and Islamic banks in other countries to find similarities and differences with the findings of the current research. Practical implications: The finding of this research will be useful for bank managers, policymakers and users of financial services. In particular, this study provides important information useful for regulators in devising appropriate policies which aim to mitigate the adverse impact of COVID-19. Originality/value: To the best of the authors’ knowledge, this is the first study that attempts to examine the impact of COVID-19 on Islamic banking system in Bangladesh, a country where Islamic banks occupy one-third of the total banking system’s assets. © 2021, Emerald Publishing Limited.

COVID-19 Carves New Facets of Supply Chain Disruption

The COVID-19 pandemic has been unusually disruptive for the world economy, with retail sales dropping by record amounts and unemployment escalating rapidly. As the crisis response continues to unfold, the editors of Transportation Journal observe that the virus has presented additional nuances of supply chain disruption, and academicians should explore them. Theory development can enhance our understanding of how the COVID-19 pandemic is creating new and unique challenges. This article examines some areas of logistics that have been initially impacted, discussing them under the topics of transportation capacity, marketing channels, purchasing, inventory and supply, manufacturing, human resources, public private partnerships (PPP), and security.

Acute tubular injury in patients with severe COVID-19 infection

Background: Novel coronavirus, severe acute syndrome coronavirus 2 (SARSCoV- 2), has rapidly spread all over the world. SARS-CoV-2 enters host target via angiotensin-converting enzyme-2 which are ubiquitously expressed in many organs including proximal tubules in kidney. Indeed, autopsy cases with coronavirus disease-2019 (COVID-19) revealed the existence of coronavirus particles in the renal tubular epithelium. Several reports have shown COVID-19-associated acute kidney injury (AKI), however involvements of SARS-CoV2 in tubular injury has not been fully understood. Here, we evaluated tubular injury in patients with severe and non-severe COVID19. Methods: We investigated the relationship between urinary levels of tubule markers (NAG, β2-MG, α1MG, and L-FABP) and laboratory markers in 17 COVID-19 patients without chronic kidney disease on admission. We also analyzed the relationship between the laboratory markers and respiratory status in severe (n=7) or non-severe (n=10) COVID-19 patients which were defined by requirements of supplemental oxygen. Results: Although only 2 patients developed AKI in severe cases, serum Interleukin-6 (IL-6) level significantly increased in all of severe patients and correlated with levels of proteinuria (R2=0.37, p=0.01), NAG (R2=0.41, p=0.006), α1MG (R2=0.47, p=0.007), L-FABP (R2=0.57, p=0.001) on admission. In addition, severe patients had significantly higher levels of proteinuria (severe: 0.67 vs non-severe: 0.14g/gCr), NAG (33.3 vs 10.1U/L), β2MG (17134.4 vs 1168.5μg/L), α1MG (63.6 vs 12.4mg/L), L-FABP (57.9 vs 7.5μg/gCr) as compared to non-severe cases. Proteinuria and elevated tubular markers were observed only in 2 and 6 cases respectively in non-severe patients, despite those were found in all severe cases. Conclusions: We found that acute tubular injury was associated with the severity of COVID-19 infection. Since the pathophysiological hallmark of COVID-19 is severe systemic inflammation, it remains obscure whether progressive damage of tubules in SARS-CoV-2 is the result of direct viral infection, ischemic injury, or exposure of any humoral factors. Further large scaled studies focusing on tubular damage should be needed to elucidate underlying mechanisms of renal complication in COVID-19 infection.