Ventilation Methods against Indoor Aerosol Infection of COVID-19 in Japan

The importance of effective ventilation as one of the measures against COVID-19 is widely recognized worldwide. In Japan, at the early stage of the pandemic, in March 2020, an official announcement was made about basic ventilation measures against COVID-19. WHO also used the term "long-range aerosol or long-range airborne transmission” for the first time in December 2021. Based on the aerosol infection control measures before 2021 by the Japanese government, we conducted experiments on methods related to partition placement as an element of effective ventilation methods. In July 2022, the governmental subcommittee on Novel Coronavirus Disease Control provided an emergent proposal about effective ventilation methods to prevent two types of aerosol infection;infection by large aerosol on the air current and infection by small floating aerosol diffusion in a room. They also showed the way of setting droplet prevention partitions, which do not block off ventilation based on this investigation's results. © 2023 by the authors.

Association of subpleural ground-glass opacities with respiratory failure and RNAemia in COVID-19.

OBJECTIVES: To examine the radiological patterns specifically associated with hypoxemic respiratory failure in patients with coronavirus disease (COVID-19). METHODS: We enrolled patients with COVID-19 confirmed by qPCR in this prospective observational cohort study. We explored the association of clinical, radiological, and microbiological data with the development of hypoxemic respiratory failure after COVID-19 onset. Semi-quantitative CT scores and dominant CT patterns were retrospectively determined for each patient. The microbiological evaluation included checking the SARS-CoV-2 viral load by qPCR using nasal swab and serum specimens. RESULTS: Of the 214 eligible patients, 75 developed hypoxemic respiratory failure and 139 did not. The CT score was significantly higher in patients who developed hypoxemic respiratory failure than in those did not (median [interquartile range]: 9 [6-14] vs 0 [0-3]; p < 0.001). The dominant CT patterns were subpleural ground-glass opacities (GGOs) extending beyond the segmental area (n = 44); defined as "extended GGOs." Multivariable analysis showed that hypoxemic respiratory failure was significantly associated with extended GGOs (odds ratio [OR] 29.6; 95% confidence interval [CI], 9.3-120; p < 0.001), and a CT score > 4 (OR 12.7; 95% CI, 5.3-33; p < 0.001). The incidence of RNAemia was significantly higher in patients with extended GGOs (58.3%) than in those without any pulmonary lesion (14.7%; p < 0.001). CONCLUSIONS: Extended GGOs along the subpleural area were strongly associated with hypoxemia and viremia in patients with COVID-19. KEY POINTS: • Extended ground-glass opacities (GGOs) along the subpleural area and a CT score > 4, in the early phase of COVID-19, were independently associated with the development of hypoxemic respiratory failure. • The absence of pulmonary lesions on CT in the early phase of COVID-19 was associated with a lower risk of developing hypoxemic respiratory failure. • Compared to patients with other CT findings, the extended GGOs and a higher CT score were also associated with a higher incidence of RNAemia.

Protection for the Self-Employed in Japan: Needs and Measures

This article examines the protection needs of the self-employed and the developments in such protection in Japan. Arguments are put forward for further improving the protection for the self-employed beyond the existing protection framework. These efforts towards improving protection are expected to continue in the future. However, this is not to suggest that a specific stance has been adopted with regard to the content of such protection for those self-employed who are eligible. Such protection is still very much in the stage of preliminary consideration. While the development of such protection is still in the early stages, emergency steps taken in the COVID-19 pandemic have included income support measures to cover the loss of work for self-employed people whose tasks are similar to those of an employee. The self-employed who are eligible for such protection are those who seek protection. It may be argued that, regardless of the intentions of policy-makers, the policies that are pursued are a reflection of how the self-employed perceive their needs. © 2022 Kluwer Law International BV, The Netherlands

Safety and efficacy of atezolizumab (Atezo) + bevacizumab (Bev) in Japanese patients (pts) with unresectable hepatocellular carcinoma (uHCC): A prospective, multicenter, observational study (ELIXIR) - A preliminary analysis

Background: Atezo + Bev has been approved as first-line treatment in pts with uHCC based on a global phase 3 study (IMbrave 150). However, there is a lack of real-world data worldwide. Thus, we conducted the ELIXIR study to evaluate the safety and efficacy of Atezo + Bev prospectively in 500 real-world Japanese pts. Here, we report the first pre-planned safety assessment in 105 initially registered pts out of 500 pts. Method(s): In this prospective, multicenter, observational study, 500 systemic treatment-naive pts with uHCC and Child-Pugh A received Atezo 1200 mg IV q3w + Bev 15 mg/kg IV q3w. The primary endpoint was adverse events of special interest (AESI). Efficacy outcomes including progression-free survival (PFS) and objective response rate (ORR) were assessed in this analysis. Result(s): A total of 500 pts were enrolled between Apr 2021 and Feb 2022. One hundred and five initially registered pts finished enrollment by Aug 2021 and the median follow-up time was 6.4 mo. A total of 49 AESIs and 35 AESIs Grade >=3 were observed in these pts (Table). Median PFS was 6.0 mo (95% CI, 5.1, 6.7) per RECIST 1.1 and 6.5 mo (95% CI, 5.2, 8.0) per modified RECIST (mRECIST). ORR was 23.8% (95% CI, 16.0, 33.1) per RECIST 1.1 and 34.3% (95% CI, 25.3, 44.2) per mRECIST. [Formula presented]. Conclusion(s): In this analysis, additional safety signals were not observed in Japanese pts. Efficacy data could be underestimated at this time. The ELIXIR study showed that Atezo + Bev is a promising first-line treatment for Japanese pts with uHCC in the real world. Clinical trial identification: UMIN000043463. Editorial acknowledgement: Medical writing assistance for this was provided by Tetsuji Asao, PhD, of SunFlare Co., Ltd. Legal entity responsible for the study: Chugai Pharmaceutical Co., Ltd. Funding(s): Chugai Pharmaceutical Co., Ltd. Disclosure: M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, NIHON Servier, Novartis, Ono, Takeda, GlaxoSmithKline;Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Bristol Myers Squibb, Chugai, Eli Lilly Japan, Eisai, NIHON SERVIER, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Abbott Japan, Fujifilm Toyama Chemical, Incyte Biosciences Japan, ASLAN, Chugai, NIHON SERVIER, Takeda;Financial Interests, Institutional, Invited Speaker: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, Merck Serono, MSD, Ono, Yakult, Novartis, Takeda, J-Pharma, Pfizer, Chiome Bioscience, NIHON SERVIER, Delta-Fly Pharma, Syneos Health, Merus.N.V. N. Kato: Financial Interests, Personal, Invited Speaker: Gilead Sciences Inc., AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Olympus Corporation, Eisai Co., Ltd., Aska Pharmaceutical Co., Ltd., Tsumura & Co., Mochida Pharmaceutical Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., Covidien Japan Inc., Eli Lilly Japan K.K., Nobelpharma Co., Ltd., Kowa Company, Ltd., Incyte Biosciences Japan GK, Yakult Honsha Co.,Ltd., Olympus Marketing, Inc., Taisho Pharmaceutical Co.,Ltd., Janssen Pharmaceutical K.K.;Financial Interests, Institutional, Research Grant: AbbVie G.K., Ohtsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Shionogi & Co., Ltd., Eisai Co., Ltd., Tsumura & Co., Nippon Kayaku Co., Ltd., JIMRO Co., Ltd., Kowa Company, Ltd. T. Kagawa: Financial Interests, Personal, Invited Speaker: AbbVie, Eisai, Chugai, Sumitomo Pharma, Gilead, EA Pharma, Asuka, Takeda, Miyarisan, Otsuka, Eli Lilly, Kowa, Bayer;Financial Interests, Personal, Funding: AbbVie, Chugai, Sumitomo Pharma, Diichi Sankyo, Tanabe Mitsubishi, Takeda, MSD, Eisai, Shionogi, EA Pharma, Otsuka, Kyowa Kirin, Sanofi, Teijin, Eli Lilly. T. Yamashita: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Lilly, Bayer;inancial Interests, Institutional, Invited Speaker: Bristol Myers Squibb, MSD, Ono. M. Moriguchi: Financial Interests, Personal, Invited Speaker: Eisai Co., Ltd., Bayer Yakuhin, Ltd., Eli Lilly Japan K.K., Chugai Pharmaceutical Co., Ltd.;Financial Interests, Personal, Advisory Board: Eisai Co., Ltd., Bayer Yakuhin, Ltd., Eli Lilly Japan K.K., Chugai Pharmaceutical Co., Ltd.;Financial Interests, Institutional, Funding: MSD K.K. Eisai Co., Ltd., Bristol Myers Squibb K.K., Bayer Yakuhin, Ltd. H. Iijima: Financial Interests, Institutional, Funding: Canon Medical systems, GE healthcare. K. Ohkawa: Financial Interests, Personal, Invited Speaker: Gilead, Eisai, Century Medical, Takeda;Financial Interests, Personal, Research Grant: Towa, Sumitomo Chemical. R. Sugimoto: Financial Interests, Personal, Invited Speaker, Speaker and moderator fees: Eisai Co, Eli Lilly Japan K.K., Ono Pharmaceutical Co., Ltd.;Financial Interests, Personal, Invited Speaker, Speaker fees: Gilead Sciences, Chugai Pharmaceutical Co., Ltd.;Financial Interests, Personal, Invited Speaker, Speaker fees: Bayer Yakuhin Ltd, Nobelpharma Co., Ltd., Takeda Pharmaceutical Company Limited. T. Takehara: Financial Interests, Personal, Invited Speaker: Chugai;Financial Interests, Institutional, Research Grant: Chugai. M. Kudo: Financial Interests, Personal, Invited Speaker: Eisai, Chugai, Eli Lilly, Bayer, Takeda, MSD;Financial Interests, Institutional, Research Grant: Otsuka, Sumitomo Dainippon Pharma, EA Pharma, Taiho, Eisai, AbbVie, Gilead Sciences, Takeda, GE Healthcare, Chugai. K. Yamamoto: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical, CMIC holdings, Johokiko, Triceps, Kanagawa Medical Practitioners Association;Financial Interests, Personal, Other, Statistical analysis: Otsuka Pharmaceutical;Financial Interests, Personal, Other, Statistical consultation: J-Pharma, Craif, Kanagawa Prefectural Hospital Organization;Financial Interests, Institutional, Other, unlimited grant: Taiho Pharmaceutical;Financial Interests, Institutional, Other, Unlimited grant: Boehringer Ingelheim, Ono Pharmaceutical, Takeda Pharmaceutical, Bayer Yakuhin, Daiichi-Sankyo, Astellas, Kyowa Kirin, Data Vehicle Inc., EP Croit. All other authors have declared no conflicts of interest. Copyright © 2022

Late-Onset Hypogonadism Detected in Young Male Patients Suffering From Post COVID-19 Condition

At least one-third of post COVID-19 patients suffer from various chronic symptoms, defined by WHO as "post COVID-19 condition". However, the pathogenesis of post COVID-19 condition and its clinical course remain unclear. In February 2021, we set up an outpatient clinic specialized for COVID-19 after care (CAC) in Okayama University Hospital in Japan and we have investigated the clinical characteristics of patients with post COVID-19 condition. Our recent study revealed that general fatigue is the most common symptom in the post COVID-19 condition. Direct effects of viruses on each organ and conditions such as post-intensive care syndrome, post-traumatic stress disorder, and myalgic encephalomyelitis / chronic fatigue syndrome have been considered as possible etiologies. Recently, it has been suggested that endocrine disruption including the hypothalamic damage might be involved in the underlying mechanism. In the present study, we focused on male hypogonadism, called late-onset hypogonadism (LOH) syndrome. LOH syndrome causes fatigue and metabolic syndrome in middle-aged males. The aim of this study was to clarify the clinical characteristics of patients with LOH syndrome who visited our CAC outpatient clinic. We retrospectively reviewed medical records of all 39 male patients in whom serum free testosterone (FT) level was measured between February 2021 and November 2021 in our CAC outpatient clinic. As a result, 19 patients (48.7%) met the criteria for LOH syndrome (FT < 8.5 pg/mL;LOH group), and 14 (73.6%) of those patients were under the age of 50 years. A weak negative correlation was found between age and serum FT level (R=-0.301, p=0. 0624). A comparison of the LOH group with the non-LOH group showed that there were no significant differences in the patients’ background factors including age (36. 0 vs. 37.5 years), acute hospitalization (9 patients, 47.4% vs. 5 patients, 25. 0%), and number of days between COVID-19 onset and CAC outpatient clinic visitation (71 vs. 81 days). There were also no significant differences in various laboratory parameters between the two groups. However, symptoms including anxiety, cough and hair loss were more frequent in the LOH group. Compared to the incidence of LOH syndrome in the general population, the present study revealed that there is a relatively high incidence of LOH syndrome in young patients with post COVID-19 condition. Although it is known that gonadal functions are impaired in the acute phase of COVID-19, hypogonadism is also thought to be related to the chronic phase of COVID-19. Leydig cells in the testis may be susceptible to damage by SARS-CoV-2 virus because of the high level of ACE2 receptor expression;however, the underlying mechanisms of LOH syndrome due to post COVID-19 condition have yet to be elucidated.Presentation: No date and time listed

Inhibitory effects of toothpaste and mouthwash ingredients on SARS-CoV-2 infection in vitro

Background and Aim: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2). Recently, some reports indicate that the severity of COVID-19 is associated with periodontal disease. SARS-CoV-2 host cell entry is mediated by viral spike protein binding to the host angiotensinconverting enzyme 2 (ACE2) and its cleavage by transmembrane protease serine 2 (TMPRSS2). ACE2 and TMPRSS2 are expressed in the oral cavity including periodontal pocket epithelium, tongue and saliva glands. Therefore, we hypothesized that inhibiting these two factors may prevent SARS-CoV-2 infections. This study aimed to investigate the inhibitory effects of general ingredients in commercially available toothpaste and mouthwash on SARS-CoV-2 infection. Methods: We evaluated the effects of 30 toothpaste and mouthwash ingredients on the SARS-CoV-2 spike protein-ACE2 interaction and TMPRSS2 protease activity using enzyme-linked immunosorbent assay and an in vitro enzyme activity assay, respectively. We also investigated whether the ingredients were in the presence of saliva. In addition, the binding state of each ingredient to the inhibitor-binding site of ACE2 or TMPRSS2 was evaluated by molecular docking simulation to understand the mechanisms involved. Results: Sodium tetradecene sulfonate, sodium N-lauroyl-N-methyltaurate, sodium N-lauroylsarcosinate, sodium dodecyl sulfate, and copper gluconate inhibited both spike protein-ACE2 interaction and TMPRSS2 activity. Furthermore, these ingredients also showed inhibitory effects on both spike protein-ACE2 interaction and TMPRRS2 activity in the presence of saliva. Molecular docking simulations suggested that these ingredients could bind to the inhibitor-binding site of ACE2. Conclusions: Our findings suggest that five ingredients in commercial toothpaste and mouthwash could inhibit the entry points of SARSCoV- 2 and could help to prevent SARS-CoV-2 infection.

Classification of Covid-19 Infection Status in Japan

The purpose of this study was to visualize and classify the COVID-19 infection status in Japan by prefecture. Three methods were used for classification, taking into account the difference in the number of tests by day of the week and the difference in the scale of infection by population. © 2021 IEEE.

Choropleth Map of Newly Infected People with COVID-19 in the Prefecture

We wanted to know how COVID-19 wasspreading in Japan. The COVID-19 data were obtained through webscraping and text extraction from pdf files on the internet. Visualizing with maps was for visual understanding, and the population was also considered. To visualize the map, we usedthe shiny and ggplot2 packages from the R statistical software. © 2021 IEEE.

Prognostic significance of urinary biomarkers in patients hospitalized with COVID-19

Background: Acute kidney injury (AKI) is common in patients with COVID-19 and associated with poor outcomes. Urinary biomarkers have been associated with adverse kidney outcomes in other settings and may provide additional prognostic information in patients with COVID-19. Methods: We evaluated 19 urinary biomarkers of injury, inflammation, and repair in patients hospitalized with COVID-19 at 2 academic medical centers between April and June 2020. We associated biomarkers with a primary composite outcome of KDIGO stage 3 AKI, requirement for dialysis, or death within 60 days of admission. We also compared various kidney biomarker levels in the setting of COVID-19 versus other common AKI settings. Results: Out of 157 patients, 24 (15.3%) experienced the primary outcome. Twofold higher levels of neutrophil gelatinase-associated lipocalin (NGAL) (HR: 1.53;95% CI: 1.33-1.76), monocyte chemoattractant protein (MCP-1) (HR: 1.86;95% CI: 1.48-2.33), and kidney injury molecule-1 (KIM-1) (HR: 2.32;95% CI: 1.69-3.18) were associated with highest risk of the primary outcome. Higher epidermal growth factor (EGF) levels were associated with a lower risk of the primary outcome (HR 0.52;95% CI: 0.40-0.69). Individual biomarkers provided moderate discrimination and biomarker combinations improved discrimination for the primary outcome. Conclusions: Urinary biomarkers are associated with severe kidney complications in patients with COVID-19 and provide valuable information to monitor kidney disease recovery and progression.

Recent Advances in Computer Audition for Diagnosing COVID-19: An Overview

Computer audition (CA) has been demonstrated to be efficient in healthcare domains for speech-affecting disorders (e. g., autism spectrum, depression, or Parkinson's disease) and body sound-affecting abnormalities (e. g., abnormal bowel sounds, heart murmurs, or snore sounds). Nevertheless, CA has been underestimated in the considered data-driven technologies for fighting the COVID-19 pandemic caused by the SARS-CoV-2 coronavirus. In this light, summarise the most recent advances in CA for COVID-19 speech and/or sound analysis. While the milestones achieved are encouraging, there are yet not any solid conclusions that can be made. This comes mostly, as data is still sparse, often not sufficiently validated and lacking in systematic comparison with related diseases that affect the respiratory system. In particular, CA-based methods cannot be a standalone screening tool for SARS-CoV-2. We hope this brief overview can provide a good guidance and attract more attention from a broader artificial intelligence community.

Computation of Infection Risk via Confidential Locational Entries: A Precedent Approach for Contact Tracing With Privacy Protection

To effectively mitigate the COVID-19 pandemic, various methods have been proposed to control the infection risk using mobile phone technologies. In this respect, short-range Bluetooth in mobile phones has been mostly used to detect contacts with other devices that approach within a certain range for a specific duration and to notify residents regarding potential contact with infected patients. However, the technology can only detect direct contacts and neglects various modalities of infection, which might have contributed to the pandemic worldwide. In this article, we proposed an approach that evaluates the infection risk for residents, using the locational information of their mobile phones and confidential information of infected patients. The article first outlines the proposed method, the Computation of Infection Risks via Confidential Locational Entries method. Moreover, a comparative evaluation is qualitatively and quantitatively performed against the Bluetooth method. Results highlight the advantages of the proposed method and suggest that it could work in a complementary manner with the Bluetooth method toward effective mitigation of infection risks, while protecting privacy.

Visualization of the distribution of newly infected persons with COVID-19 in the prefecture

The purpose of this study was to understand the status of COVID-19 spread in Japan and other countries around the world. To visually grasp, visualization was performed using a map, and the population was also considered. We implemented visualization on the map using statistics software R shiny package and leaflet package. © 2020 IEEE.

An early study on intelligent analysis of speech under COVID-19: Severity, sleep quality, fatigue, and anxiety

The COVID-19 outbreak was announced as a global pandemic by the World Health Organisation in March 2020 and has affected a growing number of people in the past few weeks. In this context, advanced artificial intelligence techniques are brought to the fore in responding to fight against and reduce the impact of this global health crisis. In this study, we focus on developing some potential use-cases of intelligent speech analysis for COVID-19 diagnosed patients. In particular, by analysing speech recordings from these patients, we construct audio-only-based models to automatically categorise the health state of patients from four aspects, including the severity of illness, sleep quality, fatigue, and anxiety. For this purpose, two established acoustic feature sets and support vector machines are utilised. Our experiments show that an average accuracy of.69 obtained estimating the severity of illness, which is derived from the number of days in hospitalisation. We hope that this study can foster an extremely fast, low-cost, and convenient way to automatically detect the COVID-19 disease. © 2020 ISCA