Impact of in-hospital medical management for COVID-19 pandemic on door-to-balloon time in patients with ST-elevation myocardial infarction

Background: Delayed door-to-balloon (DTB) time and deterioration of inhospital mortality during the coronavirus disease 2019 (COVID-19) pandemic have been reported. Little is known about the impact of changes in in-hospital medical management before primary percutaneous coronary intervention (PCI) for COVID-19 such as screening test (antigen or polymerase chain reaction (PCR) tests, chest CT for excluding the pneumoniae) and primary PCI under full personal protective equipment (PPE) on DTB time and in-hospital mortality. Purpose(s): The purpose of this study was to evaluate the impact of inhospital medical management for COVID-19 on DTB time and in-hospital mortality during COVID-19 pandemic period. Method(s): We compared DTB time and in-hospital mortality of 502 STelevation myocardial infarction (STEMI) patients during COVID-19 pandemic (February 2020 and January 2021) with 2035 STEMI patients before pandemic (February 2016 and January 2020) using date from Mie ACS registry, a retrospective and multicenter registry. Result(s): The COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was performed on 173/502 (34.5%) patients (antigen or PCR tests;39 (7.8%), chest CT;156 (31.3%), full PPE;11 (2.2%)). These patients had lower rate of achievement of DTB time <=90 min compared with others (Figure 1A). Moreover, In-hospital management of COVID-19 screening tests and/or primary PCI under full PPE was an independent factor of DTB time>90 min with odds ratio of 1.94 (95% confidential interval: 1.37-2.76, p<0.001). In addition, in-hospital mortality of those patients was higher compared with others (Figure 1B). Conclusion(s): In-hospital medical management for COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was the independent factor of DTB time>90 min. This study reinforces the need to focus efforts on shortening DTB time, while controlling the epidemic of infection.

A Case of Thoracic Esophageal Cancer Treated with COVID-19 Pneumonia during Preoperative Chemoradiotherapy(CRT).

INTRODUCTION: There is concerned that prognosis of cancer-bearing patients is adversely affected by postponement of cancer treatment due to infection with a new type of coronavirus(COVID-19). We report a case of thoracic esophageal cancer treated with COVID-19 pneumonia during preoperative CRT. A 60-year-old female diagnosed as having Stage IV thoracic esophageal cancer(cT3N0M1LYM[104R])started receiving preoperative chemoradiotherapy. On the 12th day, she had a fever and was diagnosed with COVID-19 infection. CRT temporarily interrupted and she was treated for COVID-19 pneumonia preferentially. CRT was resumed promptly after remission. Finally, video-Assisted radical esophagectomy was performed. There were no postoperative complications. Nivolumab was started as an adjuvant therapy on the 2nd postoperative months. CONCLUSION(S): We experienced a case of thoracic esophageal cancer in which COVID-19 pneumonia was treated during preoperative CRT, and CRT and surgery were completed without complications by appropriate treatment.

[A Case of Thoracic Esophageal Cancer Treated with COVID-19 Pneumonia during Preoperative Chemoradiotherapy(CRT)]

INTRODUCTION: There is concerned that prognosis of cancer-bearing patients is adversely affected by postponement of cancer treatment due to infection with a new type of coronavirus(COVID-19). We report a case of thoracic esophageal cancer treated with COVID-19 pneumonia during preoperative CRT. A 60-year-old female diagnosed as having Stage IV thoracic esophageal cancer(cT3N0M1LYM[104R])started receiving preoperative chemoradiotherapy. On the 12th day, she had a fever and was diagnosed with COVID-19 infection. CRT temporarily interrupted and she was treated for COVID-19 pneumonia preferentially. CRT was resumed promptly after remission. Finally, video-Assisted radical esophagectomy was performed. There were no postoperative complications. Nivolumab was started as an adjuvant therapy on the 2nd postoperative months. CONCLUSIONS: We experienced a case of thoracic esophageal cancer in which COVID-19 pneumonia was treated during preoperative CRT, and CRT and surgery were completed without complications by appropriate treatment.

Which Is More Effective for Job Satisfaction, Expert Knowledge or Career Status Through Training? Differences between Large Enterprises and SMEs

In this study, we clarified the effect of training by enterprise size for the training service (TOSA Marugoto Business Academy Project [Tosa MBA]) provided by Kochi Prefecture in Japan by applying structural equation modeling to online survey data. In large enterprises, expert knowledge that can be used at work had a positive effect on job satisfaction rather than career status such as annual income and job title. This may have been the case as while promotion involves higher wages and greater privileges, in large enterprises, the extent of responsibility and working hours increase even more. Conversely, in small and medium-sized enterprises (SMEs), career status has a more positive effect on job satisfaction than does expert knowledge. For SMEs with a simple organizational structure, job position has a greater influence on work attitudes. The results present meaningful suggestions to enhance the design of local government training services. © The Author(s) 2022.

Predictive prognostic biomarkers in patients with COVID‑19 infection

The present study aimed to identify useful biomarkers to predict deterioration in patients with coronavirus disease 2019 (COVID‑19). A total of 201 COVID‑19 patients were classified according to their disease severity into non‑severe (n=125) and severe (n=76) groups, and the behavior of laboratory biomarkers was examined according to the prognosis. Neutrophil count, aspartate aminotransferase (AST), alanine aminotransferase, lactate dehydrogenase (LDH), C‑reactive protein (CRP), sialylated carbohydrate antigen KL‑6 (KL‑6), procalcitonin (PCT), presepsin (PSP) and D‑dimer levels were significantly higher, and lymphocyte count and platelet count were significantly lower in the non‑severe group compared with the severe group. In the non‑severe group, ROC analysis demonstrated that only four biomarkers, CRP, PSP, AST and LDH were useful for differentiating the prognosis between improvement and deterioration subgroups. No strong correlation was revealed for any of the markers. Multivariate analysis identified CRP as a significant prognostic factor in non‑severe cases (odds ratio, 41.45;95% confidence interval, 4.91‑349.24;P<0.001). However, there were no blood biomarkers that could predict the outcome of patients in the severe group. Overall, several blood markers changed significantly according to disease severity in the course of COVID‑19 infection. Among them, CRP, PSP, LDH and AST were the most reliable markers for predicting the patient's prognosis in non‑severe COVID‑19 cases.

Which Is More Effective for Job Satisfaction, Expert Knowledge or Career Status Through Training? Differences between Large Enterprises and SMEs

In this study, we clarified the effect of training by enterprise size for the training service (TOSA Marugoto Business Academy Project [Tosa MBA]) provided by Kochi Prefecture in Japan by applying structural equation modeling to online survey data. In large enterprises, expert knowledge that can be used at work had a positive effect on job satisfaction rather than career status such as annual income and job title. This may have been the case as while promotion involves higher wages and greater privileges, in large enterprises, the extent of responsibility and working hours increase even more. Conversely, in small and medium-sized enterprises (SMEs), career status has a more positive effect on job satisfaction than does expert knowledge. For SMEs with a simple organizational structure, job position has a greater influence on work attitudes. The results present meaningful suggestions to enhance the design of local government training services. © The Author(s) 2022.

The clinical impact of maternal COVID-19 on mothers, their infants, and placentas with an analysis of vertical transfer of maternal SARS-CoV-2-specific IgG antibodies.

INTRODUCTION: The effect of SARS-CoV-2 severity or the trimester of infection in pregnant mothers, placentas, and infants is not fully understood. METHODS: A retrospective, observational cohort study in Chapel Hill, NC of 115 mothers with SARS-CoV-2 and singleton pregnancies from December 1, 2019 to May 31, 2021 via chart review to document the infants' weight, length, head circumference, survival, congenital abnormalities, hearing loss, maternal complications, and placental pathology classified by the Amsterdam criteria. RESULTS: Of the 115 mothers, 85.2% were asymptomatic (n = 37) or had mild (n = 61) symptoms, 13.0% had moderate (n = 9) or severe (n = 6) COVID-19, and 1.74% (n = 2) did not have symptoms recorded. Moderate and severe maternal infections were associated with increased C-section, premature delivery, infant NICU admission, and were more likely to occur in Type 1 (p = 0.0055) and Type 2 (p = 0.0285) diabetic mothers. Only one infant (0.870%) became infected with SARS-CoV-2, which was not via the placenta. Most placentas (n = 63, 54.8%) did not show specific histologic findings; however, a subset showed mild maternal vascular malperfusion (n = 26, 22.6%) and/or mild microscopic ascending intrauterine infection (n = 28, 24.3%). The infants had no identifiable congenital abnormalities, and all infants and mothers survived. DISCUSSION: Most mothers and their infants had a routine clinical course; however, moderate and severe COVID-19 maternal infections were associated with pregnancy complications and premature delivery. Mothers with pre-existing, non-gestational diabetes were at greatest risk of developing moderate or severe COVID-19. The placental injury patterns of maternal vascular malperfusion and/or microscopic ascending intrauterine infection were not associated with maternal COVID-19 severity.

Opposition in Japan to the Olympics during the COVID-19 pandemic

Little is known about the responses of citizens toward sporting mega-events held during a period of extended disasters, such as the 2020 Olympics held during the COVID-19 pandemic. This study aims to clarify the factors affecting citizens' attitudes by testing the following hypotheses: the perception of high cost, the burden on medical institutions, and high risk of infectious disease spread negatively affect attitudes, while the perception of pandemic countermeasures, economic benefits, and athletes positively affect attitudes. Based on an online survey of 800 citizens before the 2020 Olympics, the hypotheses were tested using logistic regression models with the extracted factors as the explanatory variables and the attitude toward the Olympics as the objective variable. The test results confirm the factors lineated by the hypotheses, except for the perception of high cost. The fear of a healthcare system collapse from the medical burden of dealing with an outbreak has an especially strong negative effect on the attitude toward the Olympics. These results have important implications for city governments and municipalities and suggest that they should not underestimate citizens' perceptions and attitudes when organizing mega-events and formulating proper communication. Further, the results may offer insights for the smooth strategic planning of large-scale events during unprecedented disasters.

Observations on student behaviors in a university distance learning using LMS

Due to the global new coronavirus pandemic in 2020, universities have shifted from face-to-face education to distance education. We conducted distance learning lessons of four months' duration for 1147 students, using learning management systems (LMSs). We chose the "Information Literacy" class, which is compulsory for first-year university students. In this chapter, we have analyzed student behaviors collected from three different LMSs, each having a specific role, and clarified the characteristics of student behaviors. We also examined the access timing, frequency, and success rate, and found that the students' final grades were influenced by those parameters as well as class announcements, gender differences, and instructors' attitudes. Additionally, we scrutinized the time when the students accessed the assignments, how many assignments they submitted, and how their behavior affected the final results. Consequently, we succeeded in obtaining meaningful results. We observed that the access frequency decreased over time, regardless of the type of assignment. It may be difficult for students to maintain their motivation in distance education. We noticed that both categories of students-those who submitted the assignments early and late-tended to obtain lower scores than those submitting them in between, i.e., during the middle period, who tended to obtain higher scores than the others. We also found that female students tended to give up on solving assignments at an early stage. Our analysis and results will help instructors to understand the general characteristics of students, and enable them to form models for certain groups of students, so that they can support each group differently from the early stages of distance education. © 2021 Nova Science Publishers, Inc.

Remote Learning of Speaking in Syntactic Forms with Robot-Avatar-Assisted Language Learning System

To help second language (L2) learners acquire oral communication skills, dialogue-based computer-assisted language learning (DB-CALL) systems are attracting more interest than ever. When robot-assisted language learning (RALL) is used for realizing such systems, L2 learners are provided with a sense of reality and tension similar to that in a real L2 conversation. At the same time, there are increasing demands for remote learning, accelerated in part by the spread of the novel coronavirus. We have therefore developed a robot-avatar-assisted language learning system that simulates a trialogue in English with two robot avatars and a learner for remote learning. The conversation scenarios deal with various daily topics to keep the learner’s interest and the system prompts the learner to acquire oral skills by using specific syntactic forms in conversation. We conducted a six-day remote learning experiment with ten Japanese university students to evaluate the learning effect, using eye gaze as an index of the learners’ degree of concentration. Our findings demonstrated the effectiveness of our system for remote learning and showed that the learners’ eye gaze activities changed between question answering and repeating tasks. © 2021, Springer Nature Switzerland AG.