Bone Regeneration in Artificial Jaw Cleft by Use of Carbonated Hydroxyapatite Particles and Mesenchymal Stem Cells Derived from Iliac Bone

Objectives of the Study. Cleft lip and palate (CLP) is a prevalent congenital anomaly in the orofacial region. Autogenous iliac bone grafting has been frequently employed for the closure of bone defects at the jaw cleft site. Since the related surgical procedures are quite invasive for patients, it is of great importance to develop a new less invasive technique. The aim of this study was to examine bone regeneration with mesenchyme stem cells (MSCs) for the treatment of bone defect in artificially created jaw cleft in dogs. Materials and Methods. A bone defect was prepared bilaterally in the upper incisor regions of beagle dogs. MSCs derived from iliac bone marrow were cultured and transplanted with carbonated hydroxyapatite (CAP) particles into the bone defect area. The bone regeneration was evaluated by standardized occlusal X-ray examination and histological observation. Results. Six months after the transplantation, perfect closure of the jaw cleft was achieved on the experimental side. The X-ray and histological examination revealed that the regenerated bone on the experimental side was almost equivalent to the original bone adjoining the jaw cleft. Conclusion. It was suggested that the application of MSCs with CAP particles can become a new treatment modality for bone regeneration for CLP patients

Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis

What counts as global health? There has been limited discourse to date on the ways in which country-level contexts may shape positioning in global health agendas. By reviewing Japan’s response to the refugee crisis, we demonstrate a clash between rhetoric and action on global responsibility, and suggest that cultural and historical factors may be related to the ways of perceiving and acting upon global health

COVID-19: challenges faced by Nepalese migrants living in Japan

Worldwide, COVID-19 has exacerbated the vulnerability of migrants, impacting many facets of their lives. Nepalese make up one of the largest groups of migrants residing in Japan. Crises, such as the ongoing COVID-19 pandemic could disproportionately affect migrants from low- and middle-income countries like Nepal, widening health and economic inequalities. An in-depth, comprehensive assessment is needed to appraise the diverse problems they encounter. Drawing upon qualitative interviews, this study aimed to identify challenges faced by Nepalese migrants in Japan as a consequence of the COVID-19 pandemic and to discuss their needs to counter these challenges. This qualitative study employed an interpretivist approach to appraise the first-hand experience of Nepalese migrants living in Japan. Fourteen participants (8 males and 6 females, aged 21 to 47 years old) were recruited to participate in semi-structured in-depth telephone interviews (45–60 min) regarding: (a) their perceived current physical and mental health, (b) problems faced as a result of the COVID-19 pandemic, and (c) perception of available and necessary support structures. Purposive and snowball sampling techniques were used to recruit the participants. Interviews were recorded, transcribed, and thematically analyzed. Six themes were identified: 1) experiencing psychosomatic symptoms, 2) adoption of new healthy behaviors, 3) financial hardship, 4) family concerns, 5) reflections on discrimination and 6) reflections of existing support and expectations of support systems. The findings of our study illustrate the specific impact of COVID-19 among Nepalese migrants regarding their unstable employment conditions, perceived lack of social support, possible obligation to send money home, difficulty in accessing services due to the language barrier, and a lack of effective governmental support from Nepal. Pandemic-related adversity has negatively impacted migrants’ mental well-being, exacerbating their vulnerability. Comprehensive and timely support should be provided to the vulnerable migrant population. Effective coordination among relevant parties in both countries, including the governments concerned, should be facilitated.Institute of Medical Care and Societal Health, Japan

Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan

Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for COVID-19. Cross-sectional study using regression and correlation analysis. We retrieved domestic laboratory-confirmed cases, deaths, and the number of RT-PCR testing for COVID-19 from January 15 to April 6, 2020 in 47 prefectures in Japan, using publicly-available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. The median prefectural-level incidence and number of RT-PCR testing per 100,000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (p < 0.001) and the number of RT-PCR testing (p = 0.03); and those for RT-PCR testing were the incidence (p = 0.025), available beds (p = 0.045) and cluster infections (p = 0.034). Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.N/

Evaluation of Financial and Non-financial Conflicts of Interest and Quality of Evidence underlying Psoriatic Arthritis Clinical Practice Guidelines-Analysis of Personal Payments from Pharmaceutical Companies and Authors' Self-citation Rate in Japan and the United States

OBJECTIVE: To assess financial conflict of interest (FCOI) and non-financial conflicts of interest (NFCOI) among psoriatic arthritis clinical practice guideline (PsACPG) authors in Japan and US, and to evaluate the quality of evidence and strength of recommendations of PsACPG.METHODS: We performed a retrospective analysis using payment data from major Japanese pharmaceutical companies and the US Open Payments Database from 2016 to 2018. All authors of PsACPG issued by Japanese Dermatological Association (JDAPsACPG) and American College of Rheumatology (ACRPsACPG) were included.RESULTS: Of 23 CPG authors in Japan, 21 (91.3%) received at least one payment, with the combined total of $3,335,413 between 2016 and 2018. Regarding 25 US authors, 21 (84.0$4,081,629 during the same period. The 3-year combined average payment per author was $145,018 (standard division [SD]:$114,302) in Japan and $162,825 (SD:$259,670) in US. 18 (78.3%) JDAPsACPG and 12 (48.0%) ACRPsACPG authors had undisclosed FCOI worth $474,663 and$218,501, respectively. The percentage of citations with at least one CPG author relative to total citations were 3.4% in Japan and 33.6% in US. 71.4% and 88.8% of recommendations for psoriatic arthritis in JDA and ACR were supported by low or very low quality of evidence.CONCLUSION: More rigorous cross-checking of information disclosed by pharmaceutical companies and self-reported by physicians, and more stringent and transparent COI policies are necessary.</p

Safety of SARS-CoV-2 BNT162b2 Vaccine in Elderly Patients from Japan - A Preliminary Assessment and A Call on Careful Pharmacovigilance

Vaccines are efficacious, effective and safe measures to control COVID-19. Despite phase 3 and 4 studies, some concerns should be addressed in certain populations regarding its specific vaccine safety. One of them is the safety of the elderly. The majority of enrollees in clinical studies on COVID-19 vaccines have been young to middle-aged individuals, with few exceptions