As Japan reopens, coronavirus testing slowed by bureaucracy and staff shortages – Physician’s Weekly

By Ju-min Park and Kiyoshi Takenaka

TOKYO (Reuters) At the beginning of April, a young Japanese sumo wrestler known as Shobushi came down with a fever. His coaches tried calling a local public health centre to get him a coronavirus test, but the phone lines were busy.

For four days, he was turned away by clinics in Tokyo overwhelmed during a surge of COVID-19 cases. He was finally admitted to hospital on April 8 when he began coughing up blood, but died of the disease on May 13, the Japan Sumo Association said.

Shobushis death caused a public outcry over Japans testing limitations and reliance on overstretched public health centres at a time when most experts say widespread virus checks are crucial to contain the pandemic.

With Japan lifting its state of emergency and reopening its economy this week, its pandemic response has been hailed as an unlikely success. In a global death toll of more than 300,000, Japan has confirmed around 800 deaths from 16,000 cases.

Yet at the same time, Japan ranks the second lowest in its testing among OECD countries.

As of May 20, Japan conducted 3.4 tests per 1,000 people, far below Italys 52.5 and 39 in the United States, according to Oxford University data. South Korea has carried out tests on 15 people per 1,000 people.

In more than a dozen interviews with Reuters, public health officials, doctors and experts warned Japans slow scaling up of tests could mask the scale of infections and make its population vulnerable to future outbreaks.

Critics say vested interests and bureaucracy inside Japans health ministry caused bottlenecks at overworked public health centres, and officials waited too long to allow private labs to run tests.

It is true that announced figures for infection and deaths are low, but those are based on the tests that were curbed, said Yasuharu Tokuda, the director of the Muribushi Okinawa Center for Teaching Hospitals. It is clear that there are quite a few (cases) that have fallen through the cracks.

Even the governments top advisor, Shigeru Omi, told parliament nobody knows whether the true number of coronavirus cases could be 10 times, 12 times or 20 times more than reported.

Omis panel of experts has called on the government to speed up testing, including of people with mild symptoms.

The health ministry said it is ramping up the use of private labs to reduce the workload on public health centres.

Our stance that tests should be conducted on people in need has been consistent from the beginning. We have had testing capacity increased continuously, Takuma Kato, a senior health ministry official, told Reuters.

NOT ENOUGH TESTS

Public health centres are at the forefront of Japans response to the pandemic. While South Korea bolstered its public health system in the wake of past epidemics, Japan has halved the number of public health centres since the 1990s.

Struggling with overworked staff and flooded with calls, public health centres have asked the government to allow more private clinics to administer polymerase chain reaction (PCR) tests.

Japan says it can run up to 22,000 PCR tests a day, but less than a third around 6,000 tests are actually conducted on a daily basis. About 75% of tests have been processed through public health centres and government institutions, according to the health ministry.

In a previously unreported May 6 letter, the association of public health centre directors urged Katsunobu Kato, the minister of health, to overhaul Japans testing policy.

Currently, there are not enough PCR tests conducted for the coronavirus, they wrote in the letter seen by Reuters.

Some regional governments have begun running temporary testing stations with the help of local medical associations in April, bypassing public centres.

IDLE LABS, UNUSED MACHINES

While public health centres are overwhelmed, university labs are sitting idle.

Shinya Yamanaka, a Nobel Prize-winning stem cell biologist at Kyoto University, has offered his lab to boost testing capacity.

If we can make good use of resources at places like university labs, PCR testing can exceed 100,000 (per day), far more than 20,000, Yamanaka said in an internet TV debate with Prime Minister Shinzo Abe on May 6.

The health ministry welcomed his proposal, but said further considerations were needed.

We are grateful for their offer of help at this time of emergency. We want to work together, carefully matching our needs to their offer, Masami Sakoi, the assistant health minister, told Reuters.

Critics say testing was limited, in part, by health ministry technocrats who wanted to maintain a tight grip on information, rather than cooperate with private institutions.

Kenji Shibuya, who heads the Institute for Population Health at Kings College London, said officials wanted to gather high-quality research data using public health centres.

The health ministry denies suggestions that ministry technocrats are intentionally curbing testing, and say their approach has proven successful so far.

Sakoi from the health ministry said it was important to carry out PCR tests that doctors deemed necessary, and pointed out Japans public insurance system started covering the tests in March as part of the governments effort to make them more accessible.

When we think about using the test results to form policy measures, the current method needs to be maintained for the time being though concerns that it lacks flexibility for boosting the number of tests is understandable, Sakoi said.

Still, the approach is alarming some experts.

Its safer to assume that Japan has just been lucky than to believe it has taken the right steps, said Tokuda, the epidemiology expert.

(Reporting by Ju-min Park, Kiyoshi Takenaka, Antoni Slodkowski, Ami Miyazaki, Sakura Murakami; Editing by Mari Saito and Lincoln Feast.)

See the article here:
As Japan reopens, coronavirus testing slowed by bureaucracy and staff shortages - Physician's Weekly

VICTORY BELL: GMC’s Coach Williams reaches remission | News – The Union-Recorder

Ring this bell three times well. Its toll to clearly say, my treatments done, this course is run and I am on my way!

With the reading of those words and the ceremonial ringing of the bell at Emorys Winship Cancer Institute in Atlanta, longtime Georgia Military College head football coach and Athletic Director Bert Williams celebrated the completion of his chemotherapy treatment last week for mantle cell lymphoma. He is in remission from the rare cancer he was diagnosed with back in December, which now gives one of junior college footballs winningest coaches an off-the-field victory to add to his career total.

It was a very exciting and emotional moment, Williams said of ringing the bell. We had been on the other side of that numerous times as others completed their treatment at Emory. Everybody just stops what theyre doing patients, doctors, nurses, the whole bunch its a very humbling and emotional experience, to say the least. That was a moment Ill never forget.

Williams oldest son Parker posted the video of his father ringing the bell on Twitter Friday and it had reached nearly 100,000 views as of Tuesday afternoon. Current and former GMC players, fellow coaches and many others replied with their congratulations and well wishes for the head coach as he reached the milestone. The celebration continued Friday when Williams was greeted inside his home by his two sons, Parker and Zach, who were each packing their own confetti cannons.

We still have confetti floating all over the house, Williams said laughing. Note to reader: Do not use inside.

The ability to laugh at confetti scattered throughout his home and a strong family support system are two things that have served Williams well in his battle.

Weve been very positive and upbeat the whole time, he said. Its certainly a challenge you think youre never going to have to deal with until you do. Theres high points and low points. We didnt have many low points, but sometimes you start thinking about things and get the bigger picture without question. Id get up in the morning with the mindset to fight every day and do every little thing I could do from dieting to getting what activity I could get to keep working to do all the things I needed and wanted to do. My wife and kids support that, and have from the start.

The GMC head football coach of more than 20 years now is glad to be off medication for a while, but his fight is not over. Mantle cell lymphoma is not yet curable, so the next step is to harvest stem cells (possibly in mid-July) for a stem cell transplant to keep the cancer in remission for as long as possible while a cure is hopefully worked out.

They dont know how to cure it yet, but I fully expect to be the first one and set the standard, Williams said.

Outpatient chemotherapy has done little to keep Williams away from his job as a junior college football coach and athletic director. The COVID-19 pandemic has changed the way most everyone works, so hes been able to handle his duties from home and even attend Zoom meetings while receiving his treatments. The pandemic canceled spring football practices along with the Bulldogs annual intra-squad scrimmage, but signing day still came and went like normal. Junior college programs like GMC often get guys whose grades do not qualify them to enroll at the big universities they were initially recruited to, but the NCAA has relaxed some of its eligibility criteria due to COVID-19. That means that five or six guys Coach Williams and his staff were expecting to come to Milledgeville now will not be. GMCs recruiting efforts always go into the summer anyway though, so the Bulldog coaches will just have a few more roles to fill than normal.

If conditions allow the 2020 football season to occur as planned, Williams hopes to be on the Davenport Field sideline coaching his guys up. His status will depend heavily on how his stem cell transplant goes.

I may be a couple weeks delayed, he said. I wouldnt call it a likelihood, but it is a possibility at this time. Theres a lot of decisions my family and I have to make about what we do and how we do it. Youll see me out there hollerin and trying to get some wins at some point though.

Finally, Coach Williams wanted to take the opportunity to thank the local community for continually having his back throughout this process.

I would like to thank the GMC family and the Milledgeville/Baldwin County community. As a whole, they have been unbelievable. The cards and notes I've received since January from people letting me know theyre rooting for me have really been a blessing. I cant tell you how much my wife and I and my family appreciate that constant outpouring of care, concern and prayers that have gotten us to the point where we are today.

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

Originally posted here:
VICTORY BELL: GMC's Coach Williams reaches remission | News - The Union-Recorder

DKMS-BMST Foundation India completes one year of operation in India – Express Healthcare

Celebrates milestone with registration of over 42,000 potential life savers in same time period in country

This World Blood Cancer Day, DKMS-BMST celebrates a milestone of registering over 42,000 potential lifesavers in a time period of one year in India. This group comprises of individuals who range from 18-50 years of age and have pledged to donate their blood stem cells to a blood cancer patient in need.

Focussed on helping patients with blood cancer and other blood disorders, DKMS-BMST has been able to save28unique lives in this period of one year including children diagnosed with blood cancer and other blood disorders like thalassemia.

Patients affected by blood cancer or thalassemia need a blood stem cell donation. Worldwide, only 30 per cent of them can find a match within their families and hence there is a dire need to find an unrelated donor. We started our operations in India last year with an intent to add potential blood stem cell donors of Indian ethnicity to the global database, so that patients (especially from this unique ethnicity) living in different parts of the world have a fair chance of finding a match and probably gain a second chance at life. We cannot thank enough, the people who are on-board and are helping us spread the word to add more and more people to this database,said Paul Patrick, CEO, DKMS BMST Foundation India.

Sharing his experience Mohd Saifulla, father to a 4-year-old thalassemia survivor said We went to multiple doctors trying to assess the problem our child had and thereafter to find a matching donor who could save her life. Receiving this transplant was the only chance of life for my daughter and we can never thank Debojyoti, a 28 year old software professional, enough, who donated his blood stem cells that matched our daughter. It is only because of organisations such as DKMS-BMST that people are coming forward to donate blood stem cells and save a life. My entire family is indebted to them for lifetime. Today my daughter is living a happy and healthy life and we are preparing to celebrate her fifth birthday this year that seemed like a dream to us up till a few years back.

Last year on World Blood Cancer Day, DKMS, one of the largest international blood stem cell donor centres in the world dedicated to the fight against blood cancer and blood disorders joined forces with Bangalore Medical Service Trust (BMST), a centre of excellence in blood banking, transfusion and immunohaematology adding India to the largest global repository of potential blood stem cell donors in the world. Every year, over 100,000 people in India are diagnosed with blood cancer or a blood disorder such asthalassemia or aplastic anaemia. Such life-threatening conditions can be managed by infusing a set of healthy blood stem cells from a suitable match. Since,ethnicity plays a crucial role in finding a matching donor, the ratio of potential blood stem cell donors from India needs to rise significantly, said Dr Latha Jagannathan, Director, DKMS BMST Foundation India.

Harsh, a blood stem cell donor registered with the foundation said,With very limited knowledge about blood stem cells I believed they were present only in the bone marrow and extracting them was a complex process. But to my surprise, the process is very similar to blood platelet donation. I strongly feel that anyone who is made aware that a simple process with zero complications can give you a chance to save a life will not hesitate from committing themselves towards the cause.

Capturing the challenges, the NGO faced in the country,Patrick said,We realised very early in India that a decision of this nature is not alone of the donor, but also involves his / her family. Hence, explaining the process, inculcating right awareness to break myths, updating people on the technological advances of blood stem cell donation and counselling them with medical experts has been our modus operandi in the country. Thus far, we have been able to conduct many physical drives to reach out to people urging them to register as potential donors. We plan to expand our reach to many more regions this year so that we are able to add potential donors from varied population groups in the country.

DKMS-BMST has organised over 1000donor registration drives in one year across various organisations such as corporates, educational institutes, hospitals and defence forces to spread awareness about blood stem cell donation and enroll more potential donors. Few names where physical drives have been conducted includes Mindtree, HSBC, HP enterprises, Christ University, RV College of Engineering, apart from public drives at Orion Mall Bengaluru, Lalbagh Botanical Garden etc.

In the current lockdown situation, the team is working tirelessly to ensure that patients whose donations were scheduled do not face any challenges and are organising awareness sessions through webinars and calling for registrations through the online portal:www.dkms-bmst.org/register.

See the original post:
DKMS-BMST Foundation India completes one year of operation in India - Express Healthcare

World Blood Cancer Day 2020: Bring down your risk of this condition with easy diet tips – TheHealthSite

Bloodcanceris one of the most common types of cancer that generally affects people of all age groups. According to a report published by WHOs International Agency for Research on Cancer, India has the third-highest number of haematologicalcancers,popularly known as blood cancer. There was a time when cancer was considered an incurable disease, but over the recent years, the situations have changed drastically with the evolution in medical technology. This has made cancer treatments possible with up to 90 per cent survival chances. The World Blood Cancer Day is observed every year on May 28th around the world to show support for blood cancer patients. According to experts, early diagnosis in cancer, especially blood cancer, increases the chance of survival, thanks to evolved treatment modalities of the modern times. Also Read - World Blood Cancer Day 2020: Understanding the types and symptoms

Mostly, heamatological cancers originate in bone marrow, where blood is produced. This condition occurs when faulty blood cells affect the function of the normal ones that fend off infections and generate new cells. There are three types of blood cancers leukaemia, lymphoma and myeloma. In leukaemia, your body develops too many abnormal white blood cells (leukocytes) and makes it tough for your bone marrow to produce red blood cells. Lymphoma occurs when in the lymphocites while myeloma has its origin in the plasma cells of the blood. These are white blood cells produced in your bone marrow. Also Read - Researchers discover role of mutation in blood cancers

The prominent symptoms of blood cancer include chills, fatigue and weakness, night sweats, pain in the bones and joints, and swollen lymph nodes. It takes a toll on your immunity, making you susceptible to various infections and other conditions. Cancer also affects the rate at which your blood clots. So, small cuts or injuries may tend to bleed for a longer period of time. You may also experience unusual bruising, bleeding of the gums, and blood in stool. Women may go through heavy bleeding during their periods. Also Read - Today health tips: 6 lifestyle modifications to bring down your breast cancer risk

Experts are of the opinion that lymphoma in adults is 80-90 per cent curable and acute leukaemia in adults can be 40-50 per cent curable. However, many of the myeloma cases are incurable. The treatment for blood cancer mostly depends on the type of cancer, age of the patient and the severity of the cancer. On the basis of these factors, doctors may suggest chemotherapy, supportive care, stem cell transplantation, etc.

According to the guidelines of the American Oncology Institute, one can decrease the risk of blood can by following certain lifestyle measures. They include exercising regularly, eating healthy, avoiding exposure to herbicides, insecticides and radiations. Here are some simple dietary tips to bring down your chance of falling prey to this condition.

Eat generous amounts of vegetables and fruits, salads, beans and cereals in your diet. This will try increase your immunity.

These acids have anti-cancer properties. The best food sources could be fish, walnuts, soya bean, so on and so forth. You can also opt for fish oil supplements.

An antioxidant known as lycopene is present in tomatoes. It comes with cancer fighting properties. The best way to get lycopene from tomatoes is to heat them well. So, tomato soup can be a good option. You can also have it with other anti-oxidant rich veggies in the form of a salad.

Several studies have associated high intake of olive oil with cancer risk reduction. You can have this oil in your salads or sprinkle it on cooked veggies too. Also, try using olive oil while marinating your meat, fish or poultry.

Published : May 28, 2020 12:30 pm | Updated:May 28, 2020 1:17 pm

See the rest here:
World Blood Cancer Day 2020: Bring down your risk of this condition with easy diet tips - TheHealthSite

Studying the development of ovarian cancer with organoids – Science Codex

Researchers from the group of Hans Clevers at the Hubrecht Institute have modeled the development and progression of high-grade serous ovarian cancer in mini-versions of the female reproductive organs of the mouse. They found out that the cells of the oviduct, the equivalent of fallopian tubes in humans, are more prone to develop into tumors than those of the ovarian surface epithelium, the outer layer of the ovaries. In the future, such mini-versions, or organoids, of human tissue may be used to better understand how this disease, that is often diagnosed very late, develops. The researchers published their results in the scientific journal Nature Communications on the 27th of May.

High-grade serous ovarian cancer (hereafter referred to as simply "ovarian cancer") is the most common type of ovarian cancer and has the lowest rate of survival. It is often only diagnosed when it has already spread within the pelvis and abdomen, making it harder to treat. Because the early stages of ovarian cancer are not often observed, much is still unknown about the early development of the disease. We do know that ovarian cancer cells often have mutations, or mistakes, in certain genes, such as Trp53, a gene that is often mutated in many types of cancer, Brca1, a gene often mutated in breast cancer, Nf1 and Pten.

Organoids

Researchers in the group of Hans Clevers at the Hubrecht Institute used mini-versions of two parts of female reproductive tract of mice to study the early development of ovarian cancer. They grew mini-versions, or organoids, of the oviducts (in humans called the fallopian tubes) that transport the egg from the ovary to the uterus, and of the ovarian surface epithelium, the outer layer of the ovaries, in the lab from small pieces of tissue from mice. In these organoids, they recreated the mutations found in ovarian cancer. Using the state-of-the-art CRISPR-Cas9 genome editing approach, they mutated the genes Trp53, Brca1, Nf1 and Pten to study how these genes contribute to the development of a tumor.

Mutations

When mutations were introduced in three of the four genes, namely Trp53, Brca1 and either Nf1 or Pten, the organoids acquired characteristics of tumors, such as more densely packed cells and changes in chromosome number. In addition, when these organoids were transplanted back into mice, they developed into tumors that are similar to ovarian cancer tumors in humans.

The researchers found out that organoids from the oviduct were more likely to develop into tumors, grew faster and grew into larger tumors than the organoids from the ovarian surface epithelium. This suggests that ovarian cancer is more likely to originate in the oviduct, or the fallopian tube in humans, compared to the ovarian surface epithelium.

Earlier diagnosis and preventive care

Studying the development and progress of ovarian cancer in such organoid models may help to better understand how ovarian cancer develops in the body. Researchers in the group of Hans Clevers have previously shown that organoids can also be made from the human fallopian tube and the human ovarian surface epithelium. In the future, the researchers may also introduce the specific mutations found in ovarian cancer in these human organoids to further study the development of this disease.

Patients with a mutation in one of the Brca genes are at a high risk of ovarian cancer and can receive preventive treatment. This includes radical surgery in which both ovaries as well as the fallopian tubes are removed, leading to premature menopause in these women. The results in this study support the emerging view that the fallopian tube, not the ovarian surface epithelium around the ovaries, are the main origin for ovarian cancer, which may direct future changes in (preventive) treatment. For example, the Dutch Gynecological Oncology Group recently launched a clinical trial to study whether early removal of only the fallopian tubes and later removal of the ovaries can improve the quality of life for these patients, while also reducing the risk of ovarian cancer.

Knowing more about the development and progression of ovarian cancer may help doctors to better recognize ovarian cancer in the future, enabling earlier treatment and a higher chance of survival.

Publication

Assessing the origin of high-grade serous ovarian cancer using CRISPR-modification of mouse organoids. Kadi Lhmussaar*, Oded Kopper*, Jeroen Korving, Harry Begthel, Celien P. H. Vreuls, Johan H. van Es, Hans Clevers. Nature Communications 2020.

*These authors contributed equally to this work

Hans Clevers is group leader at the Hubrecht Institute and the Princess Mxima Center for Pediatric Oncology, professor of Molecular Genetics at the UMC Utrecht and Utrecht University, and Oncode Investigator.

About the Hubrecht Institute

The Hubrecht Institute is a research institute focused on developmental and stem cell biology. It encompasses 23 research groups that perform fundamental and multidisciplinary research, both in healthy systems and disease models. The Hubrecht Institute is a research institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), situated on Utrecht Science Park. Since 2008, the institute is affiliated with the UMC Utrecht, advancing the translation of research to the clinic. The Hubrecht Institute has a partnership with the European Molecular Biology Laboratory (EMBL). For more information, visit http://www.hubrecht.eu.

See the original post:
Studying the development of ovarian cancer with organoids - Science Codex