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Past work investigating the lingual articulation of devoiced vowels in Tokyo Japanese has revealed optional but categorical deletion. Some devoiced vowels retained a full lingual target, just like their voiced counterparts, whereas others showed trajectories that are best modelled as targetless, i.e., linear interpolation between the surrounding vowels. The current study explored the hypothesis that this probabilistic deletion is modulated by the identity of the surrounding consonants. A new EMA experiment with an extended stimulus set replicates the core finding of Shaw, Jason & Shigeto Kawahara. 2018b. The lingual gesture of devoiced [u] in Japanese. Journal of Phonetics 66. 100-119. DOI:https://doi.org/10.1016/j.wocn.2017.09.007 that Japanese devoiced [u] sometimes lacks a tongue body raising gesture. The current results moreover show that surrounding consonants do indeed affect the probability of tongue dorsum targetlessness. We found that deletion of devoiced vowels is affected by the place of articulation of the preceding consonant; deletion is more likely following a coronal fricative than a labial fricative. Additionally, we found that the manner combination of the flanking consonants, fricative-fricative versus fricative-stop, also has an effect, at least for some speakers; however, unlike the effect of C1 place, the direction of the manner combination effect varies across speakers with some deleting more often in fricative-stop environments and others more often in fricative-fricative environments., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Aim: Nurses are expected to have a role in the transition of care from pediatric to adult medical practices for adolescents and young adults with childhood-onset chronic diseases. This study compares the experience, knowledge, and perceptions regarding the ideal care among adult unit and pediatric nurses regarding the transition to adult care for those with childhood-onset chronic diseases., Methods: A cross-sectional study using self-report questionnaires was conducted with nurses in a tertiary hospital in Tokyo. Questions were generated based on a literature review and expert discussion. Data from 1,064 participants were analyzed (adult unit nurses: n = 959, 90.1%; pediatric nurses: n = 105, 9.9%)., Results: Among 623 adult unit nurses who had care experience for adult patients with a childhood-onset chronic disease, 458 nurses (73.6%) were unaware of the concept of transitional care. As the obstructive factors for transition, pediatric nurses recognized problems in healthcare providers' attitudes and lack of transitional care coordinators, while the adult unit nurses emphasized the patients' wishes to continue to receive pediatric healthcare. Most adult unit nurses expected pediatric nurses to function as transitional care coordinators., Conclusion: Adult unit and pediatric nurses had different perceptions of the barriers in transitioning children with chronic diseases to adult care. It is important to have educational programs focusing on transitional care for all nurses, both to enable pediatric nurses to improve transition readiness of children with chronic diseases and to offer adult patients with a childhood-onset chronic disease continuing support through adult unit nurses., (© 2020 Japan Academy of Nursing Science.)

Vaccination is an important factor in public health. The recombinant bacillus Calmette Guérin (rBCG) vaccine, which expresses foreign antigens, is expected to be a superior vaccine against infectious diseases. Here, we report a new recombination platform in which the BCG Tokyo strain is transformed with nucleotide sequences encoding foreign protein fused with the MPB70 immunogenic protein precursor. By RNA-sequencing, mpb70 was found to be the most transcribed among all known genes of BCG Tokyo. Small oligopeptide, namely, polyhistidine tag, was able to be expressed in and secreted from rBCG through a process in which polyhistidine tag fused with intact MPB70 were transcribed by an mpb70 promoter. This methodology was applied to develop an rBCG expressing the receptor binding domain (RBD) of severe acute respiratory syndrome coronavirus 2. Immunoblotting images and mass spectrometry data showed that RBD was also secreted from rBCG. Sera from mice vaccinated with the rBCG showed a tendency of weak neutralizing capacity. The secretion was retained even after a freeze-drying process. The freeze-dried rBCG was administered to and recovered from mice. Recovered rBCG kept secreting RBD. Collectively, our recombination platform offers stable secretion of foreign antigens and can be applied to the development of practical rBCGs., (© 2024 The Societies and John Wiley & Sons Australia, Ltd.)

Home clutter can adversely affect work performance, health and well-being. Clinical-level hoarding disorders usually manifest during early adolescence, so early detection and prevention of subclinical hoarding tendencies are essential. This study aimed to evaluate a community-based programme for individuals with poor organising and decluttering skills who volunteered to receive education on how to organise their homes. We conducted an open-label randomised controlled trial beginning in January 2016 in Tokyo. We enrolled 61 volunteers aged 12-55 years with problems with organising and decluttering. A workshop and home visit group (n = 30) attended four workshop sessions on organising skills and received a visit from a home organiser. The home visit only group (n = 31) only received the home organiser visit. The primary outcome was Saving Inventory-Revised (SI-R; Japanese version) scores. The secondary outcomes were Clutter Image Rating Scale and Rosenberg Self-Esteem Scale (Japanese version) scores. Between-group changes from baseline to 7 months were analysed using a general linear model. At follow-up, the SI-R scores of both groups had improved. The mean change from baseline in SI-R scores was -20.8 (standard deviation = 9.8) and -13.1 (standard deviation = 14.3) in the workshop and home visit and home visit only groups, respectively. The estimated between-group difference in SI-R score changes from baseline (adjusted for baseline SI-R score) was non-significant at -5.7 (95% confidence interval, -12.4 to 0.9; p = .089). However, the difference was significant in the univariate model: -7.2 (95% confidence interval, -13.7 to -0.8; p = .029). Although both groups improved, after adjusting for baseline values and participant characteristics, there was no significant difference between the groups. Our results suggest that a workshop-style educational intervention and assistance and advice from professional organisers may help to improve the living conditions of people with hoarding tendencies., (© 2021 John Wiley & Sons Ltd.)

Many cities advocate retrofitting green roofs and green walls (GRGW) to create additional green areas, especially in cramped urban areas. Yet, worldwide, only a handful of studies have evaluated the public views towards the benefits and negative issues and promotion policies of this innovative greening option. To address this gap in the literature, we conducted a survey (N = 500) of residents' opinions towards GRGW in Tokyo, a city with mandatory installation of GRGW for almost two decades. Respondents mostly agreed with the contribution of GRGW to thermal comfort, air quality, and cityscape but weakly endorsed other potential benefits. High costs as well as mosquitoes and plant litter nuisances were the most recognized negative issues. Mandatory installation was the least preferred promotion policy. Instead, respondents expected installation on public buildings and provision of installation guidance. Respondents predominantly held a "moderate" view towards both the benefits and negative issues, showing indifferent attitudes towards GRGW. Income level and housing type shaped the overall perceptions, whereas age, sex, and current living environment influenced perceptions of individual aspects. Our findings signified a need for a bottom-up strategy to heighten public awareness for the advanced development of GRGW to complement and prime the top-down mandatory installation policy., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Maternal exposure to fine particulate matter (PM 2.5 ) was associated with pregnancy complications. However, we still lack comprehensive evidence regarding which specific chemical components of PM 2.5 are more harmful for maternal and foetal health., Objective: We focused on exposure over the first trimester (0-13 weeks of gestation), which includes the early placentation period, and investigated whether PM 2.5 and its components were associated with placenta-mediated pregnancy complications (combined outcome of small for gestational age, preeclampsia, placental abruption, and stillbirth)., Methods: From 2013 to 2015, we obtained information, from the Japan Perinatal Registry Network database, on 83,454 women who delivered singleton infants within 23 Tokyo wards (≈627 km 2 ). Using daily filter sampling of PM 2.5 at one monitoring location, we analysed carbon and ion components, and assigned the first trimester average of the respective pollutant concentrations to each woman., Results: The ORs of placenta-mediated pregnancy complications were 1.14 (95% CI = 1.08-1.22) per 0.51 μg/m 3 (interquartile range) increase of organic carbon and 1.11 (1.03-1.18) per 0.06 μg/m 3 increase of sodium. Organic carbon was also associated with four individual complications. There was no association between ozone and outcome., Significance: There were specific components of PM 2.5 that have adverse effects on maternal and foetal health., (© 2021. The Author(s).)

Aim: To determine the relationship between multiple medications and falls., Methods: This case-control and case-crossover study was carried out at Kudanzaka Hospital in Chiyoda, Tokyo, Japan. A total of 325 patients who experienced their first falls when hospitalized between January 2016 and November 2018, and 1285 controls matched by sex, age and clinical departments were included in this study. Hospitalization duration and fall risk score were adjusted for in the analyses., Results: In the case-control study, multivariable logistic regression showed that increasing the intake of oral medications was not significantly associated with the incidence of falls (odds ratio 1.02, 95% confidence interval 0.998-1.049). In contrast, drugs prescribed with special caution in accordance with the Elderly Oral Medication Guidelines were significantly associated with falls (odds ratio 1.17, 95% confidence interval 1.09-1.26). A similar pattern was observed in the case-crossover analysis. Among the drugs to be prescribed with special caution according to the guidelines, atypical antipsychotics, non-benzodiazepine hypnotics and magnesium oxide were significantly associated with the risk of falls., Conclusion: The drugs to be prescribed with special caution according to the guidelines were associated with an increased fall risk. The risk of falls in hospitalized older people due to multiple medications varies among medications. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••., (© 2021 Japan Geriatrics Society.)

Microplastic (MP) pollution is a rising environmental concern. This study investigated MP concentrations in Tokyo Bay using neuston net for surface sampling and deep-sea plankton pump for underwater sampling across six stations at multiple depths. Results revealed substantial variation in MP concentrations. Surface large microplastics (LMP, > 350 μm) ranged from 0.21 × 10 -3 to 3.34 × 10 -3 pieces L -1 , averaging 1.26 × 10 -3 pieces L -1 , while surface small microplastics (SMP, 60 μm to 350 μm) were highest at head of the bay (11.5 ± 3.05 pieces L -1 ). SMP concentrations varied with depth and position, peaking at center of the bay (5.79 ± 1.63 pieces L -1 at 2 m). Additionally, the total amount of surface LMP was estimated at 10.3 m 3 and SMP at 15.0 m 3 in the Tokyo Bay. This study provides a comprehensive picture of the spatial and vertical distribution of MP in Tokyo Bay., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The Tokyo 2020 Olympic and Paralympic Games (Games) were held during the height of the coronavirus disease 2019 (COVID-19) pandemic. To detect people infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) early enough to contain the spread and to facilitate the timely arrival of athletes at their game venues, all participating athletes staying in the Olympic Village (up to 14,000) were screened daily for the infection. Toward this aim, a two-step strategy was adopted comprising screening of self-collected saliva samples using a chemiluminescence enzyme immunoassay, followed by confirmatory testing using polymerase chain reaction. The testing system was integrated with an information management system covering all steps. To ensure the accuracy of the test results, rigorous quality assurance measures and monitoring of performance/specimen quality were implemented. A chronological chart analysis was implemented to monitor the holistic process and to give feedback to improve the sampling. Nearly all test results for 418,506 saliva samples were reported within 12 hours of sample collection, achieving the target mean turnaround time of 150 minutes for confirmatory testing. As a result, athlete activity and performance for the Games were ensured. The chronological chart confirmed that no athletes were withdrawn due to a false-positive result, and no infection clusters were identified among the athletes in the Olympic Village. In conclusion, continuous quality improvement as part of the two-step strategy for mass screening for COVID-19 contributed to the success of the Games during the pandemic. The quality practice, systems, and workflows described here may offer a model for future mass-gathering sporting events during similar major infectious disease epidemics., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: For non-financial conflicts of interest, H.M., S.A., S.S., and C.I. have published several papers about COVID-19 and could have conflicts of interest among healthcare professionals. For financial conflicts of interest, H.M. was a consultant at SRL Laboratories and an adviser for the laboratory in the Olympic and Paralympic Village in Harumi, Tokyo, Japan. H.M. and S.A. were involved in the nationwide external quality assessment of SARS-CoV-2 nucleic acid tests, a project commissioned by the Ministry of Health, Labour and Welfare of Japan. S.A. contributed to studies on SARS-CoV-2 PCR tests developed by DENSO Corp. and KYORIN Pharm. Co., Ltd. that were financially supported by the Japan Agency for Medical Research and Development. R.K. and K.O. rendered laboratory service for athletes and team officials during the Tokyo 2020 Games as a commission project by the Tokyo Organizing Committee of the Olympic and Paralympic Games. S.S. and C. I. worked as staff members for Tokyo 2020 during the Tokyo 2020 Games. The authors report no other potential conflicts of interest., (Copyright: © 2024 Miyachi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: Patients with the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) are unstable and often experience rearrest, after which ROSC may be reattained. This study investigated the incidence and risk factors of post-ROSC events (rearrest and subsequent reattainment of ROSC) and their impact on outcomes in patients with prehospital ROSC following OHCA., Methods: Patients with OHCA and prehospital ROSC were identified from the Tokyo Fire Department database between 1 January 2018 and 31 December 2022. The factors associated with post-ROSC events and their impact on 1-month favourable neurological outcome (cerebral performance category scale: 1 or 2) were assessed using multivariable logistic regression analysis., Results: Overall, 64,000 individuals experienced OHCA, and 6,190 (9.7%) had ROSC. Rearrest was confirmed in 28.4% of patients with ROSC, and was associated with age, time of emergency call, location of cardiac arrest, dispatcher instruction regarding cardiopulmonary resuscitation, first recorded cardiac rhythm, bystander cardiopulmonary resuscitation, defibrillation by a bystander, response time, and prehospital interventions. ROSC reattainment was confirmed in 34.5% of patients with rearrest and associated with the first recorded cardiac rhythm and defibrillation by a bystander. Patients without rearrests had the highest proportion of favourable neurological outcomes, followed by those with solved and unsolved rearrests (38.6% vs. 22.4% and 4.4%, P < 0.001). The difference remained significant after adjustment for confounders., Conclusion: This study revealed population-based incidence and risk factors of post-ROSC events. Rearrest was common, leading to unfavourable neurological outcome; however, its deleterious impact may be mitigated by successful resuscitation efforts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Modern Pentathlon (MP) includes an equestrian Jumping discipline, with horses drawn blindly by unfamiliar riders. At the Tokyo 2020 Olympic Summer Games, concerns regarding inadequate horsemanship generated adverse publicity for MP. Conventional stadium Jumping in Tokyo provided an opportunity for comparison of the two closest Olympic equestrian Jumping disciplines. The objectives of this study were to complete an objective analysis of the Tokyo MP riding phases, and to test the hypothesis that MP riding faults in women's and men's Tokyo competitions combined were more frequent than in the Individual Jumping Qualifier (JQ). Types of faults for Tokyo MP (n = 71 riders) and JQ (n = 73 riders) were tabulated from published official results and detailed observation of online videos of each competition. Fault distributions were compared using Chi-square analysis (significance at P < .05). MP riders had more jumping faults (15.4 %) than JQ (7.8 %, P < .0001). Both MP and JQ riders had more faults at oxers (17.1 %, P < .0001 and 9.7 %, P = .0171, respectively) than verticals (14.5 % and 6.2 %). JQ (9.8 %, P = .0093) but not MP (15.7 %, p = .5166) riders had more faults in the second half of the course compared to the first half (5.7 % and 15.0 %, respectively). Double clear rounds (no jumping or time faults) were 4.9 times more likely in JQ (34.2 %) than in MP (6.9 %: P < .0001). Proposed solutions to decrease MP fault frequency include lower maximum fence heights, fewer jumping efforts, and a more liberal re-ride policy., Competing Interests: Declaration of competing interest The author has no financial or personal relationship that could inappropriately influence or bias the content of the paper. The author was a member of the AAEP task force charged with studying and making recommendations to the AAEP President and Board of Directors regarding horse safety in pentathlon after Tokyo 2020., (Copyright © 2024. Published by Elsevier Inc.)

The Tokyo 2020 Olympic and Paralympic Games was one of the largest international mass-gathering events held after the beginning of coronavirus disease 2019 (COVID-19) pandemic. In this scoping review, we extracted papers discussing COVID-19 risk assessment or management at the Tokyo 2020 Games to determine the nature of studies that were conducted. Among the 75 papers obtained from two search engines (PubMed and ScienceDirect) and four papers collected from hand-searches, 30 papers were extracted. Only eight papers performed both COVID-19 prior risk assessment and quantitative evaluation of effectiveness measures, highlighting the importance of rapid, solution-focused risk assessment. Furthermore, this review revealed that the findings regarding the spread of COVID-19 infection to citizens in the host country were inconsistent depending on the assessment methods and that assessments of the spread of infection outside the host country were lacking., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may considered as potential competing interests: F.K. received salaries from the Kao Corporation. W.N. and T.Y. have received financial support from the Japan Professional Football League, the Yomiuri Giants, Tokyo Yakult Swallows, the Japan Professional Basketball League, and the Kao Corporation in the context of measures at mass-gathering events. M.M., Masashi.K., W.N, T.Y., and S.I. have attended the New Coronavirus Countermeasures Liaison Council jointly established by the Nippon Professional Baseball Organization and the Japan Professional Football League as experts without any reward. F.K., W.N., and T.Y. were advisors to the Japan National Stadium. W.N. and T.Y. are advisors to Japan Professional Football League. Masaaki.K. received research funding from SHIONOGI & CO., LTD and AdvanSentinel, Inc. and patent royalties from SHIONOGI & CO., LTD.　The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of any institution., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Nerve agents (G- and V-series) are a group of extremely toxic organophosphorus chemical warfare agents that we have had the opportunity to encounter many times on a massive scale (Matsumoto City, Tokyo subway and Gulf War). The threat of using nerve agents in terrorist attacks or military operations is still present, even with establishing the Chemical Weapons Convention as the legal framework. Understanding their environmental sustainability and health risks is critical to social security. Due to the risk of contact with dangerous nerve agents and animal welfare considerations, in silico methods were used to assess hydrolysis and biodegradation safely. The environmental fate of the examined nerve agents was elucidated using QSAR models. The results indicate that the investigated compounds released into the environment hydrolyse at a different rate, from extremely fast (<1 day) to very slow (over a year); V-agents undergo slower hydrolysis compared to G-agents. V-agents turned out to be relatively challenging to biodegrade, the ultimate biodegradation time frame of which was predicted as weeks to months, while for G-agents, the overwhelming majority was classified as weeks. In silico methods for predicting various parameters are critical to preparing for the forthcoming application of nerve agents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

In the early 1960s, I was working as a traditional chemical engineer studying inanimate objects without the slightest clue of the biological world. At that time, I met Dr Melvin H. Knisely and he encouraged me to use my engineering skills to improve on the Krogh capillary tissue cylinder. I derived a detailed mathematical model and performed a complex computer simulation to achieve that goal. We attended professional meetings on oxygen transport to tissue all over the world, but mainly in Europe, presenting case studies. It became my goal to honour Dr Knisely with a meeting on oxygen transport to tissue at Clemson University in South Carolina, USA. Melvin's wife, Verona, convinced me to also have the meeting at the Medical University of South Carolina located in Charleston, since it was meant to honour Dr Knisely's work with his quartz rod crystal for illumination. He is credited as the first human being to observe the particulate matter in blood flowing in the microcirculation. He was nominated for the Nobel prize four times as a result of his discoveries. When I decided to have part of the meeting at the medical school, I invited Dr Haim Bicher to work with me from there and I focused on Clemson University and the combined meeting structure. As the meeting evolved, we decided it would be a good idea to establish an international society and call it the "International Society on Oxygen Transport to Tissue" (ISOTT). I wrote a paper on the pillars of our young society, "ISOTT from the Beginning: A Tribute to Our Deceased Members (Icons)," and another that shares more detail about its beginnings, "The Founding of ISOTT: The Shamattawa of Engineering Science and Medical Science". The roots of ISOTT are all the members, new and old, who continue to make valuable contributions to an exceedingly important component of human health. I hope that the society lasts for a long time, continuing to make important contributions to the medical world. It is a society that has been instrumental in bringing together brilliant scientists from the medical, engineering, and natural science fields to work together. It has contributed to the evolution of "bioengineering" as we know it today., (© 2024. Oxygen Transport to Tissue International.)

Purpose: Extant research elucidating the domains of knowledge and bias on epilepsy has consistently underscored a deficiency in cognizance and an inclination toward bias within non-urban areas. Investigations into geographical disparities concerning epilepsy awareness and prejudice within the Japanese context remain conspicuously absent. To address this lacuna in the literature, we undertook a post-hoc analysis to elucidate the discernible regional differentials in epilepsy awareness and the associated stigma., Methods: From July to August 2021, we conducted an internet questionnaire survey for 310 people with epilepsy (PWE) and 213 ordinary people without epilepsy who registered on the database of the Japanese Research Company. We inquired PWE to answer the Epilepsy Self-Stigma Scale (ESSS), the Rosenberg Self-Esteem Scale (RSES), and the Epilepsy Knowledge Scale (EKS). We inquired to answer ordinary people without epilepsy EKS. We analyzed residential addresses separately for Greater Tokyo and non-urban areas by comparing the degree of knowledge of people with epilepsy and people without epilepsy., Results: The average knowledge of people with and without epilepsy in the Greater Tokyo area was 39.60 and 28.43 points, although in non-urban areas (nine regions from all over Japan except for the Greater Tokyo, Tokai region, and Kinki region), the knowledge averages were 38.44 and 28.66 points of 100. In addition, self-stigma was highest in the Greater Tokyo area: 22.99 and in non-urban areas: 22.77. An two-way ANOVA with knowledge as the dependent variable and epilepsy diagnosis status and region (Greater Tokyo area/non-urban areas) as the independent variables revealed no interaction between diagnosis and region (F(1,346) = 1.48, η 2  = 0.003). Knowledge was significantly higher in PWE than in people without epilepsy, but we could not identify any significant difference between ESSS (t = 0.24, d = 0.03) and RSES (t = 1.16, d = 0.16) in the Greater Tokyo/non-urban areas., Conclusions: We obtained specific information about regional differences in the level of knowledge and stigma about epilepsy in Japan. Because Japan underwent educational reforms after World War II and more than 90% of the population received equally advanced education, the results found no regional differences in knowledge and stigma about epilepsy. We believe collecting information about the respondents' birth and upbringing environment and conducting a thorough investigation is necessary in the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have seemed to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

To reduce microplastic (MP) discharge into the aquatic environment, it is necessary to properly identify its sources and amounts. Here, specific MP sources, i.e., personal care products (PCPs), fibers from clothes, and tire-wear particles (TWPs) were focused, and MP generations from these sources in the Tokyo Bay watershed, Japan, were estimated based on statistical data on production and reported emission factors of the MP sources and executing considering uncertainty on the data. Potential annual MP emission into Tokyo Bay was estimated to be 10.2 ± 1.6, 38 ± 22, and 1500-1800 tons for PCPs, fibers, and TWPs, respectively. Emissions into Tokyo Bay by assuming MP density and diameter was estimated. For fiber, the fraction to potential emission was estimated at 1.0-2.8 %. This study contributes to determining potential discharge pathways. This will assist in the application of appropriate measures to reduce MP discharge into water bodies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

As a pandemic hotspot in Japan, between March 1, 2020-October 1, 2022, Tokyo metropolis experienced seven COVID-19 waves. Motivated by the high rate of COVID-19 incidence and mortality during the seventh wave, and environmental/health challenges we conducted a time-series analysis to investigate the long-term interaction of air quality and climate variability with viral pandemic in Tokyo. Through daily time series geospatial and observational air pollution/climate data, and COVID-19 incidence and death cases, this study compared the environmental conditions during COVID-19 multiwaves. In spite of five State of Emergency (SOEs) restrictions associated with COVID-19 pandemic, during (2020-2022) period air quality recorded low improvements relative to (2015-2019) average annual values, namely: Aerosol Optical Depth increased by 9.13% in 2020 year, and declined by 6.64% in 2021, and 12.03% in 2022; particulate matter PM2.5 and PM10 decreased during 2020, 2021, and 2022 years by 10.22%, 62.26%, 0.39%, and respectively by 4.42%, 3.95%, 5.76%. For (2021-2022) period the average ratio of PM2.5/PM10 was (0.319 ± 0.1640), showing a higher contribution to aerosol loading of traffic-related coarse particles in comparison with fine particles. The highest rates of the daily recorded COVID-19 incidence and death cases in Tokyo during the seventh COVID-19 wave (1 July 2022-1 October 2022) may be attributed to accumulation near the ground of high levels of air pollutants and viral pathogens due to: 1) peculiar persistent atmospheric anticyclonic circulation with strong positive anomalies of geopotential height at 500 hPa; 2) lower levels of Planetary Boundary Layer (PBL) heights; 3) high daily maximum air temperature and land surface temperature due to the prolonged heat waves (HWs) in summer 2022; 4) no imposed restrictions. Such findings can guide public decision-makers to design proper strategies to curb pandemics under persistent stable anticyclonic weather conditions and summer HWs in large metropolitan areas., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 National Institute of R&D for Optoelectronics INOE 2000. Published by Elsevier Inc. All rights reserved.)

Background: The profile of deaths related to coronavirus disease of 2019 (COVID-19) that occurred outside the hospital in Japan remains unclear because of cautious stance on performing autopsies of COVID-19 positive cases., Methods: Autopsy cases that tested positive for COVID-19 in the Tokyo Metropolis from April 2020 to July 2022 were handled by medical examiners (n = 41). Age, sex, medical history, autopsy findings, cause of death, postmortem computed tomography (PMCT) findings, and the causal relationship between death and COVID-19 were examined., Results: The mean age of the deceased was 58.0 years (range: 28-96 years), and the study sample consisted of 33 males (80.5%) and 8 females (19.5%). The most frequent medical histories were hypertension (n = 7) and diabetes (n = 7), followed by mental disorders (n = 5). Nineteen cases showed a body mass index ≧25.0 (46.3%). The leading cause of death was pneumonia (n = 17), in which diffuse ground-glass opacification and/or consolidation was noted on PMCT. There were 26 deaths directly related to COVID-19 (63.4%), including pneumonia, myocarditis, laryngotracheobronchitis, and emaciation. The proportion of deaths directly related to COVID-19 was lower after 2022 (42.1%) than prior to 2022 (81.8%)., Conclusion: Pneumonia was the leading cause of death in this study sample; however, the causes of death in COVID-19 positive cases varied, especially after 2022, when the omicron variant was dominant. Mortality statistics may be affected by viral mutations, and the results of this study further emphasize the need for autopsy because more differential diagnoses should be considered in the phase of the omicron variant., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The eighth wave of COVID-19 infection in the Tokyo area has brought daily confirmed cases to a new higher level. This paper aims to explain the previous seven epidemic waves and forecast the eighth epidemic trend of the area using agent-based modeling and extended SEIR denotation. Four key considerations are investigated in this research, that are: 1. Vaccination, 2. Virus mutations, 3. Governmental policies and 4. PCR tests. Our study finds that the confirmed cases in the previous seven epidemic waves were only the tip of the iceberg. Using data prior to December 1 2022, the eighth wave is expected to hover high in December 2022 and January 2023. Our research pioneers in the simulation of antibody declination on an individual level. Comparing the simulated results, we find that the arrival of new epidemic waves are related to the decline in the number of antibody possessors, especially the sixth and the seventh epidemic waves. Our simulation also suggests that faced with low severe and death rates, PCR tests would not make much difference to reduce overall infections. In this case, maintaining PCR tests to a low level helps to reduce both social cost and public anxiety. However, if faced with the opposite case, PCR tests should be adjusted to a higher level to detect early infections. Such level of PCR tests should be compatible with available medical resources.

There is no nationwide necropsy database of animals in Japan, and most of the records are available from the postwar period. To clarify the chronological transition of animal necropsy cases in Tokyo, Japan, the records accumulated in The University of Tokyo from 1902 were investigated. Of necropsy records on paper or electronic from 1902 to 2021 kept at the Laboratory of Veterinary Pathology, The University of Tokyo, totally 3,137 cases including 572 in 1903-1914 (the Meiji-Taisho period), 1,258 in 1956-1969 (the Showa period) and 1,307 in 2006-2020 (the Heisei-Reiwa period), respectively, were examined for species, breed, age and pathological diagnosis. Dogs (44.6%) and horses (34.8%) in the Meiji-Taisho period, dogs (62.9%) and cats (17.3%) in the Showa period, and dogs (46.0%), cats (26.1%) and exotic animals (20.5%) in the Heisei-Reiwa period were the most necropsied animal species. With the passage of time, the number of animal species increased, and the breeds of dogs and cats came to be more various. The median ages of death were 2 years, 3 years and 10 years old in dogs in the Meiji-Taisho, Showa and Heisei-Reiwa periods, respectively, and 2 years and 10 years old in cats in the Showa and Heisei-Reiwa periods, respectively. Viral, bacterial and parasitic infections were decreased, and inversely tumor cases increased due to the prolonged lifespan.

During the first half of the twentieth century, Western psychiatry was quickly absorbed in Japan, particularly the versions from Germany and Austria. By 1940, over 130 psychiatric hospitals were caring for approximately thirty thousand patients in cities, while in rural areas about sixty thousand people still depended on family members for care. Japan's empire expanded during this same period, and many immigrants came to the country. Growth in immigration from Korea was particularly important. Korean immigrants encountered Japanese psychiatric hospitals during the second quarter of the twentieth century, and this paper examines the complex nature of their hospital stays.

We examine the historical changes of 236 U/ 238 U and 235 U/ 238 U in a sediment core collected in Tokyo Bay and elucidate the anthropogenic sources of uranium in the 1960s-2000s. Uranium-236 was detected in samples deposited in the 1960s-2000s, and the 236 U/ 238 U ratio of the sediment core shows peak values in the 1970s. The 235 U/ 238 U isotopic ratios in samples deposited in the early 1960s are almost identical to that of natural uranium, implying that the 236 U might have originated from global fallout. A decrease in 235 U/ 238 U was observed in the late 1960s-2000s, suggesting that depleted uranium from nuclear fuel reprocessing increased the 236 U/ 238 U ratios in the sediment. The 236 U/ 238 U values in sediments from the 1980s-2000s were lower than those in the 1970s but considerably higher than those in the 1960s, suggesting that the main source of depleted uranium still remains around Tokyo Bay. Our results demonstrated that the depleted uranium released in the 1970s should be considered as an important end-member when using uranium isotopic ratios as environmental tracers in closed aquatic environments around industrial cities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

A nested double neuston net was prepared and used to collect samples from the surface of coastal waters around Japan to obtain information about the properties of both small microplastics (SMPs; <350 μm) and large microplastics (LMPs; >350 μm). The SMP concentrations ranged from 1000 to 5900 pieces m -3 in the open ocean and averaged approximately 3000 pieces m -3 in the inner part of Tokyo Bay. The SMP concentrations were around 20-60 times greater than the LMP concentrations. By analyzing the seawater, we obtained a microplastic size distribution that spanned 50-5000 μm. The LMPs mainly comprised packaging-related plastics, such as polyethylene (PE) and polypropylene, while the SMPs were dominated by paint-related plastics. SMPs derived from packaging materials (e.g., PE) may have gradually sank down from the sea surface when they were smaller than 600 μm., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The doping control analyses at the XXXII Olympic Games (July 23 to August 8, 2021) and the XVI Paralympic Games (August 24 to September 5, 2021) held in Tokyo, Japan, after a year of delay due to the COVID-19 pandemic are summarized in this paper. A new satellite facility at the existing World Anti-Doping Agency (WADA)-accredited Tokyo laboratory was established and fully operated by 278 staff, including 33 Tokyo laboratory staff, 49 international experts, and 196 Japanese temporary staff. The numbers of urine samples were 5081 (Olympics) and 1519 (Paralympics), and the numbers of blood samples were 1103 (Olympics) and 500 (Paralympics). The laboratory could prepare for analysis in advance using a paperless chain-of-custody system, allowing for faster turnaround time reporting. For the first time, a new polymerase chain reaction method for detecting erythropoietin (EPO) gene doping was used. The laboratory also analyzed blood samples for detecting steroid esters following the spotting of collected venous EDTA blood onto dried blood spot cards. Moreover, full-scan data acquisition using high-resolution mass spectrometers was performed for all urine samples, allowing for detecting traces of doping substances, which are not currently analyzed in the subsequent data processing. The presence of some prohibited substances was confirmed, resulting in 8 atypical findings (ATFs) and 11 adverse analytical findings (AAFs), including homologous blood transfusion (2 cases) and recombinant EPO in the blood (1 case), at the Olympics, whereas 2 ATFs and 10 AAFs were reported at the Paralympics., (© 2022 John Wiley & Sons Ltd.)

Background: COVID-19 vaccines have been used across Japan since 17 February 2021, and as of 17 April 2022, 1690 deaths potentially caused by vaccine-related adverse effects have been reported to the Ministry of Health, Labour and Welfare. However, the causal relationship between vaccination and death could not be fully evaluated because of a lack of sufficient information., Methods: Autopsy cases in which deaths occurred within seven days after COVID-19 vaccination in Tokyo Metropolis and were handled by medical examiners were selected (n = 54). Age, sex, vaccine-related information, cause of death, and possible causal relationship between vaccination and death were examined., Results: The mean age of the deceased individuals was 68.1 years, and the study sample consisted of 34 males (63.9%) and 20 females (37.0%). Thirty-seven and six individuals received Comirnaty and Spikevax, respectively (68.5% and 11.1% respectively). The manner of death included natural (n = 43), non-natural (n = 8), and undetermined (n = 3). The most frequent cause of death was ischemic heart disease (n = 16). Regarding causal relationships, 46 cases (85.2%) did not show a causal relationship to vaccination, except for myocarditis (n = 3), thrombosis-related death (n = 4), and others (n = 1)., Conclusion: Although many cases of deaths after COVID-19 vaccination in this study showed no definite causal relationship between the vaccination and deaths, some cases showed possible adverse events such as myocarditis. Autopsies are essential for detecting vaccine-related deaths, and the Japanese death investigation system needs to be reinforced from this viewpoint., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This paper explores domestic dynamics in the complex making of institutional psychiatry in Japan in c . 1920-45. It mainly examines gender issues between the relatively long-lasting system of the family care of mentally ill members and the use of freshly introduced systems of psychiatric hospitals. I shall look at the record of Ohji Brain Hospital (1901-45) in Tokyo, which has several thousands of case histories mainly in Tokyo c . 1920-45. From the analysis of the cases of male and female patients, as well as the complex situations of their households and kin groups, I shall look at the gender issues in the making of the psychiatric hospital regime.

Background: The number of coronavirus disease 2019 (COVID-19) cases was expected to increase during the Tokyo Olympic Games because of the increased physical contact within and between the domestic population and international participants of the Games. The rapid rise of the Delta variant (B.1.617) in Japan meant that hosting the Olympic Games without any restrictions was likely to lead to an increase in cases. We aimed to quantitatively assess possible COVID-19 response strategies for the Olympic Games, comparing the prevalence of severe cases and the cumulative number of COVID-19 deaths via scenario analysis., Methods: We used a discrete-time deterministic compartmental model structured by age group. Parameters were calibrated using the age-stratified COVID-19 incidence data in Osaka. Numerical simulations incorporated the planned Olympics Games and nationwide COVID-19 vaccination into the proposed model, alongside various subjects and types of countermeasures., Results: Our model-informed approach suggested that having spectators at the Tokyo Olympic Games could lead to a surge in both cases and hospitalization. Projections for the scenario that explicitly incorporated the spread of the Delta variant (i.e., time-dependent increase in the relative transmissibility) showed that imposing stringent social distancing measures (R t =0.7) for more than 8 weeks from the end of the Olympic Games might be required to suppress the prevalence of severe cases of COVID-19 to avoid overwhelming the intensive care unit capacity in Tokyo., Conclusions: Our modeling analyses guided an optimal choice of COVID-19 response during and after the Tokyo Olympic Games, allowing the epidemic to be brought under control despite such a large mass gathering., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

The coronavirus disease (COVID-19) pandemic has aggravated anxiety and depression worldwide, particularly in patients with chronic illnesses and mental disorders. Using validated questionnaires, in this paper, we examine the psychological effects of the pandemic in Japan in detail. The General Mental Health Scale (GHQ), the State-Trait Anxiety Inventory (STAI), and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess mental health, state and trait anxiety, and depression, respectively. The survey was completed during the patients' first visits to the clinic of Psychosomatic Internal Medicine from November 2018 to April 2021. The Mann-Whitney U test was used to compare data from 226 participants before and during the COVID-19 pandemic. The GHQ total, GHQ subscales of "social dysfunction" and "anxiety and dysphoria", and state anxiety scores were significantly higher during than before the pandemic. The GHQ total, some GHQ subscales, and state anxiety scores were significantly higher among male than female participants during the pandemic. The GHQ total, some GHQ subscales, CES-D, and state anxiety scores in those aged 10-39 years were significantly higher. Thus, the COVID-19 pandemic may have caused mental health changes in many individuals based on their gender, age, and with time.

Background: The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud's segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021., Methods: The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts' opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations., Results: This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed., Conclusions: The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system., (© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

Do different degrees of cleanliness preference affect consumers' choice of daily drinking water at home? The purpose of the present paper is to test the validity of various hypotheses related to this question by analyzing the results of an online survey conducted in the Tokyo area. Cleanliness has an aspect of personal norm for normalcy of things. Preference of cleanliness can be divided into the following two types. One is orderly cleanliness and the other is aversive cleanliness. Orderly cleanliness is oriented toward the control of impure things, while aversive cleanliness is oriented toward retention of immaculacy. We demonstrate that each of these cleanliness preference is involved in the choice of drinking water in its own way. Our survey results suggest that orderly cleanliness encourages the choice of tap water filtered through water purifier, while aversive cleanliness urges the choice of bottled water.

Airborne pollens cause pollinosis and have the potential to affect microphysics in clouds; however, the number of monitored species has been very limited due to technical difficulties for the morphotype identification. In this study, we applied an eDNA approach to the airborne pollen communities in the suburbs of the Tokyo metropolitan area in Japan, within a mixed urban, rural, and mountain landscape, revealing pollen seasonality of various taxa (a total of 78 families across the period) in the spring season (February to May). Those taxa distinctly shifted in the season, especially in the beginning of February and the middle of April. Air temperature shift was an obvious key factor to affect the airborne pollen community, while the influence of other meteorological factors, such as wind speed, humidity, and precipitation, was not clear. Taxonomic classification of major Amplicon Sequence Variants (ASVs) indicates multiple pollen sources, including natural forest, planted forest, roadside, park lands, and horticultural activities. Most major ASV belongs to Japanese cedar (Cryptomeria japonica), which is the most notable allergen that causes pollinosis in Japan, peaking in mid-February to March. Backward trajectory analysis of air masses suggests that the Japanese cedar and other Cupressaceae plantation forests in the western mountains were a significant source of airborne pollen communities detected at our sampling site. Other major plant pollen sources, including Japanese zelkova (Zelkova serrata) and ginkgo (Ginkgo biloba), emanated from the nearby parks or roadside regions. This study's approach enables us to visualize the phenology of multiple pollen, including timing and duration. Long-term monitoring of this type would provide additional insight into understanding the role of climate change on pollen transmission and links to flowering events., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: The SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test is useful for diagnosing COVID-19, and the RT-PCR positive rate is an important indicator for estimating the incidence rate and number of infections. COVID-19 pneumonia is also associated with characteristic findings on chest CT, which can aid in diagnosis., Methods: We retrospectively evaluated patient background characteristics, the number of cases, the positivity rate, and chest CT findings for positive and negative cases in 672 patients who underwent RT-PCR for suspected COVID-19 at our hospital between April 3 and August 28, 2020. In addition, we compared trends in the positive rates at approximately weekly intervals with trends in the number of new infections in Machida City, Tokyo., Results: The study included 323 men and 349 women, with a median age of 46 years (range: 1 month-100 years). RT-PCR findings were positive in 37 cases, and the positive rate was 5.51%. Trends in the positive rate at our hospital and the number of new COVID-19 cases in the city were similar during the study period. Among patients with positive results, 15 (40.5%) had chest CT findings, and 14 had bilateral homogeneous GGOs. Among patients with negative results, 190 had chest CT findings at the time of examination, and 150 were diagnosed with bacterial pneumonia or bronchitis, with main findings consisting of consolidations and centrilobular opacities. Only 11 of these patients exhibited bilateral homogeneous GGOs., Conclusion: Bilateral homogeneous GGOs are characteristic of COVID-19 pneumonia and may aid in the diagnosis of COVID-19., Competing Interests: Taisuke Kazuyori, Akihito Sato, Yasuhiro Morimoto, and Kazuyoshi Kuwano declare no conflicts of interest regarding the publication of this paper., (Copyright © 2021 Taisuke Kazuyori et al.)

The primary concentration and molecular process are critical to implement wastewater-based epidemiology for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the previously developed methods were optimized for nonenveloped viruses. Few studies evaluated if the methods are applicable to the efficient recovery of enveloped viruses from various types of raw sewage. This study aims (1) to compare the whole process recovery of Pseudomonas phage φ6, a surrogate for enveloped viruses, among combinations of primary concentration [ultrafiltration (UF), electronegative membrane vortex (EMV), and polyethylene glycol precipitation (PEG)] and RNA extraction methods (spin column-based method using QIAamp Viral RNA Mini Kit and acid guanidinium thiocyanate-phenol-chloroform extraction using TRIzol reagent) for three types of raw sewage and (2) to test the applicability of the method providing the highest φ6 recovery to the detection of SARS-CoV-2 RNA. Among the tested combinations, PEG+TRIzol provided the highest φ6 recovery ratio of 29.8% to 49.8% (geometric mean). UF + QIAamp Viral RNA Mini Kit provided the second highest φ6 recovery of 6.4% to 35.8%. The comparable φ6 recovery was observed for UF + TRIzol (13.8-30.0%). PEG + QIAamp Viral RNA Mini Kit provided only 1.4% to 3.0% of φ6 recovery, while coliphage MS2, a surrogate for nonenveloped viruses, was recovered comparably with PEG + TRIzol. This indicated that the nonenveloped surrogate (MS2) did not necessarily validate the efficient recovery for enveloped viruses. EMV + QIAamp Viral RNA Mini Kit provided significantly different φ6 recovery (1.6-21%) among the types of raw sewage. Then, the applicability of modified PEG + TRIzol was examined for the raw sewage collected in Tokyo, Japan. Of the 12 grab samples, 4 were positive for SARS-CoV-2 CDC N1 and N3 assay. Consequently, PEG + TRIzol provided the highest φ6 recovery and allowed for the detection of SARS-CoV-2 RNA from raw sewage., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Fine particulate matter (PM 2.5 ) is composed of a variety of chemical components, and the dependency of the health effects of total PM 2.5 on specific components is still under discussion. We hypothesised that specific PM 2.5 components are responsible for the health effects, and investigated the association between PM 2.5 components and mortality in 23 Tokyo wards. We obtained mortality data from the Ministry of Health, Labour and Welfare for the period from April 2013 to March 2017. At a monitoring site within the study area, we collected daily samples of PM 2.5 on a filter, and determined the daily mean concentrations of total carbon (organic carbon and elemental carbon) and ions such as nitrate and sulphate. A case-crossover design was employed, and a conditional logistic regression model was used to estimate the strength of the association. Over the study period, we identified 280,460 total non-accidental deaths, and the average daily mean concentration of total PM 2.5 was 16.0 (standard deviation = 8.9) μg/m 3 . We observed a positive association of total PM 2.5 with total, cardiovascular, and respiratory mortality. After adjustment for total PM 2.5 and its components associated with mortality in the single-component models, the percentage increase per interquartile range (2.3 μg/m 3 ) increase in the average total carbon concentration of the case- and previous-day was 2.1% (95% confidence interval = 1.0 to 3.1%) for total mortality. Carbon elements were associated with respiratory but not cardiovascular mortality. Our results suggest that specific components of PM 2.5 account for its adverse health effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

With increasingly stringent regulations on emission criteria and environment pollution concerns, marine fuel oils (particularly heavy fuel oils) that are commonly used today for powering ships will no longer be allowed in the future. Various maritime energy strategies are now needed for the long-term upgrade that might span decades, and quantitative predictions are necessary to assess the outcomes of their implementation for decision support purpose. To address the technical need, a novel approach is developed in this study that can incorporate the strategic implementation of fuel choices and quantify their adequacy in meeting future environmental pollution legislations for ship emissions. The core algorithm in this approach is based on probabilistic simulations with a large sample size of ship movement in the designated port area, derived using a Bayesian ship traffic generator from existing real activity data. Its usefulness with scenario modelling is demonstrated with application examples at five major ports, namely the Ports of Shanghai, Singapore, Tokyo, Long Beach, and Hamburg, for assessment at Years 2020, 2030, and 2050 with three economic scenarios. The included fuel choices in the application examples are comprehensive, including heavy fuel oils, distillates, low sulphur fuel oils, ultra-low sulphur fuel oils, liquefied natural gas, hydrogen, biofuel, methanol, and electricity (battery). Various features are fine-tuned to reflect micro-level changes on the fuel choices, terminal location, and/or ship technology. Future atmospheric pollutant emissions with various maritime energy strategies implemented at these ports are then discussed comprehensively in details to demonstrate the usefulness of the approach., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study leverages satellite remote sensing to investigate the impact of the coronavirus outbreak and the resulting lockdown of public venues on air pollution levels in East Asia. We analyze data from the Sentinel-5P and the Himawari-8 satellites to examine concentrations of NO 2 , HCHO, SO 2 , and CO, and the aerosol optical depth (AOD) over the BTH, Wuhan, Seoul, and Tokyo regions in February 2019 and February 2020. Results show that most of the concentrations of pollutants are lower than those of February 2019. Compared to other pollutants, NO 2 experienced the most significant reductions by almost 54%, 83%, 33%, and 19% decrease in BTH, Wuhan, Seoul, and Tokyo, respectively. The greatest reductions in pollutants occurred in Wuhan, with a decrease of almost 83%, 11%, 71%, and 4% in the column densities of NO 2 , HCHO, SO 2 , and CO, respectively, and a decrease of about 62% in the AOD. Although NO 2 , CO, and formaldehyde concentrations decreased in the Seoul and Tokyo metropolitan areas compared to the previous year, concentrations of SO 2 showed an increase in these two regions due to the effect of transport from polluted upwind regions. We also show that meteorological factors were not the main reason for the dramatic reductions of pollutants in the atmosphere. Moreover, an investigation of the HCHO/NO 2 ratio shows that in many regions of East China, particularly in Wuhan, ozone production in February 2020 is less NO X saturated during the daytime than it was in February 2019. With large reductions in the concentrations of NO 2 during lockdown situations, we find that significant increases in surface ozone in East China from February 2019 to February 2020 are likely the result of less reaction of NO and O 3 caused by significantly reduced NO X concentrations and less NO X saturation in East China during the daytime., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

We continue (Ref. 1: Proc. Jpn. Acad. Ser. B 97, 22-49) to analyze the COVID-19 status. We concentrate on the following issues in this work:1. Effect of vaccination against the spreading of SARS-CoV-2.2. General landscape of the world situation concerning vaccinations.3. Some aspects of the new variants of SARS-CoV-2.Our findings include:1. With vaccinations, it is fair to say that we have entered a new phase in the fight against the virus SARS-CoV-2. We have analyzed some preliminary data to find how vaccinations can be effective against COVID-19 spreading. This analysis is based on, and is a continuation of, our first paper quoted in Ref. 1.2. If Tokyo (or Japan) continues to keep its vaccination schedule (starting in early April, 2021 and finishing it for elderly, 65 or older, in 4 months), it will see a sign of control of the virus in early June, 2021 although we see changes of this status due to new, more contagious variants.3. The strength (parameter β) of a new contagious variant can be estimated based on the initial data on the variant (Section 5).

Most single-factor and multifactor asset pricing models constitute special cases of the consumption-based asset pricing theory, in which investors' marginal utility is the key determinant of asset prices. However, in recent years, production-based asset pricing models have been extraordinarily successful in correctly pricing a wide range of anomaly portfolios that are typically mispriced in previous research. In parallel, research on conditioning information has contributed to significantly improve the performance of classic consumption-based asset pricing models. On this basis, in this paper we conduct an in-depth research on the performance of consumption and production-based asset pricing models on the Tokyo Stock Exchange, for the period from 1992 to 2018, in order to test to what extent consumer confidence helps consumption models to correctly capture shifts in the investment opportunity set of investors. To overcome the constraints imposed by the periodicity of macroeconomic data, we use a factor-mimicking portfolio approach that allows us to test the performance of the models into consideration at different frequencies. Our results suggest that the consumer confidence index for Japan helps consumption-based asset pricing models outperform production-based models for different anomaly portfolios. Conversely, in those cases where consumption models perform worse, the production models also perform poorly. These results help to partially reconcile the results provided by the consumption and production models, and constitute a step forward for the purpose of identifying the fundamental risk factors that drive asset prices., Competing Interests: The authors have declared that no competing interests exist.

Economies are frequently affected by natural disasters and both domestic and overseas financial crises. These events disrupt production and cause multiple other types of economic losses, including negative impacts on the banking system. Understanding the transmission mechanism that causes various negative second-order post-catastrophe effects is crucial if policymakers are to develop more efficient recovery strategies. In this work, we introduce a credit-based adaptive regional input-output (ARIO) model to analyse the effects of disasters and crises on the supply chain and bank-firm credit networks. Using real Japanese networks and the exogenous shocks of the 2008 Lehman Brothers bankruptcy and the Great East Japan Earthquake (March 11, 2011), this paper aims to depict how these negative shocks propagate through the supply chain and affect the banking system. The credit-based ARIO model is calibrated using Latin hypercube sampling and the design of experiments procedure to reproduce the short-term (one-year) dynamics of the Japanese industrial production index after the 2008 Lehman Brothers bankruptcy and the 2011 Great East Japan earthquake. Then, through simulation experiments, we identify the chemical and petroleum manufacturing and transport sectors as the most vulnerable Japanese industrial sectors. Finally, the case of the 2011 Great East Japan Earthquake is simulated for Japanese prefectures to understand differences among regions in terms of globally engendered indirect economic losses. Tokyo and Osaka prefectures are the most vulnerable locations because they hold greater concentrations of the above-mentioned vulnerable industrial sectors., Competing Interests: The authors have declared that no competing interests exist.

The tuberculosis (TB) notification rate in Japan is gradually decreasing but has not yet achieved "pre-elimination," defined by the World Health Organization. To effectively tackle, control, and eliminate TB, estimating and monitoring the annual risk of TB infection (ARI) using tuberculin skin testing (TST) to understand the dynamics of TB epidemiology are significantly important. However, studies estimating ARIs using TST are few considering that Bacillus Calmette-Guérin vaccination coverage is high in Japan. This was a single-center, cross-sectional study conducted between January 2011 and December 2018 in Tokyo area where interferon-gamma release assays (IGRAs) were performed in newly hired researchers of Keio University School of Medicine and healthcare workers of Keio University Hospital to determine TB infection. We estimated the prevalence of TB infection and ARI based on their IGRA results. Among the 3908 subjects, 83 (2.124%) had positive IGRA results. Multiple logistic regression analysis revealed that age was a significant risk factor for positive IGRA result (adjusted odds ratio, 1.046). The ARIs were 0.049%-0.156% between 1986 and 2004, midyears of TB infection, but have not significantly decreased over approximately two decades. To decrease the risk of TB infection, advanced strategies to control and eliminate TB in Tokyo area are significantly required., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare on the subject of this paper., (Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

The measurement of radioactivity in food and agricultural ecosystems is an essential task for keeping the population safe after a nuclear emergency. Prior to the Tokyo Electric Power Company's Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident in 2011, the probability of such an accident, combining complex effects of natural and technical factors, was not reflected in detail in national emergency preparedness guidelines. The lack of such guidelines resulted in a limited efficiency response to the Fukushima accident in agriculture. This outcome showed a need for the preparation of such guidelines as a part of emergency preparedness for nuclear and radiological emergences. This paper provides information and generic, non-country-specific guidance on approaches to sampling food. The paper is intended for scientists, policy makers and decision makers involved in nuclear emergency preparedness and responses, particularly on large scales and at different stages of nuclear emergency based on lessons learned from the FDNPP accident., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: For novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use. This pilot study was performed to examine the use of tobacco products in three Japanese urban regions., Methods: This study was a cross-sectional epidemiological survey administered in Sendai, Tokyo and Osaka, Japan, from May 19th to June 25th, 2018. Participants were selected with a three-stage probability random sampling process that first identified primary sampling units, then households and finally individuals. Eligible participants were aged at least 20 years who were willing to participate after information about the study was provided. People younger than 20 years and those living in institutions were excluded. Questionnaires were paper based and administered door to door., Results: Responses were obtained from 4154 participants. Sixty-five percent self-reported being never, 19% current and 16% former users of any tobacco product at the time of the survey. Combustible tobacco products (almost all being cigarette) were used most (16%) followed by HTPs (5%). In the categories of combustible tobacco users and HTP users, 70% and 16%, respectively, used these products exclusively. Dual use was reported by 11% of respondents. Compared with 12 months before the survey, 12% of sole combustible tobacco products users were using HTPs exclusively or as dual users and 6% had quit tobacco products completely; 94% of sole HTP users remained sole users and 4% had quit tobacco products completely; and amongst dual users 12% had reverted to exclusive use of combustible tobacco products, 14% had switched to sole use of HTPs and 4% had quit tobacco products completely., Conclusion: HTPs seem to be accepted as an alternative tobacco product amongst combustible tobacco users. Given complex findings for dual use, improved understanding of the motivations underlying this behaviour would be of interest.

The Gd-based contrast agents utilized in magnetic resonance imaging are difficult to remove by usual sewage treatment technology, and they enter rivers in the discharges from waste water treatment plants. Gd anomaly in rivers has been considered depends on used amount of Gd-based contrast agents. In this study, variation of Gd anomaly in rivers of Tokyo was determined by comparisons to previously reported values. The range of anthropogenic Gd was 0.1-138.8 ppt with an average value of 35.5 ppt (n = 40); in particular, the anthropogenic Gd was significantly changed depending on the location of the waste water treatment plants, and the measurement revealed significant increases in the Gd anomaly in the range of 5.0-6.6 times compared to data obtained 22 years ago. This study highlights the necessary of continuous research in setting new public policies for medical practices., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

We investigated differences in the feeding habits of the starspotted smooth-hound, Mustelus manazo, in Tokyo Bay between the mid-1990s (low stock size) and the late 2000s (high stock size). The frequency of M. manazo with empty stomachs increased from 5.9% in the mid-1990s to 16.1% in the late 2000s. A decrease in the relative weight of the stomach contents was evident from the mid-1990s to the late 2000s, especially in the small size classes, along with changes in the species composition in the stomach contents. Although crustaceans were the main constituents of the stomach contents, the proportion of crabs increased while those of shrimps and hermit crabs decreased. Changes in the feeding habits of M. manazo may be associated with shifts in the benthic community structure in Tokyo Bay., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

PCBs and PBDEs in microplastics and zooplankton collected in surface water at 27 locations in the Pacific Ocean and around the coast of Japan were investigated. Both PCBs and PBDEs were observed in buoyant microplastics, even in smaller particles of 0.315-1 mm. Concentrations of Σ13 PCBs were 0.04-124 ng/g, and were higher in urban bay areas such as Tokyo Bay. Sporadic moderate to high concentrations of PBDEs were observed in both urban-offshore and rural-offshore locations, consisting mostly of higher-brominated congeners. From the latter, BDE 209 ranged from not detected to 2158 ng/g. The microplastic-to-zooplankton abundance ratio threshold was 0.6 for PCBs and 0.08 for PBDEs, above which exposure would be greater from microplastics than from zooplankton., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

There have been prior attempts to utilize machine learning to address issues in the medical field, particularly in diagnoses using medical images and developing therapeutic regimens. However, few cases have demonstrated the usefulness of machine learning for enhancing health consciousness of patients or the public in general, which is necessary to cause behavioral changes. This paper describes a novel case wherein the uptake rate for colorectal cancer examinations has significantly increased due to the application of machine learning and nudge theory. The paper also discusses the effectiveness of social impact bonds (SIBs) as a scheme for realizing these applications. During a healthcare SIB project conducted in the city of Hachioji, Tokyo, machine learning, based on historical data obtained from designated periodical health examinations, digitalized medical insurance receipts, and medical examination records for colorectal cancer, was used to deduce segments for whom the examination was recommended. The result revealed that out of the 12,162 people for whom the examination was recommended, 3264 (26.8%) received it, which exceeded the upper expectation limit of the initial plan (19.0%). We conclude that this was a successful case that stimulated discussion on potential further applications of this approach to wider regions and more diseases.

Background: Glycemic variability has been suggested to be related to some unfavorable outcomes, but malignancy development has not been evaluated. The aim of this study was to evaluate the association of glycemic variability with malignancy development among the population without diabetes., Methods: We conducted a retrospective cohort study at a large teaching hospital in Tokyo, Japan, from 2005 to 2016. We included all participants without diabetes who underwent voluntary health check-ups. Our outcome was the development of any malignancy. As a measure of glycemic variability, we calculated the quotient of CV in HbA1c and categorized subjects into quartile groups. A Cox proportional hazard model was applied, adjusting for patient demographics and social and family histories., Results: A total of 42,731 participants were included in this study; the mean age was 53.8 and 48.3% were male. During the median follow up of 2639 (interquartile range (IQR):1787-3662) days, 2435 participants (5.7%) developed malignancies. Participants who had larger glycemic variability (CV in HbA1c; hazard ratio (HR) 1.15, 95%confidence interval (CI):1.02-0.31 for the second quartile group; HR 2.20, 95%CI:1.95-2.48 for the third quartile group, HR 4.66, 95%CI:4.16-5.21 for the fourth quartile group, compared to first quartile group) had a significantly higher risk of malignancies., Conclusion: We found an association between large glycemic variability and a high risk of future malignancies in a dose-dependent manner among people without diabetes. This finding suggests that maintaining a constant level of glucose may have favorable effects on cancer prevention in people without diabetes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier B.V. All rights reserved.)