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A diet supplemented with cholic acid (CA), the primary 12α-hydroxylated bile acid, can induce hepatic lipid accumulation in rats without obesity. This study examined the effects of a CA-supplemented diet on blood pressure (BP). After acclimation, WKAH/HkmSlc rats (3 weeks old) were divided into two groups and fed with a control AIN-93-based diet or a CA-supplemented diet (0.5 g CA/kg) for 13 weeks. The CA diet increased systolic and diastolic BP as well as hepatic lipid concentrations in the rats. No changes were found in the blood sodium concentration. Urinary albumin concentration increased in CA-fed rats. An increase was observed in the hepatic expression of ATP-binding cassette subfamily B member 1B that correlated BPs and urinary albumin concentration accompanied by an increase in portal taurocholic acid concentration. These results suggest that 12α-hydroxylated bile acids are involved in increased BP and albuminuria via alteration of hepatic function.

A lot of sound can be heard in a hospital. The Ministry of Environment recommends that noise be kept below 50 dBA during the day and below 40 dBA at night to maintain a calm environment inside a medical facility. However, the noise in general wards typically exceeds these standards; therefore, it is necessary to adjust these sounds to foster patients’ recuperation. We examined whether the noise generated by nurses in a simulated ward changes with walking speed and the presence or absence of luggage. Sounds generated by nurses include footsteps and pass-by sound from objects (e.g., wagon, stretchers, wheelchairs, bedside tables, overhead tables, beds, IV poles.). Walking speed was classified into three types: slow (0.5 m/s), normal (1 m/s), and fast (2 m/s). Sound (dBA) was measured by measuring the pass-by sound generated when moving in a straight distance (four meters) in the corridor of a simulated ward. Objects were also compared for their pass-by sound generated with and without a load. Results revealed that normal and fast walking speeds generated louder sounds than did the slow speed (the volume of slow, normal, and fast speeds were 37.0 dBA, 39.3 dBA, and 38.7 dBA, respectively). The pass-by sound of objects increased in volume in proportion to nurses’ walking speed. The pass-by sound of wagons and stretchers was significantly lower when they had (vs. did not have) a load; however, the reverse was true for wheelchairs carrying patient dummies. The sound of footsteps did not change per walking speed. Decreasing walking speed may thus lead to noise modification. Nurses’ awareness of adjusting their walking speed per object use may prevent noise pollution. This study was conducted to obtain basic data regarding the wards’ sound environment. Future studies should consider the occurrence of the sound in clinical settings.

Background We previously conducted a survey on users of tele-health consultations system to investigate their willingness to pay (WTP). To assess the economic value of the tele-health system, we need to investigate the demand and value of the tele-health in another way. Therefore, the purpose of this study is to submit basic information to create a sustainable business model and to investigate the economic value of the tele-health consultation system. Methods The 480 respondents were instructed to assume an environment where a tele-health consultation system is implemented in a region with no prior experience with such a service. This study adopted a Contingent Valuation Method to measure the demand and value of tele-health. A WTP fee for using the tele-health consultation system for 10 min was calculated using a Double-Bounded Dichotomous Choice and a Random Utility Logit Model. Results The median and average amount of the WTP fee for using the tele-health consultation system for 10 min was ¥ 367 (US$ 3.30) and ¥ 495 (US$ 4.40) respectively. Further analysis indicates that the WTP fee tends to be higher when a certain factor is present, namely, intention to use the service. Conclusion To gather basic information concerning the economic value of the tele-health consultation system, we clarified the appropriate WTP fee and the factors leading to a higher WTP fee. In future research, we will conduct follow-up research and consider adding more information concerning the advantages and limitations of implementing remote health consulting to build a clearer scenario.

Humans perceive sound lags and differences in loudness between their two ears to ascertain the location of sounds in terms of azimuth, elevation and interval, etc. Humans and animals can determine the direction of sounds using only two ears, by making use of interaural time difference (ITD), interaural phase difference (IPD), interaural intensity difference (IID), etc. Robots can also use sound localization to detect changes in the environment around them; consequently, various sound localization methods for robots have been investigated. Since many animals have two ears, two ears seem to be the minimum requirement for determining sound localization. While most robot’s sound localization systems are based on microphone arrays that consist of three or more microphones, several researchers have attempted achieving binaural sound localization in robots. Nakashima (Nakashima and Mukai, 2004) developed a system that consisted of two microphones with pinnae and a camera that was only utilized in learning. By adopting a neural network that estimated the control command, he proposed a method utilizing sound signals for guiding the robot in the direction of a sound. Takanishi (Takanishi et al., 1993) achieved continuous direction localization of a sound source in the horizontal plane. They used the interaural sound pressure difference and the ONSET time difference as parameters and proposed a method for achieving two-step direction localization in a humanoid head using these parameters. Kumon (Kumon et al., 2003) approached the problem using an adaptive audio servo system based on IID as the control method for orientating the robots in the direction of the sound source in the horizontal plane by using two microphones. This chapter describes the use of an audio servo of elevation for achieving sound localization using spectral cues caused by pinnae. Here, the term “audio servo” denotes a method for simultaneously localizing sound sources and controlling the robot’s configuration, in contrast with conventional methods that are based on the “listen-and-move” principal. The audio servo is characterized by a feedback system that steers the robot toward the direction of the sound by combining dynamic motion of the robot with auditory ability. In order to achieve this, this chapter proposes a method for detecting instantaneous spectral cues, when these cues are not very accurate. Furthermore, controllers that compensate for the inaccuracy of the measured signalare also considered. In addition, this

Background: Despite a long average lifespan, increased life expectancy does not guarantee higher quality of life. Methods: To contribute in understanding some determinants of healthy life expectancies in older Japanese individuals in a snowy winter region, we investigated the indicators of health. Local residents (n = 124) in the city of Iwamizawa volunteered for health examinations from January 2016 to March 2016. We recorded activity via daily steps for 2-week periods. In addition, we measured body composition, grip strength, and assessed nutritional status. Results: Analysis of body composition and daily activity indicated that women who walked more than 4000 steps had lower fat mass and increased muscle mass. Men with &gt, 3.0 metabolic equivalents (METs) when walking had lower body fat. Conclusion: For healthy older Japanese individuals in this snowy winter region, walking &gt, 4000 steps daily for women and exercise of &gt, 3.0 METs for men may indicate health-promoting activities.

Background Inbred strains are characterized by less genetic variation, which suggests usefulness of inbred strains for evaluations of various parameters. In this study, experimental reproducibility in several parameters was compared between an outbred Wistar rat and Wistar King A Hokkaido (WKAH/HkmSlc) rat, the inbred strain that is originated from Wistar rats. Methods Difference of variations was investigated in parameters of body compositions and liver functions such as body weight, liver weight, liver triglycerides (TG), liver cholesterol and plasma alanine aminotransferase activity (ALT) between WKAH rats and outbred Wistar rats by using the coefficient of variation (CV). Results There was no difference in the CVs of body weight and relative liver weight between WKAH and Wistar rats. The CVs of body weight and relative liver weight were below 10% in both WKAH and Wistar rats. The CVs of TG, cholesterol, and ALT in Wistar rats were between 30 and 40%, whereas those in WKAH rats were between 10 and 25%. A low CV level of TG was observed in WKAH rats compared to that in Wistar rats regardless of the duration of the experimental period in those rat strains. Conclusion The low CV values in metabolic parameters involved in liver functions in the inbred rats suggested an advantage of using inbred rather than outbred rats for the evaluation of liver lipid metabolism.

Previous works have demonstrated considerable variability in hospital cleanliness in Japan, suggesting that contamination is driven by factors that are currently poorly controlled. We undertook 16S rRNA sequence analysis to study population structures of hospital environmental microbiomes to see which factor(s) impacted contamination. One hundred forty-four samples were collected from surfaces of three hospitals with distinct sizes (“A”: >500 beds, “B”: 100–500 beds, “C”

Background Nurses are responsible for implementing appropriate measures to reduce hospital infections, especially with multidrug resistant bacteria, so nursing students should learn about microbiology. This helps them to understand bacterial dissemination and infectious disease control. Because of tight schedules, however, its teaching is limited in undergraduate nursing classes in Japan. We therefore tested whether a simple short practical session in a microbiology class could help to improve undergraduate nursing students’ awareness of bacterial traits and how to prevent infections. Methods This study involved second-grade nursing students (n = 76). Two short practical sessions (a total of 3 h, across 2 days) were used to assess the effectiveness of washing or disinfection on hand bacteria in a 16-class microbiology course (total class time was 24 h, plus an exam). Hand bacteria were sampled on LB agar plates with orientation during the first half-day, and the plates examined for colonies with distinct color or morphological traits, and discussed, in the second session, a week later. Questionnaires before and after the exercise were used to assess changes in awareness of unseen bacteria inhabiting around us connecting bacterial traits and how to prevent infections. Results The results showed that the practical increased the nursing students’ awareness of fomites (utensils) (p = 0.0115), fomites (contact-based) (p = 0.0016), habitats (body surface) (p = 0.0127), action facilitating hospital infection (p = 0.0166), and changes in physical condition caused by bacterial infections (p = 0.0136). There were no changes in word associations (p = 0.627) or habitats (inside body) (p = 0.308). Difficulty score, which is an element in questionnaire psychometric properties, tended to be close to the expected score through the practical, but not statistical significant. In addition, regardless of before or after practical, Cronbach α score, which is an indicator of the reliability among items of multi-choice questions, showed > 0.8, indicating validity of evaluation items. Thus, the student’s awareness of unseen bacteria inhabiting around us was significantly increased as compared to those before practical in microbiology class. Conclusions The simple short practical effectively improved nursing students’ awareness of unseen bacteria inhabiting around us in microbiology course, useful for even tight teaching schedules.

We monitored the survival of human pathogenic bacteria [Escherichia coli (ATCC), extended-spectrum beta-lactamase-producing E. coli (Clinical isolate), New Delhi metallo-beta-lactamase-producing E. coli (clinical isolate), Staphylococcus aureus (ATCC)] on dry materials (vinyl chloride, aluminum, plastic, stainless steel) at distinct temperatures (room temperature or 15 degrees C-37 degrees C). These bacteria favored a lower temperature for their prolonged survival on the dry fomites, regardless of the material type. Interestingly, when mixed with S. aureus, E. coli survived for a longer time at a lower temperature. Cardiolipin, which can promote the survival of S. aureus in harsh environments, had no effect on maintaining the survival of E. coli. Although the trends remained unchanged, adjusting the humidity from 40% to 60% affected the survival of bacteria on dry surfaces. Scanning electron microscopic analysis revealed no morphological differences in these bacteria immediately before or after one day of dry conditions. In addition, ATP assessment, a method used to visualize high-touch surfaces in hospitals, was not effective at monitoring bacterial dynamics. A specialized handrail device fitted with a heater, which was maintained at normal human body core temperature, successfully prohibited the prolonged survival of bacteria [Enterococcus faecalis (ATCC), E. coli (ATCC), Pseudomonas aeruginosa (ATCC), S. aureus (ATCC), Acinetobacter baumannii (clinical isolate), and Serratia marcescens (clinical isolate)], with the exception of spore-forming Bacillus subtilis (from our laboratory collection) and the yeast like fungus Candida albicans (from our laboratory collection)] on dry surfaces. Taken together, we concluded that the tested bacteria favor lower temperatures for their survival in dry environments. Therefore, the thermal control of dry fomites has the potential to control bacterial survival on high-touch surfaces in hospitals.

Sound generated in a ward can be classified into 1) generated by medical staff, 2) generated by patients and their visitors, and 3) others, such as from in-hospital broadcasting microphones and nurse calls. Among these sounds, the incidence from medical staff, in particular, is reportedly high. The study objective is to investigate whether sound awareness is effective in regulating the sound environment even in a busy situation, such as in a real clinical setting, and to examine the extent to which sound awareness affects sound level. Nursing students were asked to perform a series of nursing activities in a pseudo-ward, and the changes in the sound level generated during the nursing activities with or without time and sound awareness were examined. Under varying experimental conditions, the sound and time levels associated with the nursing activities were measured in the following order: condition 1, without sound or time awareness; condition 2, with time awareness but without sound awareness; and condition 3, with both sound and time awareness. The time to perform nursing activities was longer with sound awareness. However, when aware of time only, the sound level from nursing activities rose by 2.3 dB, whereas when aware of both time and sound, the sound level dropped by 3.0 dB. With both time and sound awareness, there is a distinct drop in the sound level from nursing activities, such as wagon handling, handling of items (trays, bowls), working at the sink, and opening and closing the microwave oven door. These results suggest that even in a pseudo-clinical setting it is possible to regulate the environmental sound through the environmental sound awareness of the medical staff, resulting in a drop in the sound level generated while performing nursing activities.

BACKGROUND As the onset of osteoporosis leads to reduced activities of daily living and may result in patients being bedridden, efforts to prevent decreased bone density are necessary. Various studies on the relationship between sex, age, nutrients, and exercise habits and bone mineral density have been conducted to date. However, for snowy region residents, the magnitude of influence of various factors affecting bone mineral density and the influence level have not been clarified. OBJECTIVE This study aimed to clarify the degree of influence and factors influencing bone mineral density based on survey results on health conditions and lifestyle habits in heavy snow areas. METHODS A total of 354 citizens who visited a drugstore in the target area were included in a study that included using the brief-type self-administered diet history questionnaire on lifestyle and exercise habits. Height, weight, body composition, and bone densitometer values were analyzed using multiple regression to calculate their association with bone mineral density. In addition, a Bayesian network model was used to determine the influence level of each factor as a conditional probability. RESULTS Multiple regression analysis revealed that age, sex, fracture, and calcium intake significantly influenced bone mineral density. In addition, the result of Bayesian network analysis suggested that age and sex affected bone mineral density, whereas nutrients and exercise habits might not have a direct impact. However, calcium intake and the T-score were significant factors affecting the presence or absence of fracture experiences, suggesting that adequate calcium intake is essential for preventing fractures. CONCLUSIONS In the multiple regression analysis, age, sex, fracture, and calcium intake were selected as factors; however, in the Bayesian analysis, only age and sex affected bone mineral density while nutrients did not. In addition, the fact that calcium intake and the T-score were shown to affect bone fracture history suggests that calcium intake is an important measure that can prevent bone fractures. Overall, these results suggest that measures such as ensuring a bone fracture–free environment and providing nutritional advice for calcium intake can be effective in preventing bone loss.

Lifestyle diseases, which are associated with nutrition, account for 30% of elderly requiring long-term care. To increase health expectancy among Japan’s rapidly aging population, we investigated the nutritional status and body composition of elderly adults living in a region subject to heavy snowfall, to identify pertinent health indicators. The dietary habits of 288 local residents aged ≥50 years were analyzed using body composition and a brief-type self-administered diet history questionnaire. Body mass index of all residents was normal. Basal metabolic rate (BMR) and muscle mass were reduced in the older group. Dietary habits did not differ with age among men, but older women had significantly higher dietary intake. BMR and muscle mass declined with age, even when dietary intake was sustained. Despite sufficient dietary intake, independently living older adults demonstrate less efficient use of food with age. Interventions to reduce excessive sodium and protein intake are required.

Background: As the onset of osteoporosis leads to reduced activities of daily living and may result in patients being bedridden, efforts to prevent decreased bone density are necessary. Various studies on the relationship between sex, age, nutrients, and exercise habits and bone mineral density have been conducted to date. However, for snowy region residents, the magnitude of influence of various factors affecting bone mineral density and the influence level have not been clarified. Objective: This study aimed to clarify the degree of influence and factors influencing bone mineral density based on survey results on health conditions and lifestyle habits in heavy snow areas. Methods: A total of 354 citizens who visited a drugstore in the target area were included in a study that included using the brief-type self-administered diet history questionnaire on lifestyle and exercise habits. Height, weight, body composition, and bone densitometer values were analyzed using multiple regression to calculate their association with bone mineral density. In addition, a Bayesian network model was used to determine the influence level of each factor as a conditional probability. Results: Multiple regression analysis revealed that age, sex, fracture, and calcium intake significantly influenced bone mineral density. In addition, the result of Bayesian network analysis suggested that age and sex affected bone mineral density, whereas nutrients and exercise habits might not have a direct impact. However, calcium intake and the T-score were significant factors affecting the presence or absence of fracture experiences, suggesting that adequate calcium intake is essential for preventing fractures. Conclusions: In the multiple regression analysis, age, sex, fracture, and calcium intake were selected as factors; however, in the Bayesian analysis, only age and sex affected bone mineral density while nutrients did not. In addition, the fact that calcium intake and the T-score were shown to affect bone fracture history suggests that calcium intake is an important measure that can prevent bone fractures. Overall, these results suggest that measures such as ensuring a bone fracture–free environment and providing nutritional advice for calcium intake can be effective in preventing bone loss.

This paper shows an application of a learning method for acoustic signal classification by an auditory robot. The learning approach provides an unified acoustic signal classification method without considering the characteristics of target signals. Support Vector Machine was adopted to obtain the classifier and the target signal was characterized by Mel-Scale Log Spectrum which was a general form to symbolize acoustic signals. Results of actual experiments to classify 4 class of acoustic signals at single sound source case and to classify 3 class of acoustic signals at plural sound source case showed the validity of the method.

Although sexually transmitted disease due to Chlamydia trachomatis occurs similarly in both men and women, the female urogenital tract differs from that of males anatomically and physiologically, possibly leading to specific polymorphisms of the bacterial surface molecules. In the present study, we therefore characterized polymorphic features in a high-definition phylogenetic marker, polymorphic outer membrane protein (Pmp) F of C. trachomatis strains isolated from male urogenital tracts in Japan (Category: Japan-males, n = 12), when compared with those isolated from female cervical ducts in Japan (Category: Japan-females, n = 11), female cervical ducts in the other country (Category: Ref-females, n = 12) or homosexual male rectums in the other country (Category: Ref-males, n = 7), by general bioinformatics analysis tool with MAFFT software. As a result, phylogenetic reconstruction of the PmpF amino acid sequences showing three distinct clusters revealed that the Japan-males were limited into cluster 1 and 2, although there were only four clusters even though including an outgroup. Meanwhile, the phylogenetic distance values of PmpF passenger domain without hinge region, but not its full-length sequence, showed that the Japan-males were more stable and displayed less diversity when compared with the other categories, supported by the sequence conservation features. Thus, PmpF passenger domain is a useful phylogenetic maker, and the phylogenic features indicate that C. trachomatis strains isolated from male urogenital tracts in Japan may be unique, suggesting an adaptation depending on selective pressure, such as the presence or absence of microbial flora, furthermore possibly connecting to sexual differentiation.

SUMMARY 1 We have recently segregated a new line of rabbit, named TGH, with severely high levels of plasma triglyceride and cholesterol. The aim of the present study was to investigate the progression of atherosclerosis and haemodynamic parameters in TGH rabbits. 2 Japanese white (JW) and TGH rabbits (24–27 months old) were anaesthetized with ketamine and xylazine. Plasma concentrations of triglyceride were 63.1 8.0 and 446.0 35.2 mg/dL in JW and TGH rabbits, respectively. Blood pressure was measured by a catheter implanted in the femoral artery. Histological examinations were performed using haematoxylin–eosin and elastica–Masson trichrome staining to detect atherosclerotic lesions. 3 The JW rabbits had no atherosclerotic lesions. In TGH rabbits, severe atherosclerotic lesions were observed throughout the aorta, especially in the aortic arch. Basal femoral arterial pressure was not significantly different between JW and TGH rabbits. However, the basal pulse pressure in TGH rabbits (48.3 4.5 mmHg) was significantly greater than that of JW rabbits (28.0 5.6 mmHg). Intravenous infusion of NG-nitro-l-arginine methyl ester (l-NAME; 26.9 mg/kg) increased the blood pressure of TGH and JW rabbits. There was no significant difference in the response to l-NAME between the two rabbit strains. 4 The present study shows that severe atherosclerotic changes develop in TGH rabbits and suggests that the hyperlipidaemia combined with hypercholesterolaemia and hypertriglyceridaemia is an important factor for promoting atherosclerosis in TGH rabbits. The greater pulse pressure in TGH rabbits may be due to the increased vascular stiffness with atherosclerosis. 5 This newly developed TGH rabbit line of heritable hypertriglyceridaemia with hypercholesterolaemia will become a useful animal model for studies on the role of hyperlipidaemia in the progression of atherosclerosis and in many atherosclerosis-related diseases.

An important ability in auditory robots is the localization of sound source. In this paper, a robust method to localize the vertical direction of the sound source with two microphones and pinnae is proposed. In order to achieve vertical sound source localization, the method of detecting spectral cues, the relationship between spectral cues and source direction are studied. In addition, this paper considers sound source separation in order to recognize and isolate spectral cues only from the sound source in order to make the method robust to extraneous noise. Furthermore the authors designed an audio servo with the proposed spectral cues and implemented the method in an actual robot. The experimental results confirmed the effectiveness of the method.

Sound localization is one of important abilities for robots which utilize auditory information. Binaural information such as interaural time difference (ITD) or interaural intensity difference(IID) is effective for horizontal sound localization. In order to extend this ability to vertical sound localization, spectral cues were utilized in this paper instead of increasing number of microphones. Spectral cues were the information about the vertical position of the sound source on frequency domain. Since spectral cues strongly depended on the shape of pinnae, artificial pinnae for auditory robots were designed based on diffraction-reflection model. A method to detect spectral cues was also developed. By utilizing them, a controller which made the robot orient to the sound source was proposed. Results of an experiment showed the validity of the proposed method.

Background Our previous study into assessing hospital cleanliness in Japan by two common methods, ATP bioluminescence and the stamp agar method, revealed considerable variability in the data of both methods (BMC Research Notes, 7: 121, 2014). To investigate the reason(s) for the variability, we reanalyzed the data (n = 752) from the point of view of the material surface properties of sampling sites. Methods Data obtained from surfaces with unknown properties and different purposes such as floor were omitted, and the remaining data (n = 488) were used for this study. The material surface properties on sampling sites were divided into six categories: melamine coated (n = 216), vinyl chloride (n = 16), stainless steel (n = 144), wood (n = 63), and acrylonitrile-butadiene styrene resin coated (n = 48). The data between individual material properties were compared. Results The ATP values of high-touch places were significantly different depending on the type of surface, but no significant difference in stamp values between material properties was seen, indicating that in contrast to stamp values, ATP-accumulation more depends on the physical properties of the material surface such as electronic charges or roughness. To confirm this, we assessed a degree of roughness on vinyl chloride material surface (disutilized floor samples actually used for each of the hospitals) by observation with scanning electron microscope (SEM). As a result, SEM observation similarly revealed considerable roughness on the materials, which may allow microbes to contaminate the materials without noticing it. Conclusion Material properties must be considered when evaluating hospital cleanliness with ATP values, and provide a strong warning into evaluating hospital cleanliness.

Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface was sampled 8 times in 2 months. These areas were located in different ward units (Internal Medicine, Surgery, and Obstetrics and Gynecology). Detection limits for the ATP and stamp methods were determined by spike experiments with a diluted bacterial solution and a wipe test on student tables not in use during winter vacation, respectively. Values were expressed as the fold change over the detection limit, and a sample with a value higher than the detection limit by either method was defined as positive. Results The detection limits were determined to be 127 relative light units (RLU) per 100 cm2 for the ATP method and 5.3 colony-forming units (CFU) per 10 cm2 for the stamp method. The positive frequency of the ATP and stamp methods was 59.8% (450/752) and 47.7% (359/752), respectively, although no significant difference in the positive frequency among the hospitals was seen. Both methods revealed the presence of a wide range of organic contamination spread via hand touching, including microbial contamination, with a preponderance on the entrance floor and in patient rooms. Interestingly, the data of both methods indicated considerable variability regardless of daily visual assessment with usual wiping, and positive surfaces were irregularly seen. Nurse areas were relatively cleaner than patient areas. Finally, there was no significant correlation between the number of patients or medical personnel in the hospital and organic or microbiological contamination. Conclusions Ongoing daily hospital cleanliness is not sufficient in Japanese hospitals with a tendency toward long-term care.