Osaka City Research Articles

P-2168. The Intervention of Infectious Diseases Physicians Might Enhance the Value of Broad-Range 16S rRNA Gene Polymerase Chain Reaction in the Clinical Aspect

Abstract Background Evaluation of Broad-Range 16S rRNA gene polymerase chain reaction (BRPCR) has been reported to aim in diagnosing infection by detecting and identifying bacterial genes in clinical specimens from patients with suspected infections. However, collecting the right specimens at the right time and determining whether the bacteria detected by BRPCR are the true cause or contamination requires infectious disease expertise. We investigate whether there is an association between the detection of bacteria that caused infection using BRPCR and intervention by Infectious Diseases (ID) physicians. Methods We reviewed the patients who underwent BRPCR at Osaka City General Hospital between April 2017 and March 2024. The collected items are age, sex, bacteria detected by BRPCR, determination of whether the bacteria if detected, caused infection, or were contaminated, and with or without the intervention of ID physicians (consultation to ID physicians). Then we analyzed the correlation between the intervention of ID physicians and the identification of the bacteria that caused the infection by BRPCR using Fisher's exact test. We also investigated whether the BRPCR results had affected the final diagnosis. Results There was a total of 149 clinical specimens from 138 patients. Of these, 84 (60%) were male, with a median age of 48 years (IQR 6-72). Bacteria were identified in 101 (67.7%) clinical specimens. In 70 specimens of them, the identified bacteria were presumed to have caused the infection. Of the 70 specimens, 56 had interventions by ID physicians. Whereas there were 79 specimens in which bacteria were identified but were presumed to be contaminants, and in which bacteria were not identified, of which 49 had intervention by ID physicians. The results showed an association between the intervention of ID physicians and the identification of the bacteria that caused the infection by BRPCR (p=0.0196). In 29 (19.4%), the final diagnosis changed from infectious to non-infectious based on the results of BRPCR. Conclusion Interventions by ID physicians might relate to identifying the bacteria causing an infection using BRPCR, and that might lead to enhancing the value of BRPCR. Disclosures All Authors: No reported disclosures

Successful biventricular repair following strategic treatment focused on left ventricular growth in a patient with hypoplastic left heart complex and unbalanced right dominant atrioventricular septal defect: a case report.

A patient with borderline left ventricle successfully underwent biventricular repair following a staged surgical approach to promote left ventricular growth. Despite initial concerns about left ventricle size, apex formation and adequate size of atrioventricular valve indicated potential for future growth. The patient demonstrated significant left ventricular growth, resulting in stable biventricular circulation and a favourable outcome over a three-year postoperative follow-up period.Clinical Registration Number: Institutional Review Board of Osaka City General Hospital, number 1902139.

Analysis of Transportation Choices Affected by the 2024 Hokuriku Shinkansen Tsuruga Extension

The Hokuriku Shinkansen is among the five main Shinkansen lines in Japan. It starts from the capital, Tokyo, and passes through the Hokuriku region (Nagano City, Toyama City, and Kanazawa City) before reaching the Kansai region (Kyoto City and Osaka City). In Japan, the Hokuriku Shinkansen is being developed to increase the number of visitors in the area by shortening travel times and ensuring transportation networks in the event of a disaster; the Kanazawa–Tsuruga extension was opened on Saturday, 16 March 2024. The shortened travel times with this opening are expected to increase the number of visitors to the Hokuriku region and other regions, such as the Tokyo metropolitan area. The Tsuruga extension opening will connect the Hokuriku region with the Tokyo metropolitan area through direct service; however, travel between the Kansai and Chukyo regions will require transfers at Tsuruga Station, which would reduce convenience. Consequently, the flow of people in the Hokuriku region is expected to change significantly after spring 2024. Therefore, this study conducted a questionnaire survey of Kanazawa residents in Ishikawa Prefecture prior to the opening of the Tsuruga extension to analyze its effect on the choice of modes of transportation for travel to the Kansai region. The Hokuriku Shinkansen was found to be the most popular route for travel to the Kansai region after the opening of the Tsuruga extension, and the Hokuriku Shinkansen users prioritized comfort during travel and shorter travel times. Moreover, a high proportion of Hokuriku Shinkansen users were unemployed and received pensions, whereas a high proportion of private automobile users were students, housewives, or other people with no income.

Educational Interventions to Improve Knowledge and Attitudes Toward Human Papillomavirus (HPV) Vaccination and Cervical Cancer Screening Among Japanese University Students.

Aim This study evaluates university students' knowledge and attitudes toward Human Papillomavirus (HPV) vaccination and cervical cancer screening and assesses the impact of educational interventions. Methods Participants from Osaka Metropolitan University, Osaka City University, and Osaka Prefecture University completed questionnaires before and after receiving educational materials, including cartoons and a video featuring medical professionals. We compared the correct answer rates for knowledge-related questions and evaluated changes in behavioral characteristics and attitudes toward HPV vaccination and cervical cancer screening before and after distributing the educational materials. The Health Belief Model (HBM) was used to measure changes in perceived susceptibility, severity, benefits, and barriers. Results A total of 15,061 students were invited to participate, with 234 completing the study. Significant improvements in knowledge related to HPV, cervical cancer, and associated preventative measures were observed post-intervention. The percentage of correct answers to knowledge-based questions increased across all items (P<0.01). Furthermore, positive attitudes toward HPV vaccination significantly rose, with male participants demonstrating the most substantial change (P<0.01). In terms of the HBM, perceived susceptibility and perceived benefits increased significantly among male participants (P=0.0055 and P<0.001, respectively), while perceived barriers were reduced (P<0.001). Among female participants, only the perceived benefit increased significantly (P<0.001). Most participants rated the educational materials as clear and easy to understand, reinforcing the utility of engaging and accessible content in promoting health awareness. Conclusion Educational interventions can effectively improve knowledge and attitudes toward HPV vaccination, potentially increasing preventative health behaviors and reducing the incidence of cervical cancer.

Comparison of document-based and on-site inspections of hospitals based on medical law: A case report from Osaka City during the COVID-19 pandemic

Objectives On-site inspections of hospitals were conducted in Osaka City during fiscal years 2018 and 2019, whereas document-based inspections were performed during the COVID-19 pandemic in fiscal year 2021. This case report aimed to compare the outcomes of these two methods and provide a good indication of the method that should be selected in case of a pandemic.Methods For on-site inspections, documents, including checklists, were sent to 351 hospitals from the Osaka City Public Health Office, and responses from each hospital were returned. On-site inspections were conducted, and the written instructions that indicated inadequate aspects and guidance were mailed to hospitals.For document-based inspections, documents were sent to 176 hospitals, and responses were returned. For hospitals that answered "incomplete" regarding the categories of medical safety management systems and hospital-acquired infection control, public health physicians called to confirm and instruct their inadequate responses, and the same step as the on-site inspection was executed. We compared and examined the outcomes of the on-site and document-based inspections.Results In the on-site inspections, 12 of the 351 hospitals (3.4%) were recognized as inadequate because of a shortage of healthcare workers. In the document-based inspections, eight out of 176 hospitals (4.5%) were identified, and there was no significant difference.Regarding the medical safety management system, 95 of the 351 hospitals (27.1%) on on-site inspection and 21 of the 176 hospitals (11.9%) on document-based inspection received written instructions. The proportion of hospitals that received written instructions was significantly higher for on-site inspections than for document-based inspections (P < 0.001).For hospital-acquired infection control, 65 of 351 hospitals (18.6%) on on-site inspection and 17 of 176 hospitals (9.7%) on document-based inspection got written instructions. The proportion of hospitals that received written instructions was significantly higher for on-site inspections than document-based inspections (P = 0.007).Conclusion Document-based inspection can easily unify the guiding criteria with fewer public health physicians. However, because of the limited amount of information available without checking the documents retained in hospitals, it is difficult to monitor the matters that need instructions. Thus, on-site inspection is preferable. However, if onsite inspection is difficult, inspection combined with online methods should be considered.

Response of urban flood resilience to climate change: An exploration with a novel performance-based metric considering the socioeconomic impacts of damage costs

Climate change stimulates the emergence of floods and increases flood risk for communities, resulting in extensive casualties and economic loss. Thus, flood resilience has been the focus of much attention. Integrated and holistic metrics are important for an accurate urban flood resilience evaluation. However, performance-based metrics involving surface inundation do not consider the socioeconomic impacts of damage costs on the recovery ability of the urban systems. This hinders the investigation of climate change-induced effects on flood resilience. Therefore, this study proposed a performance-based resilience metric considering the negative impacts of flooding damage costs. The proposed metric was then piloted in a highly urbanized area in Osaka City, Japan to explore the responses of flood resilience to climate change. The results suggest that climate change exerts non-negligible pressure on the study area to maintain its economic characteristics during flooding. Rainfall intensity primarily affects the urban system’s most unfavorable state, while the total amount and duration of rainfall mostly impact the relatively stable state following flooding. Climate change severity is positively linked to the reduction in overall flood resilience. Continued climate change will further expand the spatial coverage of flood resilience losses on a global scale. Furthermore, the negative impacts of economic losses on flood resilience are more noticeable during rainfall events with higher rainfall intensities. This study improves the comprehensiveness of performance-based flood resilience evaluations and provides a reference for the effective enhancement of urban flood resilience under climate change.

Impacts of building modifications on the turbulent flow and heat transfer in urban surface boundary layers

This study examines turbulent airflow and upward heat transport in real urban environments using a building-resolving large-eddy simulation model to understand the characteristics of turbulent airflow and upward heat transport when geometrical distributions of buildings are modified. The target areas were two real urban districts within Osaka City, Japan, having different morphological features. In the numerical experiments, the initial condition was set to a neutral condition in which temperature is uniformly distributed vertically, and buildings emitted heat at a constant rate. The results in the two districts indicated that the features of turbulence and heat transport distinctly differed with different building arrangement. Specifically, taller buildings significantly decelerated airflows and induced warming behind buildings. More high-rise buildings (which resulted in a larger building variability) in a district with a larger building density caused a large heat flux and warming at higher levels. The sensitivity experiments in which a density and height variability of buildings were modified showed that a building density at higher levels and a building height variability significantly influenced warming at upper levels. An increased building height variability weakened wind speed and disturbed horizontal heat advection, whereas a large building density caused numerous heat sources.

Clinical significance of the CALLY index in patients with gastric cancer undergoing gastrectomy.

The aim of this study was to elucidate the clinical impact of the CALLY index in patients with gastric cancer (GC) undergoing gastrectomy. Between January 2014 and December 2020, 617 patients who underwent gastrectomy for GC at the Osaka City General Hospital were enrolled in this study. The CALLY index was calculated using the following formula: [albumin (g/dL)×lymphocytes (/μl)]/[CRP (mg/dL)×104]. We compared the predictive value of four biomarkers [CALLY index, modified Glasgow prognostic score (mGPS), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)] for short- and long-term outcomes and focused on the CALLY index to elucidate its clinical value. Receiver operating characteristic analysis showed that the area under the curve for the CALLY index was the highest among the four biomarkers. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates in the low and the high CALLY groups were statistically significant. Multivariate analysis identified the CALLY index as an independent factor for OS and CSS but not NLR or PLR. The mGPS was an independent factor for OS but not for CSS in multivariate analysis. Regarding complications, only the CALLY index was an independent predictor of major complications (≧ Clavien-Dindo grade 3) in multivariate analysis but not others. The CALLY index may have a clinical value in predicting OS, CSS, and major complications in GC patients undergoing gastrectomy.

Division of labour in the production structure and mass production in pre‐war Japan: Lessons from the metal and machinery sectors in Osaka City

AbstractUsing 1930s panel data from Osaka City, we estimate the production function in the metal and machinery sectors in Japan to identify the factors that influence the establishment of mass‐production methods. Subcontracting income per total revenue had a positive correlation with metal and machinery output. While material‐intensive technology was used, scale‐economy‐type technology was not observed in this sector. The greater return on capital for smaller plants was attributed to efficient capital stock utilisation and subsistence wages. The division of labour between firms, through which materials and parts were traded, contributed to output expansions in the 1930s.

Forensic analysis of suicide deaths: Comparing forensic information with public information and investigating factors contributing to psychiatric consultations.

This study aimed to examine the usefulness of forensic information on suicide deaths in Japan for epidemiological studies on suicide and determine the factors that lead people with suicidal ideation to seek psychiatric care prior to attempting suicide. We focused on forensic information of 514 suicide deaths that occurred in Osaka City in 2019. First, to examine whether the data used in this study can be generalized to these cases, we compared the information on suicide deaths officially published by Osaka City with that used in this study, utilizing Pearson's χ 2 test. Next, the forensic data were analyzed using multivariate logistic regression analysis to confirm the relationship between demographic factors and the likelihood of having a history of psychiatric consultation before suicide. Both the official information and the data used in this study showed a higher number of males than females who died by suicide, with no significant differences in values between the data sets. Multivariate logistic regression analysis showed significant correlations. More females were associated with seeking a psychiatric consultation. However, those with regular jobs or students were more likely to avoid a psychiatric consultation. The findings of this study provide insights into the phenomenon of suicide deaths by using a forensic perspective. The results of this study suggest that psychiatric consultation may be effective in reducing deaths by suicide. Forensic data should be incorporated into the formulation of suicide-prevention policies in Japan to conduct a more multifaceted analysis and improve suicide-prevention measures.

Prevalence of and factors influencing Hikikomori in Osaka City, Japan: A population-based cross-sectional study.

Hikikomori is commonly defined as a social condition in which individuals avoid social participation and relationships beyond their family members by confining themselves to a room or their house for 6 months or longer. Hikikomori has been predominantly considered a problem among young people; however, as the population is ageing, hikikomori has also emerged as a social issue among adults. Nevertheless, no comparative studies have examined the differences in the factors associated with hikikomori among teenagers/young adults and middle-aged/older adults. Thus, this phenomenon has not been thoroughly examined, and it remains unclear whether the risk factors vary between teenagers/young adults and middle-aged/older adults. Based on the Japan Cabinet Office's definition of hikikomori, this cross-sectional study evaluated the prevalence and related factors of hikikomori among the working age population (15-64 years), utilising univariate and multivariate analyses. The study also compared differences in the prevalence of and factors related to hikikomori between teenagers/young adults and middle-aged/older adults. We distributed self-administered questionnaires to individual participants and their families between 24 December 2020 and 18 January 2021. Data from an anonymised sample of 3,092 individuals (split into two groups of 15-39 and 40-64 years) were subjected to analysis. The results revealed a hikikomori prevalence of 2.3% in the target population; the prevalence rate was 2.12% among individuals aged 15 to 39 years and 2.42% among those aged 40 to 64 years. The analysis demonstrated strong correlations between hikikomori and several factors, including unemployment, truancy, a history of psychiatric consultation or hospitalisation, being male and the absence of ibasho, which is defined as a place where individuals can feel peace, security, acceptance and belonging. The factors associated with hikikomori differed between teenagers/young adults and middle-aged/older adults. Our findings, thus, contribute to existing research by providing a comparative analysis of risk factors across different age groups.

Continuation situation and issues on conservation of roadside trees in Osaka city

Continuation situation and issues on conservation of roadside trees in Osaka city

Historical trend of polycyclic aromatic hydrocarbons in a sediment core from Osaka Bay during the Meghalayan

Polycyclic aromatic hydrocarbons (PAHs) are produced by incomplete combustion of biomass and fossil fuel, yet PAHs have been rarely analyzed in coastal sediment cores as a tracer for human activities before industrialization. The aim of this study was to assess if the historical trend of PAHs can be related to past human activities. To this end, we have determined the concentrations of PAHs in a 9 m-long sediment core from Osaka Bay, which records history of the last 2400 years. The concentration of PAHs before the beginning of the 17th century CE, the beginning of the peaceful Edo period, was consistently low (&lt;100 ng g−1) and mainly comprised of smoke-derived PAHs reflecting the natural background. A relative higher abundance of 4−6 ring PAHs from the early 17th century CE and a higher PAH concentration from the early 18th century CE until approximately 1800 CE agreed with a population increase, Cu smelting activities and increasing combustion of charcoal. The constant PAH concentration until the late 19th century CE overlapped with a decline in the population in the Osaka area. An increasing PAH concentration from the late 19th century CE marked the beginning of industrialization in the Modern age. The peak in PAH concentration in 1945 CE was likely caused by burning of wooden structures due to air raids on Osaka City. A second peak around 1980 CE indicated the introduction of cleaner energies. We conclude that PAHs in coastal sediment cores can be used to reconstruct past human activities.

Factors Contributing to Lower Surrogate Recoveries in PFAS Analysis Based on ISO 21675 and the River Survey of PFAS in Osaka City, Japan

Factors Contributing to Lower Surrogate Recoveries in PFAS Analysis Based on ISO 21675 and the River Survey of PFAS in Osaka City, Japan

A Study on the Discussion by Citizen Participation and Reflection on the Site Utilization Plan in the Utilization of the Site after the Closure of Elementary Schools in Osaka City

A Study on the Discussion by Citizen Participation and Reflection on the Site Utilization Plan in the Utilization of the Site after the Closure of Elementary Schools in Osaka City

Saikaku Steers a Course: Negotiating Celebrity Status as an Author in Edo-period Osaka, 1684–86

Abstract: Ihara Saikaku first achieved celebrity in his native city of Osaka as a prolific, if not always consistent, composer and critic of haikai no renga (linked-verse poetry). Later, his ukiyo-zōshi prose narratives set in the "floating world" of Japan's licensed pleasure quarters and chōninmono accounts of everyday urban life were bestsellers that lifted him to stardom. His collaboration with the most famous ukiyo-e artists of his day, Hishikawa Moronobu and Yoshida Hanbei, cemented his position as one of the most important authors of the Genroku era, one of the most prolific periods in Japanese literary history. Yet Saikaku's path to fame was by no means assured, and the course of his early career was shaped by his reactions to censorship, piracy, and market demands. This essay describes pivotal episodes that determined the course of his work during the crucial years of 1684–86, including his famous linked-verse marathon performance in front of Osaka's Sumiyoshi shrine, the pirated Edo edition of his The Life of an Amorous Man , and his ongoing responses to the Tokugawa shoguns' censorship as reflected in his books Five Women Who Loved Love and Twenty Cases of Filial Impiety in Japan .

"Shunkan on Devil Island": Domesticating Political Exile in the Japanese Puppet Play “Heike nōgyo no shima”

This essay discusses the scene entitled Shunkan on Devil Island from Chikamatsu Monzaemon’s early modern puppet play The Heike on the Island of Women as a commentary on social and political strictures of the early modern Tokugawa shogunate, which increasingly regulated social and commercial life as it sought to maintain control of the burgeoning cities of Edo and Osaka in the early 1700s. The play is loosely based on the medieval epic war tale Tale of the Heike (Heike monogatari), a beloved and foundational text that has found numerous afterlives in Japan’s theatrical, narrative and cinematic traditions. Shunkan on Devil Island refashions the Heike’s story of the Buddhist prelate Shunkan (banished to Devil Island following a botched coup attempt) as a specifically early modern tale by introducing a female character, Chidori, who becomes the wife of one of Shunkan’s two fellow male exiles and therefore a member of the "family" that they, as aristocrats banished to a distant island, create. Through exploring the idea of family relations on the remote Kigaigashima, Chikamatsu recasts the well-known tale of Shunkan on Devil Island to create a utopic staged space that comments on the oppressiveness of the early modern polity experienced acutely by the urban audiences of the early 18th century.

A study on the application of road traffic noise map in Japan through the case of Osaka

In this study, application of noise map for the prediction and examination of road traffic noise is discussed for two urban areas in Osaka Prefecture, i.e. Tennoji Ward (Osaka City) and Higashiosaka City. Noise mapping is performed based on the 2015 road traffic census data of Ministry of Land, Infrastructure, Transport and Tourism (MLIT) by employing ASJ RTN-Model 2018, which is a model developed by the Acoustical Society of Japan (ASJ) for predicting the road traffic noise (RTN). For calculating the noise attenuation due to buildings, building façades are extracted from the national base map of MLIT. To examine the effect of measures related to noise mitigation, noise maps are produced for several hypothetical cases, such as reduction of vehicle noise, adoption of porous asphalt pavement, and utilization of the speed limit for vehicle speed data.

Importance of the human factor in user satisfaction with local government office counter services: on-site survey of Higashihiroshima city hall users

This study empirically investigates the major factors determining user satisfaction with counter services at local government offices in Japan. Data were collected via on-site surveys on user satisfaction with the local government office counter services using an original three-category questionnaire scale tailored to fit local administration characteristics in Japan. A total of 1000 questionnaires were distributed at the city hall during August 23–26, 2021; a total of 537 valid responses were received (response rate: 53.7%). Regression analysis indicated that the independent variables of category C (service delivery) were the most influential, followed by the B (human-related factors) and A (office hardware) categories (adjusted R2 value: 0.58). Results showed that the human factor is a key factor in counter service in terms of user satisfaction. The human factor was found to be a statistically significant explanatory variable in two on-site surveys at Higashihiroshima City and Internet surveys of ward office users in Osaka City and the Tokyo Metropolitan Area. These findings align with the conclusions of implementation research, which first emerged in the 1970s. For instance, street-level bureaucracy research has highlighted the importance of frontline administrative officials. For service delivery (C), identified as the most important factor, promptness of service delivery and a short waiting time do not necessarily affect user satisfaction positively. Moreover, this study identified two important factors for the counter-staff responses and human-related factors category: (1) speed with which the attending counter clerk speaks and (2) atmosphere and kindness of the attending counter clerk.

Association of atmospheric temperature with out-of-hospital natural deaths occurrence before and during the COVID-19 pandemic in Osaka, Japan

In this study, we aimed to investigate the relationship between out-of-hospital natural death (OHND) and ambient temperature and examine the seriousness of the impact of the coronavirus disease-2019 (COVID-19) pandemic on this relationship. We used data from the Osaka Prefectural Office of Medical Examiners between 2018 and 2022 and performed a retrospective observational study. A Poisson regression model was applied to examine the relationship between OHND and temperature in Osaka City. The relative risk of OHND at 5 °C and 32 °C compared to the minimum mortality temperature increased from 1.81 in the pre-COVID-19 period to 2.03 in the post-COVID-19 period at 5 °C and from 1.29 in the pre-COVID-19 period to 1.60 in the post-COVID-19 period at 32 °C. The increase in relative risk per 1 °C increase from the pre- to post-COVID-19 period was 1.0551 (rate ratio [RR], p = 0.003) in the hot environment and 1.0233 (RR, p = 0.013) in the cold environment, which was larger than that in the hot environment. Although the risk of OHND increased at both temperatures, the change in OHND risk during post-COVID-19 was larger in the hot environment than in the cold environment, implicating the effect of pandemics in the current scenario of global warming.