Tokyo Research Articles

Chemotactic activity of products of Elizabethkingia anophelis derived from Aedes albopictus against RAW264 murine macrophage cell line.

Dengue viruses enter dermal macrophages which are derived from other tissues after mosquito bites. We examined chemotactic factors derived from the dengue vector mosquito, Aedes albopictus, toward a RAW264 murine macrophage cell line. We found that Elizabethkingia anophelis that was isolated from mosquitoes exhibited migration-inducing activity toward RAW264 cells. The active substances were extracted using ethyl acetate to induce chemotactic movements. Chemotactic activity was eluted in the several fractions using the reversed-phase chromatography, suggesting that multiple substances were responsible for the activity. We isolated three bacterial colonies from the wild A. albopictus mosquitoes collected in Toyama Park, Tokyo prefecture, Japan. The bacterial 16S rRNA gene sequences were the most similar to those of Lonsdalea quercina. These bacteria also exhibited migration-inducing activity toward RAW264 cells. The migration-inducing activity of mosquito bacteria might be a new aspect of mosquito-mediated viral infections.

Effects of neighbourhood characteristics on the distribution of vacant houses in Toda city, a satellite city of Tokyo metropolis of japan

As Japan faces a growing crisis of vacant housing, this study investigates the underexplored relationship between vacant house distribution and neighbourhood characteristics in Toda City, a satellite city of the Tokyo metropolis located in Saitama Prefecture. We selected 10 community features, including living convenience, housing supply, and policy support, to explore their influence on vacancy rates. Using a comprehensive dataset primarily derived from the PLATEAU data, we employed a two-step method combining global and local Moran’s I analyses to assess the spatial distribution normality of vacant houses. We then compared traditional statistical data analysis with spatial data analysis through multiscale geographically weighted regression to evaluate their effectiveness and identify the factors most closely associated with vacancy rates. Our findings reveal that spatial data analysis provides superior insights compared to traditional statistical methods. Both approaches consistently indicate a significant positive correlation between the supermarket area ratio and vacancy rates, and a significant negative correlation between road adjacency and vacancy rates. This study demonstrates the feasibility of using spatial data to analyse neighbourhood characteristics in the context of declining vacancy rates in satellite cities. The insights gained offer theoretical support for selecting data and methodologies in future research and policymaking that are aimed at mitigating the growth of vacant houses.

Animation of latissimus dorsi flap in breast reconstruction: a retrospective analysis based on 203 cases.

Breast animation is a common postoperative complication of breast reconstruction surgery. This study investigates the factors affecting the onset and degree of animation to suggest an ideal treatment strategy for this complication. This study included patients who underwent latissimus dorsi reconstruction at Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, between 2009 and 2020 and had an outpatient visit after July 2020. Statistical analysis was performed and the patients' background and surgical factors were examined to determine whether they affected the animation incidence rate. The animation incidence rate was 69.6%. There was no significant relationship between animation incidence and any patient background or surgical factors, except for the complete dissection of insertion into the humerus of the latissimus dorsi muscle (p = 0.0039). The rate of uncomfortable animation was 4% and recurrence of animation was observed in one of the two patients who underwent denervation. Prophylactic denervation is not considered necessary and should be offered only for persistent discomfort with animation. Instead, the muscle insertion must be dissected during flap elevation to prevent animation, and the thoracodorsal nerve must be preserved to avoid muscle atrophy.

Frequency and severity of hyponatremia in healthy children with acute illness.

Hyponatremia can occur in the acute phase of any illness through various mechanisms. However, the frequency and severity of hyponatremia are not well known across a broad range of illnesses including medical and surgical diseases and trauma. The present, retrospective chart review was conducted at Tokyo Metropolitan Children's Medical Center from 2018 to 2019. Included were healthy children aged < 16years with an acute illness, who were urgently admitted, and had their serum sodium level measured on arrival. In total, 2717 patients were urgently admitted and had their serum sodium level measured. Of these, 1890 were included. Hyponatremia was found in 260 patients (13.8%). The most common hyponatremic disease was type 1 diabetes mellitus (69%) followed by acute infectious encephalopathy (60%), pyogenic arthritis (60%), and Kawasaki disease (51%). Kawasaki disease, seizure, urinary tract infection, acute appendicitis, lower respiratory tract infection, and acute gastroenteritis were associated with a significantly lower serum sodium value than cases of fracture comprising a control group. Conversely, acute bronchial asthma exacerbation (3%), anaphylaxis (0%), intussusception (0%), acute scrotal disease (0%), head injury (1%), and fracture (0%) were very infrequently associated with hyponatremia. The present study determined the frequency and severity of hyponatremia in various, acute, pediatric illnesses, including medical and surgical diseases and trauma. Despite reports of respiratory distress and pain inducing vasopressin secretion, hyponatremia was rarely observed on arrival in patients with acute bronchial asthma exacerbation, anaphylaxis, intussusception, acute scrotal diseases, head injury, or fracture.

Persistent anti-vaxxers and pandemic-induced new anti-vaxxers

Persistent anti-vaxxers and pandemic-induced new anti-vaxxers Read this analysis of persistent anti-vaxxers and pandemic-induced new anti-vaxxers by Fujio Toriumi, Professor at the University of Tokyo in Japan. During the COVID-19 pandemic caused by the novel coronavirus, anti-vaccine discourses pose a threat to public health by making it challenging to achieve herd immunity. Although studies describing anti-vaxxers’ characteristics have been accumulating, a lack of understanding prevails regarding the “triggers” that lead individuals to become anti-vaxxers.

Asian Bay Areas' Experiences in Promoting Youth's Participation in Social Innovation Asian Bay Areas' Experiences in Promoting Youth's Participation in Social Innovation

This study analyzes the experiences and approaches of Asian bay areas, particularly China's Greater Bay Area and Japan's Tokyo Bay Area, in promoting youth participation in social innovation. Through a literature review and four case studies, the paper explores how social innovation helps young people address modernity challenges, including unemployment and social isolation. The cases include knowledge enhancement programs, breaking social isolation, providing work promotion opportunities, and empowering and inspiring youth to engage in social innovation. These methods not only contribute to solving social issues but also enhance young people's self-efficacy and improve their employability. The findings suggest that social innovation programs targeting youth must be tailored to meet their diverse needs, ranging from personal development and community belonging to professional advancement, all of which play a vital role.

Feasibility of vehicle-to-grid (V2G) implementation in Japan: A regional analysis of the electricity supply and demand adjustment market

Vehicle-to-Grid (V2G) technology forms a critical bridge between electric vehicles (EVs) and renewable energy, playing a transformative role in the global shift towards a low-carbon future. Despite its promise, the impact of regional differences on V2G potential, particularly within specific application scenarios, remains largely unexplored. This study employs an agent-based modeling approach to evaluate V2G potential across Japan's 47 prefectures, with a focus on its integration into an energy reserve service business model. Our analysis reveals that EV ownership is the dominant factor influencing regional variability, with the Tokyo Metropolitan Area, Aichi, and Kanagawa emerging as top candidates for V2G deployment. Interestingly, when EV ownership is excluded from consideration, regions like Okinawa, Kagoshima, and Ibaraki show leadership in V2G potential. These findings highlight the existence of regional priorities for V2G application. Moreover, a ‘High Demand Disparity’ is observed in the power supply and demand adjustment market, where V2G systems are often either underutilized or overwhelmed, leaving many idle. The study underscores the need for region-specific strategies and the integration of diverse business models to fully capitalize on V2G's potential in various demand adjustment scenarios.

Can Avatar Robots Assist Older People and Care Professionals? Evaluation of an Intervention Study in Eight Nursing Homes in Tokyo

Abstract Background Securing human resources to meet increasing demand for older people's care is challenging, particularly in Japan, where the pace of ageing is accelerating. Central and local government have been seeking partial solutions in assistive technologies such as robotics. Against such a background, the study was conducted in 8 nursing care homes in Tokyo, where avatar robots were tested to examine whether and how these robot interventions can affect the daily life of older people and care professionals. Methods Four different types of avatar robot (ORIHIME, NEWME, Piyokame and BOCCO) were introduced to and used in eight nursing care facilities, in order to create conversational opportunities over 12 weeks. Before–after studies were conducted, and a variety of data was collected (interpersonal communication, self-care and depressive tendencies using the International Classification of Functioning, Disability and Health (ICF) and InterRAI assessments). System usability scores (SUS) were collected from care professionals, who also performed a time-on-task analysis. Results Study participants who consented to taking part were 136 older adults (88.4±6.6 years old, 18 men and 118 women) and 63 care professionals. Participants with a high degree of dependency accounted for 31 percent. In total, 136 avatar robots were used. There was an overall, yet marginal, improvement for older people. While the SUS scores were poor, the majority (90 percent) responded that such devices would prove useful in the future. The time-on-task analysis indicates that more time can be secured for ‘person-to-person’ care. Conclusion Positive impacts of avatar robots (to increase the level of social interaction and communication) were observed. However, the results are inconclusive, and more needs to be done with regard to technology skills, competence enhancement and data collection methods for this type of research. The study was funded in part by the Tokyo Metropolitan Government.

The “vegetables first” dietary habit correlates with higher-level functional capacity in older adults with diabetes

BackgroundSome studies suggest that the habit of eating vegetables may initially be correlated with maintenance of a higher-level functional capacity; however, such a correlation has not been demonstrated. This study aimed to correlate the habit of eating vegetables first and higher-level functional capacity in older adults with diabetes.MethodsPatients aged ≥ 60 years who were treated at Japanese Red Cross Ise Hospital on an ambulatory basis were included in this study. A self-administered questionnaire using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate higher-level functional capacity. Participants were instructed to answer the questionnaire regarding the order in which they consumed the mentioned food types, and based on their answers, they were classified into “no order of eating,” “carbohydrates first,” “protein first,” and “vegetables first” groups. Multiple regression analyses with the TMIG-IC score as a dependent variable and the order of eating as explanatory variables were used to determine the partial regression coefficients of the “vegetables first” dietary habit with higher-level functional capacity.ResultsThis study included 346 patients. The adjusted partial regression coefficients of the “carbohydrates first,” “protein first,” and “vegetables first” dietary habits with the TMIG-IC score were 0.27 (95% confidence interval [CI], − 0.29 to 0.84), 0.17 (95% CI, − 0.54 to 0.90), and 0.77 (95% CI, 0.23 to 1.31), respectively.ConclusionsThe habit of eating vegetables first was correlated with higher-level functional capacity in older adults with diabetes.

LAND SURFACE TEMPERATURE FORECASTING IN THE CONTEXT OF THE DEVELOPMENT OF SUSTAINABLE CITIES AND COMMUNITIES

The article examines the aspects of land surface temperature forecasting for effective planning and development of sustainable cities and communities. The relevance of the research lies in the need to develop effective approaches to the analysis and forecasting of climate data, for the timely determination of existing problems and ways to solve them, in accordance with civilizational challenges. The trends of changes in the land surface temperature from the middle of the 20th to the beginning of the 21st century were analyzed, using the example of five megacities located in different regions: Tokyo (Japan), Lagos (Nigeria), Berlin (Germany), Singapore (Singapore) and Belo Horizonte (Brazil). The results of the analysis of changes in average monthly and average annual temperatures are presented. The factors affecting the formation of the temperature regime of each of the cities are determined. The role of urbanization as a key factor in the development of the city is described, the main challenges caused by it are considered. An overview of megacities from the point of view of sustainable development was carried out. Prospects for urban development and measures aimed at reducing the urban heat island effect are considered. The role of modern technologies, in particular machine learning for predicting the land surface temperature, is described. The expediency of land surface temperature forecasting, in order to implement strategies for mitigating negative consequences and achieving the goals of sustainable development, is substantiated. The conducted research makes it possible to be convinced of the need for a responsible approach to the design and development of sustainable cities and communities. The temperature of the earth’s surface is one of the key indicators that allows you to monitor the main trends of urban life and can be an indicator of the effectiveness of strategies used to increase comfort and sustainable development.

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain. This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education. The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019. After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively. These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Frontline evaluation: Atezolizumab-bevacizumab versus lenvatinib for BCLC stage B hepatocellular carcinoma exceeding the up-to-seven criteria.

This study aimed to evaluate the efficacy and safety of atezolizumab combined with bevacizumab (Atez/Bev) compared to lenvatinib (LEN) as first-line systemic therapy for patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) exceeding the up-to-seven criteria threshold, who are typically unsuitable for transarterial chemoembolization (TACE). A retrospective analysis was conducted on 49 consecutive patients with HCC treated at Tokyo Metropolitan Komagome Hospital between May 2018 and October 2023. The patients were divided into two groups: the Atez/Bev group (21 patients) and the LEN group (28 patients). Eligibility criteria included Child-Pugh A classification, no prior systemic therapy, and ineligibility for resection, ablation, or transplantation. Treatment outcomes were assessed through periodic imaging and laboratory tests, evaluating OS, PFS, ORR, and disease control rate (DCR). Both groups demonstrated comparable baseline characteristics, with a median follow-up of 15.4 months. No significant difference was observed in OS between the Atez/Bev and LEN groups (median OS: 19.80 vs. 22.20 months, p = 0.763). The median PFS was 10.23 months for Atez/Bev and 7.20 months for LEN (p = 0.343). There were no statistically significant differences in ORR or DCR between the two groups. Common adverse events included elevated AST and ALT levels, with no significant difference in the overall rate of adverse events between the groups. Atez/Bev and LEN demonstrated comparable efficacy and safety as first-line systemic treatments for patients with BCLC stage B HCC exceeding the up-to-seven criteria. Both therapeutic options are viable for this population, though further large-scale prospective studies are required to confirm these findings.

A retrospective single institutional analysis of outpatient chemotherapy in patients with cancer during the COVID-19 pandemic.

Providing treatment to patients with cancer, even during the coronavirus disease (COVID-19) pandemic, is essential. In collaboration with infectious disease specialists, we established guidelines for the management of patients with cancer receiving ambulatory treatment during the pandemic on April 8, 2020. This study examined the practice and management of ambulatory chemotherapy under emergency conditions. Following the guidelines, our Breast and Medical oncology department developed a chemotherapy strategy for the phases. Additionally, to distinguish fever during chemotherapy, we developed a flow chart for fever. As part of a fact-finding survey, the status of outpatient chemotherapy was investigated: (1) whether there was any change in the number of chemotherapies before and after the declaration of a state of emergency by the Tokyo Metropolitan Government and (2) the frequency and severity of febrile neutropenia (FN) cases. Compared to before the first declaration of the state of emergency, the number of chemotherapies decreased except after the declaration, but no decrease was observed during the rest of the period; no difference was observed in the frequency or severity of FN outbreaks or in the use of pegfilgrastim for primary prevention before and after the epidemic. With appropriate treatment guidelines, routine chemotherapy can be performed in an outpatient setting during an outbreak.

Allopurinol, Febuxostat, and Nonuse of Xanthine Oxidoreductase Inhibitor Treatment in Patients Receiving Hemodialysis: A Longitudinal Analysis

Rationale & ObjectiveAllopurinol and febuxostat, which are xanthine oxidoreductase inhibitors, have been widely used as uric acid-lowering medications. However, evidence regarding their cardiovascular effects in hemodialysis is insufficient. This study compared the effects of allopurinol and febuxostat on mortality and cardiovascular outcomes in patients receiving hemodialysis. Study DesignRetrospective observational cohort study. Setting & ParticipantsData of 6,791 patients who had no history of topiroxostat usage and underwent maintenance hemodialysis between March 2016 and March 2019 at Yokohama Daiichi Hospital, Zenjinkai, and its affiliated dialysis clinics in Japan’s Kanagawa and Tokyo metropolitan areas were collected. ExposureAllopurinol, febuxostat, and non-treatment. OutcomesAll-cause mortality, cardiovascular disease (CVD) events, heart failure (HF), acute myocardial infarction (AMI), and stroke. Analytical ApproachFor the main analyses, marginal structural Cox proportional hazards models were used to estimate hazard ratios (HRs) adjusted for time-varying confounding and selection bias due to censoring. ResultsAllopurinol and febuxostat showed significantly better survival than non-treatment for all-cause mortality (HR: 0.40, 95% confidence interval [CI]: 0.30–0.54; HR: 0.49, 95% CI: 0.38–0.63, respectively), without significant difference between allopurinol and febuxostat. Allopurinol showed significantly better survival than non-treatment, whereas febuxostat did not for CVD events (HR: 0.89, 95% CI: 0.84–0.95; HR: 1.01, 95% CI: 0.96–1.07, respectively), HF (HR: 0.71, 95% CI: 0.56–0.90; HR: 1.03, 95% CI: 0.87–1.21, respectively), and AMI (HR: 0.48, 95% CI: 0.25–0.91; HR: 0.76, 95% CI: 0.49–1.19, respectively). No comparisons showed significant results for stroke. LimitationsThe ratio of renal or intestinal excretion of uric acid and uremic toxins could not be elucidated, and we could not investigate gene polymorphism because of the large number of cases. ConclusionsAllopurinol and febuxostat improved survival for all-cause mortality. Allopurinol, and not febuxostat, reduced the risk of CVD events, HF, and AMI.

Relationship between natural ventilation modes and indoor/outdoor ratio of Japanese cedar pollen and Cry j 1 allergen

Japanese cedar pollen and its Cry j 1 allergen are major drivers of hay fever in Japan. This study conducted field measurements in an apartment room in Tokyo (Japan) to investigate the effect of indoor air changes per hour (ACH) on the indoor/outdoor (I/O) ratio of Japanese cedar pollen and Cry j 1 at different locations, as well as the variation in Cry j 1 particle size under four opening modes of the balcony door and window. A total of 220 pollen and 484 allergen samples were analyzed. Japanese cedar pollen and Cry j 1 allergens were present even when all doors and windows were closed. The I/O ratio of the Cry j 1 allergen tended to decrease with increasing ACH, and Cry j 1 particles ≤7 μm in diameter were commonly recorded. This study elaborates on the indoor–outdoor transportation dynamics of Japanese cedar pollen and Cry j 1 allergen in a conventional domestic setting and identifies potential areas for improvement in indoor allergen detection and filtering methods.

Incidence of Postoperative Diabetes Mellitus After Roux-en-Y Reconstruction for Gastric Cancer: Retrospective Single-Center Cohort Study.

Sleeve gastrectomy is an effective surgical option for morbid obesity, and it improves glucose homeostasis. In patients with gastric cancer and type 2 diabetes mellitus (DM), gastrectomy, including total gastrectomy, is beneficial for glycemic control. This study aims to clarify the effects of gastrectomy and different reconstructive techniques on the incidence of postoperative DM in patients with gastric cancer. This retrospective, single-center, cohort study included 715 patients without DM who underwent total gastrectomy at the Tokyo Metropolitan Bokutoh Hospital between August 2005 and March 2019. Patients underwent reconstruction by Roux-en-Y (RY) gastric bypass or other surgical techniques (OT), with DM onset determined by hemoglobin A1c levels or medical records. Analyses included 2-sample, 2-tailed t tests; χ2 tests; and the Kaplan-Meier method with log-rank tests to compare the onset curves between the RY and OT groups, along with additional curves stratified by sex. A Swimmer plot for censoring and new-onset DM was implemented. Stratified data analysis compared the RY and OT reconstruction methods. The hazard ratio was 1.52 (95% CI 1.06-2.18; P=.02), which indicated a statistically significant difference in the incidence of new-onset diabetes between the RY and OT groups in patients with gastric cancer. The hazard ratio after propensity score matching was 1.42 (95% CI 1.09-1.86; P=.009). This first-of-its-kind study provides insight into how different methods of gastric reconstruction affect postoperative diabetes. The results suggest significant differences in new-onset DM after surgery based on the reconstruction method. This research highlights the need for careful surgical planning to consider potential postoperative DM, particularly in patients with a family history of DM. Future studies should investigate the role of gut microbiota and other reconstructive techniques, such as laparoscopic jejunal interposition, in developing postoperative DM.

Clinical Features of RS Virus Infection before, during, and after COVID-19 Pandemic.

The COVID-19 pandemic has impacted the epidemiology of other infectious diseases. In particular, the respiratory syncytial (RS) virus infects almost all children during their first or second year of life. However, during the COVID-19 pandemic, many restrictions were enforced that isolated children from other children. Therefore, we hypothesized that the clinical features of RS virus infection were altered and conducted a study to evaluate these changes. This observational study included children below the age of six years who were admitted to the Tokyo Metropolitan Toshima Hospital. Their clinicodemographic data were extracted from medical records. The 369 children eligible for the study were assigned to three groups: "pre-pandemic" (group 1, n = 253); "during pandemic" (group 2, n = 77), and "post-pandemic" (group 3, n = 39). Logistic regression analysis revealed that compared to group 1, the odds ratio (OR) for oxygen use was significantly higher in groups 2 (OR 1.85. 95% confidence interval [CI] 1.06-3.23; p < 0.05) and 3 (OR 3.36, 95% CI 1.59-7.12; p < 0.01), and the use of mechanical ventilation was significantly higher in group 3 (OR 4.89, 95% CI 1.71-13.94; p < 0.01). This study highlights changes in the clinical features of RS virus infection during and after the COVID-19 pandemic.

Cross-sectional study to identify health literacy, health behavior, and quality of life in Chofu and Komae cities in Japan: Formative research in community-based nursing practice.

The Jikei Academic Nursing Practice Center for the Community developed a community nursing practice that matched community health problems and concerns in Chofu and Komae cities, suburban areas of the Tokyo Metropolis. This study aimed to identify health problems and high-risk populations via an understanding of the practice of health behaviors, health literacy, and quality of life. This was an online, cross-sectional study conducted in September 2023. In total, 1520 (Chofu:n=1170; Komae:n=350) participants were enrolled. Participants' demographic characteristics, health literacy, health behaviors, and quality of life scores were obtained. Sleep quality was poor compared with national data. Younger participants had higher poor health literacy, did not practice health behaviors, and had a lower quality of life. In addition, parenting and informal nursing care for family members were associated with unhealthy eating, smoking, drinking, and poor quality of life. This study found that health problems and concerns before planning were significant in increasing the salience of interventions for community residents. Based on the findings of this study, an action plan for community-wide nursing practice was created.

Coastal Waterfront Transformations, Fishing Structures, and Sustainable Tourism

Fishing is a socioeconomic activity with highly visible impacts on the water–land interface of cities. Tourism, the number and type of visitors, and attractions depend on the image and experience of coastal places. How has fishing evolved over time? How has planning attempted to influence and adapt the land use and built-up structures, leading to the activity’s development and commercialization? It utilizes three pairwise cases to analyze the land use transformations associated with fishing activities in cities and some of their most important structures, with impacts on tourism activities such as fish markets, waterfront and pier restaurants, festival marketplaces, and recreational facilities. The three pairwise cases are in three different regions of the world (i.e., North America, Southern Europe, and the Pacific Rim). New Bedford, Massachusetts (USA) and Figueira da Foz (Portugal) are utilized to analyze the land use transformations associated with fishing activities in cities. Fish markets in Tokyo (Japan) and Sydney (Australia) are analyzed to study built-up structures where fish are commercialized. Finally, the last pairwise waterfronts consisting of San Francisco (California, USA) and Fremantle (Western Australia) are examined to understand their fish consumption. The research design and methods comprised in loco visits to the six case studies; discussions with stakeholders; visual documentation and analysis; and a distillation of implications for public policy. The findings demonstrate that more attention needs to be paid to land use changes, the co-existence of working harbor operations with recreational uses, the accessibility to those areas, the “publicness” of the areas in terms of public spaces and other coastal amenities, and the impacts of mixed-use developments on adjacent residential areas. Many waterfronts have suffered radical changes and ought to be made more accessible, authentic, and livable not through the effects of nature or markets alone but with planning and urban design interventions.

The 50-year spatial transition of suburban industrial parks and impacts on sustainable urbanization in the Tokyo metropolitan area

Suburban Industrial Parks (SIP) promote orderly industrial land agglomeration, contributing to sustainable land use transition. Previous studies mostly focused on socio-economic effectiveness and environmental strategies, while the multiscale spatial transition of SIPs and their roles in sustainable urbanization were not thoroughly examined. This study analyzes the temporal pattern of spatial features (TPSF) of SIPs in the Tokyo Metropolitan Area (TMA) using an original suburban industrial community (SIC) model that integrates SIP with its neighborhood. We investigated 110 SIPs established since 1959 across three investigation periods. The results reveal: 1) SIPs influence industrial land use in their neighborhood areas, mostly ranging from 500 to 2500 m. 2) SIPs’ effects on industrial land agglomerations vary over time, demonstrating three development phases: the first phase exhibits the strongest intensity of agglomeration; the second phase falls to the weak; and the third phase recovers a strong agglomeration. 3) Multiscale industrial agglomeration patterns show that 56 % of SIPs in the TMA contribute to orderly spatial transitions; 4) Main road networks facilitate industrial agglomeration. This study proposes the importance of adaptive land use management strategies for SIPs by development phases, and the SIC model could be an applicable tool for land use planning in metropolitan suburbs.