Metropolitan Area Of Japan Research Articles

Estimating HIV-1 incidence in Japan from the proportion of recent infections.

The first step of the UNAIDS/WHO 90-90-90 targets to encourage early diagnosis with treatment for the control of HIV-1 epidemic is to achieve 90% HIV-1 diagnosis in infected individuals. In Japan, approximately 30% of newly reported cases have been annually identified by AIDS onset, implying that substantial numbers of HIV-1-infected individuals remain undiagnosed. However, the proportion of undiagnosed cases has not yet been determined. In the present study, the proportion of recent HIV-1 infections to newly-diagnosed cases was determined from 2006 to 2015 using a recent infection assay for three metropolitan areas in Japan: Tokyo, Osaka, and Fukuoka. Estimated median periods between infection and diagnosis were 1.0, 1.8, and 2.9 years for Tokyo, Osaka, and Fukuoka, respectively. Estimation of annual HIV-1 incidence by a back-calculation method using these data as well as HIV/AIDS national surveillance data indicated proportions of undiagnosed to new HIV-1 infections from 2006 to 2015 to be 18% in Tokyo, 22% in Osaka, 38% in Fukuoka, and 28% in Japan. This is the first report estimating HIV-1 incidence in Japan using a serological biomarker in combination with national HIV/AIDS surveillance data.

P2622Use of intravenous vasodilators in patients hospitalized with acute heart failure: insights from Tokyo cardiovascular care unit network database

Abstract Background Despite recommendations from clinical practice guidelines, there is scant evidence confirming the effects of vasodilators on clinical outcomes in patients with acute heart failure (AHF). Purpose We sought to investigate the effects of intravenous vasodilators on clinical outcomes and to identify the potential patient populations that would benefit from its use. Methods Data of 26 212 consecutive patients urgently hospitalized for AHF between 2009 and 2015 were extracted from a multicenter data registration system (Tokyo Cardiovascular Care Unit Network Database, including 72 institutions within the Tokyo metropolitan area in Japan). Patients who did not present with typical AHF episodes, including those without pulmonary congestion on physical and/or chest X-ray and serum B-type natriuretic peptide level <500 pg/ml, as well as those who had hypotension and/or hypoperfusion (systolic blood pressure [SBP] <100 mmHg) as dominant presentation, were excluded. Propensity scores were calculated with multiple imputation and 1:1 matching performed between patients with and without vasodilators. The primary endpoint was in-hospital mortality and the secondary endpoints were length of intensive/cardiovascular care unit (ICU/CCU) stay and hospital stay. Results Overall, 8 863 patients were included in the present analysis; they were predominantly male (57%) with a median age of 79 (interquartile range: 70–86) years. Compared with the group without vasodilator use, the vasodilator group had higher SBPs and heart rates and higher frequency of assisted ventilation use, but lower frequency of intravenous diuretics use. After propensity score matching, there were no significant differences in in-hospital mortality rates (7.8% vs. 8.9% in patients without vasodilators, p=0.16) or in length of ICU/CCU stay (5.8 days vs. 5.4 days, p=0.44) and hospital stay (22.7 days vs. 23.8 days, p=0.22) between the groups. However, in subgroup analyses, favorable impacts of vasodilator use on in-hospital mortality were observed among patients who had higher SBPs and among those who had no atrial fibrillation upon admission (Figure). In addition, vasodilators were likely to be more effective in AHF patients with SBP increasing; while levels below 140 mmHg of SBP appeared to be associated with an increased risk for mortality among patients treated with vasodilators compared with those without vasodilators. Figure 1 Conclusions In patients with AHF, vasodilator use was not universally associated with improved in-hospital outcomes; however, its effect was dependent of individual clinical presentation. Detailed phenotyping might aid tailoring of treatment strategies for patients with AHF. Acknowledgement/Funding the Tokyo Metropolitan Government

Atypical profile of aortic injury associated with blunt trauma in the metropolitan area of Japan

BackgroundAortic injury caused by blunt trauma is a critical medical condition that requires extraordinary caution in the treatment. It is often caused by direct hit and high-speed deceleration in motor...

Associations of education and income with heavy drinking and problem drinking among men: evidence from a population-based study in Japan

BackgroundSome studies in Western countries have suggested that education and income are differentially associated with different drinking patterns. This study aimed to examine the associations of education and income with heavy drinking and problem drinking among community-dwelling Japanese men.MethodsA questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25 to 50 years; valid responses were received from 2004 men. Drinking patterns were categorized as non-to-moderate drinking, non-problematic heavy drinking, and problem drinking. Multiple logistic regression analyses were conducted to determine whether educational attainment or income was associated with drinking patterns, after adjustment for age, marital status, working status, income/education, self-rated health, and psychological distress.ResultsThe study population included 84.4% non-to-moderate drinkers, 8.9% non-problematic heavy drinkers, and 6.7% problem drinkers. Lower educational attainment (high school or less) was significantly associated with increased risks of both non-problematic heavy drinking (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.21–2.67) and problem drinking (OR, 2.06; 95% CI, 1.34–3.16), compared with university education or higher. Lower income (lowest tertile) was significantly associated with a lower risk of non-problematic heavy drinking (OR, 0.66; 95% CI, 0.43–1.00), but not of problem drinking (OR, 0.80; 95% CI, 0.50–1.30), compared with the highest income tertile.ConclusionsThese findings indicate that education and income are differentially associated with alcohol drinking patterns among community-dwelling Japanese men.

Urban redevelopment and residential location choice: Evidence from a major earthquake in Japan

AbstractWe examine residential location choice behavior in a metropolitan area of Japan that experienced seismic damage. We find that the internal structure of the affected area was reshaped, although, in the long term, its total population size was robust to this temporary shock. Before the earthquake, the population was evolving toward a state of equilibrium with dense locations in the core facing redevelopment barriers and, therefore, stagnation. In contrast, the periphery was becoming increasingly appealing and thus growing. Seismic damage allowed for redevelopment at higher density, making the adjusted equilibrium with dense locations grow again. In summary, the initially expanding periphery stagnated as an unintended consequence of urban redevelopment.

Women’s Descriptive Representation in the Metropolitan Areas in Japan

Women’s Descriptive Representation in the Metropolitan Areas in Japan

Qualitative exploration of fear of childbirth and preferences for mode of birth among Japanese primiparas.

Antenatal fear of childbirth (FOC) is associated with negative effects, such as postnatal traumatic symptoms. As the birth-related culture of East Asian countries differs from that in Western countries, the aim of the present qualitative, descriptive study was to explore FOC, perceptions for Caesarean section (CS), and obstetric analgesia (OA) among Japanese primiparas. The qualitative, descriptive study included focus group interviews with 11 primiparous women, which were conducted in a birth house and a maternity hospital in a metropolitan area of Japan in 2013. As a result, seven categories emerged from the analysis: Maternal and child risk, pain, losing control, uncertainty, prolonged labor, poor family support and loneliness before hospitalization. All participants denied having a preference for CS birth due to fear. Opposing values of OA were identified in women who chose OA and those who did not. In conclusion, it is necessary to increase clinical awareness that the objects of fear are diverse. Furthermore, diverse values regarding OA should be understood and equally respected by health-care professionals.

Development of Administrative Business Continuity Plans for Earthquake Disaster Management of Metropolitan Areas in Japan and its Implications

This study aims to explore the administrative business continuity plans (BCPs) for earthquake disaster management of metropolitan areas and attempts to analyze the implications of their development. We employed the case study as a methodology, analyzing BCPs in the metropolitan area of Japan. Two samples, Tokyo and Osaka, were selected for this analysis because Tokyo experienced the East Japan Earthquake in 2011, while Osaka is apprehensive of an imminent large earthquake. The results of this study demonstrate that Tokyo's administrative BCPs were closely connected with other local governments. The results also found that the management of the Nankai Trough earthquake in Osaka was based on the plan for earthquake disaster management to minimize the inconvenience to the daily lives of citizens and the loss of economic activity caused by administrative paralysis. Keywords: Administrative Business Continuity Plan, Great Earthquake, Tokyo, Osaka

Characteristics of Energy Consumption in the Process of Regional Economic Integration Development: Beijing-Tianjin- Hebei Economic Belt versus Tokyo-to Metropolitan Area

Energy consumption plays a significant role in the integration process of Beijing- Tianjin-Hebei economic belt. This paper compares energy situation of Beijing-Tianjin-Hebei economic belt and Tokyo-to metropolitan area. The results show there are some differences between Beijing-Tianjin-Hebei economic belt and Tokyo-to metropolitan area: first, the proportion of Beijing-Tianjin-Hebei economic belt in China is lower than the proportion of Tokyo-to metropolitan area in Japan; second, energy intensity of Beijing-Tianjin-Hebei economic belt experiences a trend of descending, while it holds stable in Tokyo-to metropolitan area; third, energy structure of Beijing-Tianjin-Hebei economic belt has a serious reliance on coal, whereas, in Tokyo-to metropolitan area, consumption of oil took the main proportion of energy structure, consumption of renewable energy increasing constantly. Based on our findings, we present some policy implications for energy save in Beijing-Tianjin-Hebei economic belt.

Cross-sectional study of cognitive stress appraisal and related factors among workers in metropolitan areas of Japan

ObjectiveStress has major socioeconomic implications for all spheres of employment. It is a trigger for depression, and affects absenteeism, turnover, productivity, morale and suicide. Positive or negative cognitive stress appraisal...

Proxy Punishment: Consequences of Informal Sanctions among Families of Offenders In Japan

This study demystifies the nature of societal reactions to crime in Japan and their consequences on the family members of those who have trouble with the law. Over a 20-month period in metropolitan areas in Japan, participant observation and in-depth interviews were conducted with 50 mothers, fathers, wives, and sisters of those who had broken the law. Major findings include the role that the media and criminal justice authorities play in triggering the informal labeling of offenders’ kin. Families’ strong ties to communities also rendered them particularly vulnerable to the effects of informal sanctions, even more so than offenders themselves. Finally, this study reveals ironies of Japan’s low crime rate and its use of informal sanctions, highlighting the fundamental importance of offender rehabilitation and reentry.

Spatiotemporal land use random forest model for estimating metropolitan NO2 exposure in Japan

Adequate spatial and temporal estimates of NO2 concentrations are essential for proper prenatal exposure assessment. Here, we develop a spatiotemporal land use random forest (LURF) model of the monthly mean NO2 over four years in a metropolitan area of Japan. The overall objective is to obtain accurate NO2 estimates for use in prenatal exposure assessments. We use random forests to convey the non-linear relationship between NO2 concentrations and predictor variables, and compare the prediction accuracy with that of a linear regression. In addition, we include the distance decay effect of emission sources on NO2 concentrations for more efficient model construction. The prediction accuracy of the LURF model is evaluated through a leave-one-monitor-out cross validation. We obtain a high R2 value of 0.79, which is better than that of the conventional land use regression model using linear regression (R2 of 0.73). We also evaluate the LURF model via a temporal and overall cross validation and obtain R2 values of 0.84 and 0.92, respectively. We successfully integrate temporal and spatial components into our model, which exhibits higher accuracy than spatial models constructed individually for each month. Our findings illustrate the advantage of using a LURF to model the spatiotemporal variability of NO2 concentrations.

Evaluation of energy-related household carbon footprints in metropolitan areas of Japan

In the Post-Paris Era, urban emissions have received worldwide attention as cities are considered to be responsible for most of the world’s environmental footprint. A better understanding of urban CO2 emissions and their related carbon footprints offers benefits to policymakers interested in promoting effective and efficient low-carbon solutions. In particular, a clear determination of direct and indirect emissions inventories (that is, identification of emissions related to specific sources) can provide a valuable baseline for the planning, assessing, implementing, and monitoring of urban mitigation actions. Focusing on the Japanese urban residential sector, this paper uses an established urban database and emission database based on global-related input-output analysis to systematically analyze household carbon footprints related to energy demand, targeting both direct and indirect energy-related CO2 emissions in Japan’s megacities. The results reveal the city-specific emissions status of Japan’s three major metropolitan areas, showing, for example, that Tokyo is a source of high direct emissions, while Utsunomiya is a significant source of indirect emissions. The study also tentatively concludes that the depopulation of cities can result in higher per capital emissions, both direct and indirect, as they relate to energy demand. Improved sector and spatially explicit information for better mitigation policymaking and environmental education at the urban level is presented. Valuable insights are offered through an in-depth investigation of the relationship between CO2 emissions and urban socioeconomic activities, benefitting future low-carbon city research and practice.

Functional diversity in Keihanshin Metropolitan Area

ABSTRACTDiversity is one of the defining characteristics of complex adaptive systems – systems made up of heterogeneous agents whose interactions form a dynamic network resulting in emergent behaviour. Recent research shows that various types of diversity increase with the scale of the system. This paper uses ideas and methods from community ecology to define business types as functional traits and to calculate functional diversity as a measure of the economic diversification in an urban system. It asks how functional diversity changes with the size of the city within an urban region. Using Keihanshin Metropolitan Area in Japan as an example, the paper concludes that while functional diversity scales with city size, it reaches saturation due to the limitations of the business types classification systems. It argues that regardless of the observed saturation, the method can reveal the structural complexity of the city, showing what types of industries form its economy. It also discovers functions common to all cities in the region, and calls for further development of the method by introducing the multidimensional analysis and additional measures of diversity.

Effect of Land-Use Change on the Urban Heat Island in the Fukuoka–Kitakyushu Metropolitan Area, Japan

In coastal cities, the effect of the sea breeze in mitigating the urban heat island (UHI) phenomenon has attracted attention. This study targeted the Fukuoka–Kitakyushu metropolitan area, the fourth largest metropolitan area in Japan which is also coastal. Doppler Light Detection And Ranging (LiDAR) observations were conducted in the summer of 2015 to clarify the transition of the wind field over the targeted area. To investigate the effects on the UHI of land-use change related to urbanization, the National Land Numerical Information (NLNI) land-use datasets for Japan in 1976 (NLNI-76) and 2009 (NLNI-09) were used in the Weather Research and Forecasting (WRF) model. The results of the simulation showed that most of the northern part of the Kyushu region became warmer, with an average increase of +0.236 °C for the whole simulation period. Comparing the two simulations and the Doppler LiDAR observations, the simulation results with the NLNI-09 dataset (for the year closest to the study period in 2015) showed closer conformity with the observations. The results of the simulation using NLNI-76 showed faster sea breeze penetration and higher wind velocity than the observations. These results suggest that the land-use change related to urbanization weakened the sea breeze penetration in this area.

The ratio of serum n-3 to n-6 polyunsaturated fatty acids is associated with diabetes mellitus in patients with prior myocardial infarction: a multicenter cross-sectional study

BackgroundIn prior myocardial infarction (PMI) patients, diabetes mellitus (DM), dyslipidemia, and hypertension increase the risk of secondary cardiovascular events. Although a decreased ratio of serum eicosapentaenoic acid (EPA) to arachidonic acid (AA; EPA/AA) has been shown to significantly correlate with the onset of acute coronary syndrome, the associations between polyunsaturated fatty acid (PUFA) levels and coronary risk factors in PMI patients have not been evaluated thoroughly. This study aimed to assess the associations between PUFAs levels and the risk factors in PMI patients.MethodsWe enrolled 1733 patients with known PUFA levels who were treated in five divisions of cardiology in a metropolitan area of Japan, including 303 patients with PMI. EPA/AA and docosahexaenoic acid (DHA) to AA level ratio (DHA/AA) in patients with and without PMI were analyzed according to presence of coronary risk factors.ResultsDiabetes patients with PMI had significantly lower EPA/AA and DHA/AA than diabetes patients without PMI (EPA/AA: P <0.01; DHA/AA: P =0.003), with no such differences in dyslipidemia and hypertension patients. In DM patients with high high-sensitivity C-reactive protein (hs-CRP) levels (>0.1 mg/dL), EPA/AA was low in individuals who also had PMI, whereas DHA/AA was not (EPA/AA, with PMI: 0.43 ± 0.24; without PMI: 0.53 ± 0.30, P < 0.05). Moreover, patients on statins had significantly lower DHA/AA ratios, whereas the EPA/AA ratio did not depend on statin use. Multiple regression analysis revealed that statin use in DM patients was associated with low DHA/AA but not EPA/AA.ConclusionPMI patients with DM have low EPA/AA and DHA/AA. EPA/AA and DHA/AA are differently related to hs-CRP level in DM patients with PMI. Statin use can potentially affect DHA/AA but not EPA/AA, and therefore EPA/AA ratio is a better marker of assessment for cardiovascular events.

Convoys of Social Relations in Cross-National Context.

This study examines national variations in social networks among older adults across 4 countries in diverse regions of the world: Japan, Lebanon, Mexico, and the United States. The aim is to provide insights into universal as well as unique attributes of social networks in later life. The analyses examine convoy characteristics among adults aged 50+ in metropolitan areas of Japan (N = 557), Lebanon (N = 284), Mexico (N = 556), and the United States (N = 583). Data were collected using the hierarchical mapping technique on representative samples in each locale. Multilevel models were conducted by nation to examine whether convoy characteristics vary by age and closeness. Network size and geographic proximity were dimensions of social networks sensitive to national context. By contrast, how age and feelings of closeness varied with contact frequency and the presence of children in networks revealed universal patterns. Furthermore, feelings of closeness varied by age with regard to size and contact frequency in Lebanon, proximity in Japan, and composition in Mexico. Identifying universal and unique characteristics of social networks in later life provide a preliminary empirical basis upon which to advance a global perspective on convoys of social relations and how they inform policies that can facilitate health and well-being among middle-aged and older people around the world.

全体曲げ変形に伴う制振建物の性能低下を補償する同調質量ダンパーの最適設計法

It is being revealed that occurrence of the Nankai-Trough earthquake might cause significant damage to low-damped super high rise steel buildings in some metropolitan areas in Japan. Addition of supplemental damping devices is effective means to mitigate the damage caused by the great earthquake. However, the seismic effectiveness of dampers connected to a structural frame tends to lose due to overall bending deformation in a slender steel building. On the other hand, a tuned mass damper (TMD) connected to the frame work well even if the overall bending deformation is quite large. The combination of the two kinds of dampers therefore is expected to be effective in slender buildings with a large aspect ratio. However, an optimal design parameter of the TMD mounted on highly damped buildings and its seismic effectiveness are not clarified. The objective of this paper is to develop a design procedure of the two different damping devices. Both the dampers are limited to a linear viscous damper in this study. Firstly, a lumped mass stick model with shear springs and rotational springs is employed to take account of the overall bending deformation. Two degree of freedom (2-DOF) system is derived from this model with the help of dynamic reduction technique. The 2-DOF system becomes non-proportional damping system. Subsequently, a linear viscous TMD are connected to the 2-DOF system and a 3-DOF system is obtained for the TMD-building interaction system. Optimal design parameters of the TMD are obtained by solving a Lyapunov equation of the 3-DOF system. The optimal stiffness of the TMD is summarized in terms of equivalent damping factor due to only dampers installed into the stories. The computed optimal stiffness is almost consistent with the result of SDOF system with the same equivalent damping factor. This fact admits to use regression formulae of the optimal stiffness proposed by several researchers. It is also confirmed that the optimal parameters obtained by the criterion of minimizing top displacement and story drift is almost the same. Secondary, equivalent damping factor of the TMD-building interaction system are investigated through stochastic dynamic analysis. As a result, the equivalent damping decreases according to increase of the amount of the dampers within stories. The convenient regression formula is proposed in terms of the equivalent damping factor of the building. The equivalent damping factor is directly evaluated with a slenderness ratio of the building and a damping factor by using the formula. Finally, a design procedure of the TMD is formulated. Required amount of the TMD mass is proposed based on the concept that the loss of damping factor is equal to the additional equivalent damping factor added by the TMD.

Association between the docosahexaenoic acid to arachidonic acid ratio and acute coronary syndrome: a multicenter observational study.

BackgroundA low eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio is a known risk for acute coronary syndrome (ACS). However, the association between the docosahexaenoic acid (DHA) to AA ratio and ACS remains unclear. This study aimed to assess the association between the DHA/AA ratio and ACS by patient characteristics.MethodsWe enrolled 1733 patients and evaluated the serum levels of polyunsaturated fatty acids in 5 cardiology departments in a metropolitan area of Japan. We assessed the relationship between the DHA/AA ratio (median cut-off value: 0.903) and ACS according to the following 10 subgroups: sex, age, diabetes mellitus, hypertension, dyslipidemia, smoking history, family history of ischemic heart disease, chronic kidney disease, obesity, and history of coronary revascularization.ResultsInteraction tests in the 10 subgroup analyses revealed a significant difference for adjusted log odds ratios between male and females (p = 0.01), and those with and without hypertension (p = 0.06). Especially in the subgroup based on sex difference, a high DHA/AA ratio was significantly associated with a low risk of ACS among men (adjusted odds ratio = 0.389; 95 % confidence interval: 0.211–0.716). In contrast, a reverse association was found among women, although this was not statistically significant (adjusted odds ratio = 3.820; 95 % confidence interval: 0.718–20.325).ConclusionsThe association between the DHA/AA ratio and ACS differed by clinical characteristic. Notably, patients with a low DHA/AA ratio had a higher risk of ACS than those with a high DHA/AA ratio, and this was significant for men in particular.

Ecosystem dynamics in Tokyo Bay with a focus on high trophic levels using Ecopath with Ecosim

The present study aimed to investigate ecosystem dynamics in Tokyo Bay, a semi-enclosed bay surrounded by the Tokyo metropolitan area in Japan, which is one of the largest and most populous industrialized areas in the world. The bay has been subject to eutrophication since the 1960s, and excessive increase in phytoplankton biomass has led to hypoxia. Ecopath with Ecosim was used to simulate the phytoplankton dynamics, and it could closely reproduce the observed relative biomass. To evaluate the impacts of phytoplankton dynamics, hypoxia, and fishing on the dynamics, with a focus on high trophic levels (up to fish), 3 scenarios, “Yearly constant phytoplankton biomass,” “No hypoxia,” and “No fishing,” were tested. Comparisons with the “Control” scenario without any modifications suggested that (1) the dynamics was controlled by phytoplankton (bottom-up control), (2) hypoxia did not have a serious effect on the past dynamics, and (3) stopping fishing would not contribute to recover of the biomass of exploited fish. Predictions for future dynamics under the scenarios “DO deteriorated” and “DO unchanged” suggest that if DO deteriorates strongly enough to decrease the survival of most benthos, the ecosystem might undergo a non-negligible transformation through extinction or biomass decrease of some benthos.