Vaccination Strategy for the COVID-19 Pandemic in Early 2021 Based on Differences in People's Behavior Between Tokyo and Osaka, Japan

Background: During the fourth COVID-19 wave in Japan, a marked difference was apparent in the scale of the epidemic between Metropolitan Tokyo in eastern Japan and Osaka prefecture in western Japan.Methods: Public epidemic data were analyzed, with performance of mathematical simulations using simplified SEIR models.Results: The increase in the number of infected persons per 100,000 population during the fourth wave of expansion was greater in Osaka than in Tokyo. The basic reproduction number in Osaka was greater than in Tokyo. Particularly, the number of infected people in their 20s increased during the fourth wave: the generation-specific reproduction number of people in their 20s was higher than people of other generations. Both Tokyo and Osaka had strong correlation between the increase in the number of infected people and the average number of people using the main downtown stations at night. Simulations showed vaccination of people in their 60s and older reduced the number of infected people among the high-risk elderly population in the fourth wave. However, age-specific vaccination of people in their 20s reduced the number of infected people more than vaccination of people in their 60s and older.Conclusions: Differences in the epidemic between Tokyo and Osaka are explainable by different behaviors of the most socially active generation. When vaccine supplies are adequate, priority should be assigned to high-risk older adults, but if vaccine supplies are scarce, simulation results suggest consideration of vaccinating specific groups among whom the epidemic is spreading rapidly.

Canine Leptospirosis Outbreak in Japan

Canine leptospirosis was suspected in 11 dogs in Osaka Prefecture, Japan and 9 dogs died within a month, from October 12 to November 10, 2017. Eight of the dogs had been taken on walks along the same riverbed and 4 dogs lived in the same town. Logistic regression analysis between a comparative group and the incident cases group showed that the odds of leptospirosis infection was 13.3 times higher (p = 0.044) in the dogs taken on walks along the riverbed than in the dogs not being walked along the riverbed. It is suggesting that these walks had been a risk factor. Microscopic agglutination tests showed that antibody titers against Leptospira interrogans serovar Australis were 1:2,560 and 1:10,240 in 2 dogs. Therefore, L. interrogans serovar Australis was suspected to be the causative agent, for which no canine vaccine is available in Japan. These results suggested that L. interrogans serovar Australis can cause local outbreaks. The development of a canine vaccine against various serotypes might help reduce local infections. Leptospirosis is an important infectious disease of dogs and it is also a zoonotic disease.

Effect of Exchange Through Kendo on the Image of the elderly of Junior High School Kendo Club Members

This study targeted junior high school kendo club members who have practice experience with elderly kendo practitioners and examined the image of the elderly and the related factors that intergenerational exchange through kendo brings to the junior high school members. Kendo is one of the traditional Japanese martial arts. The subjects in this research were 193 players who practiced with the elderly kendo practitioners in Osaka prefecture. As a result of factor analysis to clarify the structure of the image, the "evaluation" factor and the "activity / competence" factor were extracted as in the previous research, and it was suggested that the junior high school players generally had positive image regarding the elderly practitioners. As a result of logistic regression analysis to clarify the factors related to the high/ low scores in the image of elderly kendo practitioners, “evaluation” factor showed a significant relationship between “intimacy with elderly practitioners” and “empathic interest”, and “activity / competence” factor indicated a significant relationship between “gender” and “intimacy with elderly kendo practitioners.” Although it is pointed out that the traditional style of kendo and the image of elderly kendo practitioners have a negative impact on children, it may be possible to control these factors through an appropriate guidance and approach depending on the children's stage of growth.

Incidence and Mortality of Emergency Patients Transported by Emergency Medical Service Personnel during the Novel Corona Virus Pandemic in Osaka Prefecture, Japan: A Population-Based Study

Although the COVID-19 pandemic affects the emergency medical service (EMS) system, little is known about the impact of the COVID-19 pandemic on the prognosis of emergency patients. This study aimed to reveal the impact of the COVID-19 pandemic on the EMS system and patient outcomes. We included patients transported by ambulance who were registered in a population-based registry of patients transported by ambulance. The endpoints of this study were the incident number of patients transported by ambulance each month and the number of deaths among these patients admitted to hospital each month. The incidence rate ratio (IRR) and 95% confidence interval (CI) using a Poisson regression model with the year 2019 as the reference were calculated. A total of 500,194 patients were transported in 2019, whereas 443,321 patients were transported in 2020, indicating a significant decrease in the number of emergency patients transported by ambulance (IRR: 0.89, 95% CI: 0.88–0.89). The number of deaths of emergency patients admitted to hospital was 11,931 in 2019 and remained unchanged at 11,963 in 2020 (IRR: 1.00, 95% CI: 0.98–1.03). The incidence of emergency patients transported by ambulance decreased during the COVID-19 pandemic in 2020, but the mortality of emergency patients admitted to hospital did not change in this study.

Evaluation of urinary extravasation after non-operative management of traumatic renal injury: a multi-center retrospective study

Purpose Urinary extravasation is one of the major complications after non-operative management of traumatic renal injury and may lead to urinary tract infection and sepsis. The purpose of this study was to evaluate these factors in patients with traumatic renal injury. Methods This was a multi-center, retrospective, observational study performed at three tertiary referral hospitals in Osaka prefecture. We included patients with traumatic renal injury transported to the centers between January 2008 and December 2018. We excluded patients who either died or underwent nephrectomy within 24 h after admission. We investigated the occurrence of urinary extravasation and the related factors after traumatic renal injury using multivariable logistic regression analysis. Results In total, 146 patients were eligible for analysis. Their median age was 44 years and 68.5% were male. Their median Injury Severity Score was 17. Renal injuries were graded as American Association for Surgery of Trauma (AAST) grade I in 33 (22.6%), II in 27 (18.5%), III in 38 (26.0%), IV in 28 (19.2%), and V in 20 (13.7%) patients. Urinary extravasation was diagnosed in 26 patients (17.8%) and was statistically significantly associated with AAST grades IV–V (adjusted odds ratio, 33.8 [95% confidence interval 7.12–160], p < 0.001). Conclusion We observed urinary extravasation in 17.8% of patients with non-operative management of traumatic renal injury and the diagnosed was made in mostly within 7 days after admission. In this study, the patients with AAST grade IV–V injury were associated with having urinary extravasation.

Twenty-three-year demographic history of the Affenberg Japanese macaques (Macaca fuscata), a translocated semi-free-ranging group in southern Austria

Demographic studies on translocated primate groups provide a unique opportunity to study population dynamics, social strategies, and reproductive parameters of a species adapting to new environments. In 1996, 38 Japanese macaques (Macaca fuscata) of the Minoo-H group (Osaka Prefecture, Japan) were translocated to Affenberg Landskron, a four-hectare naturally forested park in southern Austria. By January 2020, the population had increased to 160 individuals, and a total of 223 births were recorded. Births peaked in late April to late May, and the timing was influenced by neither offspring sex nor parity status of the mother. Infant mortality was low (8.97%), mostly involving primiparous females, and the average interbirth intervals were shorter following the death of an infant (1.10 years) than a surviving infant (1.77 years). Females rarely had offspring with the same males repeatedly, and the reproductive success among males declined with increasing years of presence in the group. The main aspects of reproduction, mortality, and mate choice are consistent with published data on natural and provisioned populations in Japan and those translocated to other countries. The life expectancy for females, however, was relatively high (11.72% chance of reaching the age of 20), whereas birth control prevented them from using their lifetime reproductive potential. By January 2020, the number of old individuals (> 18 years; 17.5%) was close to that of juveniles (< 4 years; 22.5%). The specific group composition, along with the inability of males to emigrate out of their natal group, may affect the social dynamics of the population, which merits further attention in future studies.

Prediction of severe COVID-19 cases requiring intensive care in Osaka, Japan

Background: To avoid exhaustion of medical resources by COVID-19 care, policy-makers must predict care needs, specifically estimating the proportion of severe cases likely to require intensive care. In Osaka prefecture, Japan, the number of these severe cases exceeded the capacity of ICU units prepared for COVID-19 from mid-April, 2021. Objective: This study used a statistical model to elucidate dynamics of severe cases in Osaka and validated the model through prospective testing. Methods: The study extended from April 3, 2020 through April 26, 2021 in Osaka prefecture, Japan prefecture. We regressed the number of severe cases on the number of severe cases the day prior and the newly onset patients of more than 21 days prior. Results: We selected the number of severe cases the day prior and the number of newly onset patients on 21 and 28 days prior as explanatory variables for explaining the number of severe cases based on the adjusted determinant coefficient. The adjusted coefficient of determination was greater than 0.995 and indicated good fit. Prospective out of sample three-week prediction forecast the peak date precisely, but the level was not t. Discussion and Conclusion: A reason for the gap in the prospective prediction might be the emergence of variant strains.