BACKGROUND: Older adults in Japan have the highest drowning mortality rate globally due to frequent bathing practices. Low outdoor temperatures have been linked to bath-related deaths; however, previous studies employed limited statistical models and focused on a single prefecture. Given Japan's aging population, preventing bath-related deaths is a public health priority. This study aimed to analyze the association between outdoor temperature and bath-related drowning deaths across Japan from 1995 to 2020 (n = 110,938), examining regional variations and identifying contributing prefectural characteristics. METHODS: Daily counts of bath-related drowning deaths per prefecture were matched with daily mean temperature data from the Japan Meteorological Agency. Prefecture-level demographic and environmental data were obtained from Japan's Official Statistics. We applied a generalized additive mixed model to examine the association between daily mean temperature and bath-related drowning death risk. Meta-regression was used to identify prefecture-level modifiers. RESULTS: Bath-related drowning death risk peaked at a daily mean temperature of 1.8 °C (relative risk [RR] 9.7, 95% confidence interval [CI]: 9.5-9.9), compared with the lowest risk at 30.3 °C. The association was stronger at mid-range temperatures, particularly among males and individuals aged ≥65 years. Among prefectures, Kagoshima-the southernmost prefecture on Japan's main islands-had the highest maximum RR at 19.6 (95% CI: 16.2-23.6), while Hokkaido-the northernmost prefecture-had the lowest at 3.8 (95% CI: 3.4-4.3). Prefecture-level factors that strengthened this relationship included a lower prevalence of double-pane windows as a proxy of housing insulation and higher annual mean temperatures with ratio of RR change per one standard deviation increase of 0.76 (95% CI: 0.69-0.83) and 1.27 (95% CI: 1.18-1.37), respectively. CONCLUSIONS Warmer prefectures in southern regions exhibited greater maximum-to-minimum risk ratios compared to cooler northern prefectures. This paradoxical finding underscores the importance of region-specific interventions to reduce bath-related deaths.
Japan/epidemiology* ; Humans ; Drowning/epidemiology* ; Male ; Aged ; Female ; Baths/statistics & numerical data* ; Middle Aged ; Temperature ; Aged, 80 and over ; Adult ; Young Adult ; Risk Factors ; Adolescent

BACKGROUND: Previous studies have shown that old age and cold temperatures are risk factors for bathing-related accidents (BRAs) in Japan. The differences between outdoor and indoor temperatures are believed to depend on the housing type (detached houses or apartment buildings). This study aimed to investigate the associations between age, temperature, and BRAs according to housing type in Japan. METHODS: We included cases in which patients were transported by ambulance from domestic bathrooms between April 2016 and March 2022 in Nagoya city. Age-specific BRA incidence rates measured by 5-year age groups, temperature-specific age-adjusted standardized incidence rates (SIRs) for BRA calculated by temperature quintile groups, and the BRA risk regarding temperature based on a time-stratified case-crossover (CCO) design were compared between detached houses and apartment buildings. RESULTS: We observed 4,848 ambulance dispatches owing to BRAs (3,083 in detached houses and 1,765 in apartment buildings; SIR for detached houses compared to apartment buildings: 1.37; 95% confidence interval [CI]: 1.33-1.43). The ratio of detached houses to apartment buildings in the age-specific BRA incidence was almost the same in middle-aged people, but it significantly increased from the age of 70 years onward (incidence rate ratio for the 70-74-years age group: 1.74; 95% CI: 1.43-2.11). Temperature-specific SIR for detached houses compared to apartment buildings was not significantly different in the hottest temperature quintile but increased significantly in the other colder temperature quintiles (SIR in coldest quintile: 1.56; 95% CI: 1.47-1.66). BRA risk based on CCO design increased significantly with a decrease in temperature in detached houses (risk ratio [RR] for 3 °C: 1.25; 95% CI: 1.05-1.47), but not in apartment buildings (RR for 3 °C: 1.07; 95% CI: 0.86-1.34). CONCLUSIONS Detached houses had higher BRA incidence rates than apartments. Older age and lower temperatures, which are risk factors for BRAs, were more prevalent in detached houses than in apartment buildings. Thus, public health measures that focus on detached houses are necessary for preventing BRAs in Japan.
Humans ; Japan/epidemiology* ; Aged ; Middle Aged ; Housing/statistics & numerical data* ; Baths/adverse effects* ; Ambulances/statistics & numerical data* ; Male ; Adult ; Female ; Temperature ; Incidence ; Aged, 80 and over ; Young Adult ; Age Factors ; Adolescent ; Child, Preschool ; Infant ; Child ; Risk Factors ; Infant, Newborn ; Accidents, Home/statistics & numerical data*

BACKGROUND: Although many studies have reported the therapeutic effects of hot spring bathing on various diseases, its influence on healthy individuals is not well understood. Myoban Onsen, a sulfur-rich hot spring in Beppu City, Japan, is traditionally believed to improve skin conditions, relieve fatigue, and promote relaxation. However, scientific verification of these effects, particularly their impact on gut microbiota and related metabolic outcomes in healthy individuals, remains scarce. This study aimed to evaluate the effects of Myoban hot spring bathing on gut microbiota composition and SCFA concentrations in healthy individuals. METHODS: In this study, 16 healthy adult males (n = 16) participated in Myoban hot spring bathing four times over two weeks. Fecal samples were collected before and after the intervention, and 16S rRNA sequencing and gas chromatography-mass spectrometry (GC-MS) were performed to analyze gut microbiota composition and organic acid concentrations. The effects of hot spring bathing were evaluated using the Wilcoxon matched-pair signed-rank test to compare pre- and post-intervention. RESULTS: After Myoban hot spring bathing, there was a significant increase in beneficial gut bacteria, Bifidobacterium, Blautia, and Anaerostipes, compared to pre-bathing (p = 0.0012, p = 0.0103, and p = 0.0017, respectively). Conversely, significant decreases were observed in Parabacteroides, Alistipes, and Oscillibacter (p = 0.0125, p = 0.0215, and p = 0.0125, respectively). Significant increases in SCFAs, including acetic acid, propionic acid, and butyric acid, were observed after Myoban hot spring bathing (p = 0.0067, p = 0.0125, and p = 0.0302, respectively). These findings suggest that Myoban hot spring bathing may benefit healthy adult males. CONCLUSIONS: This study suggests that Myoban hot spring bathing may improve gut health in healthy males. The observed increases in beneficial bacteria and SCFAs indicate a potential contribution to improved health status through modulation of the gut environment. TRIAL REGISTRATION Registration number: UMIN000055229, retrospectively registered.
Humans ; Gastrointestinal Microbiome ; Male ; Hot Springs ; Pilot Projects ; Fatty Acids, Volatile/analysis* ; Adult ; Japan ; Feces/chemistry* ; Bacteria/genetics* ; Young Adult ; Baths ; RNA, Ribosomal, 16S/analysis* ; Middle Aged

PURPOSE: Alpha-1-adrenoceptor blockers (e.g., naftopidil) are prescribed for the treatment of male lower urinary tract symptoms. Although the mechanism of action of naftopidil has been studied in various organs, that in the urinary bladder remains unknown. To clarify the direct effects of naftopidil on this organ, activities were assessed in the isolated rat whole urinary bladder.METHODS: A total of 30 female rats were used. In Experiment 1, bladder activity was measured during a cumulative administration of 2.5–75μM naftopidil (n=7). In Experiment 2, rats were divided into 2 groups: control (n=10) and naftopidil (5 mg/animal/day, oral gavage, once-daily for 2 weeks) (n=13). After the treatment period, plasma was obtained from each rat. The urinary bladders were harvested from the control rats. Isovolumetric rhythmic bladder contractions were induced at above the threshold volume, and intravesical pressure was recorded. Control plasma was added to the organ bath; after subsequent wash-out, plasma collected from rats administered naftopidil was added. In Experiment 3, the plasma levels of monoamines and amino acids were quantified using the individual plasma prepared in the Experiment 2.RESULTS: Cumulative dosing with naftopidil did not change the interval between spontaneous contractions compared to the interval at baseline. After adding control plasma, the interval was shortened compared to the baseline (P=0.008). The plasma collected from rats administered naftopidil suppressed the shortening of the interval compared to the control plasma (P=0.041). Naftopidil resulted in a decrease in the level of noradrenaline (P=0.009) and an increase in that of glycine (P=0.014).CONCLUSIONS: Although naftopidil did not directly act on the interval between spontaneous contractions of the urinary bladder, the plasma collected from rats administered naftopidil, with changing levels of monoamines and amino acids, may suppressed shortening the interval.
Amino Acids ; Animals ; Baths ; Capillary Permeability ; Female ; Glycine ; Humans ; In Vitro Techniques ; Lower Urinary Tract Symptoms ; Male ; Norepinephrine ; Plasma ; Rats ; Urinary Bladder

The purpose of this study was to evaluate the color stability of light cured composite resins according to the resin matrices. Three kinds of resin matrices such as Bis-GMA (Venus® Diamond; VD), Silorane (FiltekTM P90; P90), and Ormocer (Admira; Ad) were selected. Each of them were used to prepare 30 specimens. The initial CIE L*a*b* values were measured by means of a Spectrophotometer (NF999, Nippon Denshoku, Japan). For accelerated aging process, the specimens were immersed in a circulating water bath with distilled water at 60℃. Spectrophotometric analyses were made after immersion of 8, 16, 24, 41 days and the color difference (ΔE*) was calculated. The L* value increased compared with initial L* value. VD had the greatest L* value change and Ad had the smallest L* value change (p<0.05). Ad had the greatest a* value change and VD had the smallest a* value change (p<0.05). The b* value of P90 increased steadily in positive value (+)(p<0.05). ΔE* of Ad had the smallest value and that of P90 had the greatest change with time. According to this study, the value of light cured composite resins was increased with water sorption and color of those changed into greenish and yellowish. And according to the evaluation of color stability, Ad with Ormocer as resin matrices had the best color stability with time in oral environment and P90 with Silorane as resin matrices had the lowest color stability with time. And VD had the greatest initial ΔE*.
Aging ; Baths ; Bisphenol A-Glycidyl Methacrylate ; Composite Resins ; Diamond ; Immersion ; Organically Modified Ceramics ; Silorane Resins ; Water

Legionella species are abundant in the built environment and are increasingly recognized as a cause of Legionnaires' disease (LD). As the number of cases of Legionnaires' disease acquired by local communities in the Seoul metropolitan area in Korea has been increased, there was concern that changes in environmental factors could affect disease outbreaks. We described the association between climatic variables and occurrence of legionellosis in Korea and Legionella detection rate in Seoul area. A total of 418 cases of legionellosis were reported between 2014 and 2017. There was a seasonal peak in summer. LD continuously occurred from early spring to winter every year and rapidly increased in summer. In the regression analysis, the primary variables of interest- PM2.5 (µg/m³), NO₂ (ppb), and a number of the date of issue O₃ warning were not significant except for average temperature (R²=0.8075). The Legionella detection rate in Seoul, Korea showed a trend similar to precipitation (P=0.708, ANOVA). A relatively high proportion of Legionella detection rate was shown, especially cooling tower (17.7%) and public bath (19.3%). This finding is in line with current understanding of the ecological profile of this pathogen and supports the assertion that legionellosis occurs through contamination of water sources.
Baths ; Disease Outbreaks ; Epidemiology ; Korea ; Legionella ; Legionellosis ; Legionnaires' Disease ; Regression Analysis ; Seasons ; Seoul ; Water

Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and administration sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.
Adult ; Bacteremia ; Bandages ; Baths ; Catheters ; Central Venous Catheters ; Checklist ; Chlorhexidine ; Cross Infection ; Education ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infection Control ; Intensive Care Units ; Intensive Care Units, Neonatal ; Medical Staff ; Skin

We investigated whether β-carotene (β-CA) or ellagic acid (EA), originating from various fruits and vegetables, has a preventive effect against male infertility induced by exogenous scrotal hyperthermia. ICR adult mice were intraperitoneally treated with 10 mg/kg of β-CA or EA daily for 13 days consecutively. During this time, mice were subjected to transient scrotal heat stress in a water bath at 43℃ for 20 min on day 7, and their testes and blood were obtained on day 14 for histopathologic and biochemical analyses. Heat stress induced significant testicular weight reduction, germ cell loss and degeneration, as well as abnormal localization of phospholipid hydroperoxide glutathione peroxidase (PHGPx) and manganese superoxide dismutase (MnSOD) in spermatogenic and Leydig cells. Heat stress also altered the levels of oxidative stress (lipid peroxidation, SOD activity, and PHGPx, MnSOD, and HIF-1α mRNAs), apoptosis (Bax, Bcl-xL, caspase 3, NF-κB, and TGF-β1 mRNAs), and androgen biosynthesis (serological testosterone concentration and 3β-hydroxysteroid dehydrogenase mRNA) in testes. These changes were all improved significantly by β-CA treatment, but only slightly improved by EA treatment. These findings indicate that β-CA, through modulations of oxidative stress, apoptosis, and androgen biosynthesis, is a potent preventive agent against testicular injuries induced by scrotal hyperthermia.
Adult ; Animals ; Apoptosis ; Baths ; beta Carotene ; Caspase 3 ; Ellagic Acid ; Fever ; Fruit ; Germ Cells ; Glutathione Peroxidase ; Hot Temperature ; Humans ; Hydrogen Peroxide ; Infertility, Male ; Leydig Cells ; Male ; Mice ; Oxidative Stress ; Oxidoreductases ; Superoxide Dismutase ; Testis ; Testosterone ; Vegetables ; Water ; Weight Loss

Staphylococcus aureus commonly colonizes the skin of atopic dermatitis (AD) patients and contributes to the development and exacerbation of AD. Multiple factors are associated with colonization of AD skin by S. aureus, including the strength of S. aureus-corneocyte adhesion, deficiency of antimicrobial peptides, decreased levels of filaggrin and filaggrin degradation products, overexpressed Th2/Th17 cytokines, microbial dysbiosis and altered lipid profiles. S. aureus colonization on AD skin causes skin barrier dysfunction through virulence factors such as superantigens (toxins), enzymes and other proteins. Furthermore, colonization of AD skin by S. aureus exacerbates AD and may contribute to microbial dysbiosis, allergen sensitization, Th2/Th17 polarization, development of atopic march and food allergy in AD patients. Skin colonization of S. aureus, particularly methicillin-resistant S. aureus (MRSA), is one of the major challenges commonly encountered in the management of AD. Bleach bath, and topical or systemic antibiotics could be used to control S. aureus infection on AD skin. However, careful use of antibiotics is required to control the occurence of MRSA. Recently, various strategies, including microbiome transplant, monoclonal antibodies against virulent toxins, vaccines and recombinant phage endolysin, have been studied to control S. aureus infection on AD skin. Further advances in our understanding of S. aureus could provide us with ways to manage S. aureus colonization more effectively in AD patients.
Anti-Bacterial Agents ; Antibodies, Monoclonal ; Bacteriophages ; Baths ; Colon ; Cytokines ; Dermatitis, Atopic ; Dysbiosis ; Food Hypersensitivity ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbiota ; Peptides ; Skin ; Staphylococcus aureus ; Staphylococcus ; Superantigens ; Vaccines ; Virulence Factors

PURPOSE: The purpose of this study is to investigate the impact of transitional care by a nurse-led multidisciplinary team (MDT) on clinical outcomes and quality of life of patients with ankylosing spondylitis. METHODS: A randomized control study design was used. Subjects were allocated randomly to an experimental group and a control group. The experimental group received intensive transitional care by a nurse-led MDT, whereas the control group received routine nursing care. Disease activity, spinal mobility, comprehensive function, health service utilization, and quality of life were assessed at the baseline and at six months with the Bath Ankylosing Spondylitis Metrology Index, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), a health service utilization questionnaire and version 2 of the Short Form-36 health survey. RESULTS: Compared with the baseline, the BASDAI, BASFI, emergency visits, hospitalizations, hospitalization days, and bodily pain, vitality, mental health, total score, and average score of version 2 of the Short Form-36 health survey were improved in the experimental group (p < .05), whereas only bodily pain, vitality, and role-emotional were improved in the control group p < .05). At six months, the experimental group exhibited significantly more improvement on the BASDAI, BASFI, hospitalizations, all domains except Role-physical as well as total score and average score p < .05) compared with the control group. CONCLUSION: A MDT-based nurse-led transitional care improves clinical outcomes and quality of life of patients with ankylosing spondylitis. Future research should be carried out on modes of follow-up and family support.
Baths ; Emergencies ; Follow-Up Studies ; Health Services ; Health Surveys ; Hospitalization ; Humans ; Mental Health ; Nursing Care ; Patient Care Team ; Quality of Life ; Spondylitis, Ankylosing ; Transitional Care