ELPIS-JP: a dataset of local-scale daily climate change scenarios for Japan

We developed a dataset of local-scale daily climate change scenarios for Japan (called ELPIS-JP) using the stochastic weather generators (WGs) LARS-WG and, in part, WXGEN. The ELPIS-JP dataset is based on the observed (or estimated) daily weather data for seven climatic variables (daily mean, maximum and minimum temperatures; precipitation; solar radiation; relative humidity; and wind speed) at 938 sites in Japan and climate projections from the multi-model ensemble of global climate models (GCMs) used in the coupled model intercomparison project (CMIP3) and multi-model ensemble of regional climate models form the Japanese downscaling project (called S-5-3). The capability of the WGs to reproduce the statistical features of the observed data for the period 1981–2000 is assessed using several statistical tests and quantile–quantile plots. Overall performance of the WGs was good. The ELPIS-JP dataset consists of two types of daily data: (i) the transient scenarios throughout the twenty-first century using projections from 10 CMIP3 GCMs under three emission scenarios (A1B, A2 and B1) and (ii) the time-slice scenarios for the period 2081–2100 using projections from three S-5-3 regional climate models. The ELPIS-JP dataset is designed to be used in conjunction with process-based impact models (e.g. crop models) for assessment, not only the impacts of mean climate change but also the impacts of changes in climate variability, wet/dry spells and extreme events, as well as the uncertainty of future impacts associated with climate models and emission scenarios. The ELPIS-JP offers an excellent platform for probabilistic assessment of climate change impacts and potential adaptation at a local scale in Japan

Assessment of risk factors related to healthcare-associated methicillin-resistant Staphylococcus aureus infection at patient admission to an intensive care unit in Japan

<p>Abstract</p> <p>Background</p> <p>Healthcare-associated methicillin-resistant <it>Staphylococcus aureus </it>(HA-MRSA) infection in intensive care unit (ICU) patients prolongs ICU stay and causes high mortality. Predicting HA-MRSA infection on admission can strengthen precautions against MRSA transmission. This study aimed to clarify the risk factors for HA-MRSA infection in an ICU from data obtained within 24 hours of patient ICU admission.</p> <p>Methods</p> <p>We prospectively studied HA-MRSA infection in 474 consecutive patients admitted for more than 2 days to our medical, surgical, and trauma ICU in a tertiary referral hospital in Japan. Data obtained from patients within 24 hours of ICU admission on 11 prognostic variables possibly related to outcome were evaluated to predict infection risk in the early phase of ICU stay. Stepwise multivariate logistic regression analysis was used to identify independent risk factors for HA-MRSA infection.</p> <p>Results</p> <p>Thirty patients (6.3%) had MRSA infection, and 444 patients (93.7%) were infection-free. Intubation, existence of open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission, were detected as independent prognostic indicators. Patients with intubation or open wound comprised 96.7% of MRSA-infected patients but only 57.4% of all patients admitted.</p> <p>Conclusions</p> <p>Four prognostic variables were found to be risk factors for HA-MRSA infection in ICU: intubation, open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission. Preemptive infection control in patients with these risk factors might effectively decrease HA-MRSA infection.</p

Effectiveness of prehospital Magill forceps use for out-of-hospital cardiac arrest due to foreign body airway obstruction in Osaka City

Background: Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO. Methods: We retrospectively reviewed ambulance records of all patients who suffered FBAO, and were treated by EMS in Osaka City from 2000 through 2007, and assessed the characteristics of those patients. We also performed a multivariate logistic-regression analysis to assess factors associated with neurologically favorable survival among bystander-witnessed OHCA patients with FBAO in larynx or pharynx. Results: A total of 2,354 patients suffered from FBAO during the study period. There was a bimodal distribution by age among infants and old adults. Among them, 466 (19.8%) had an OHCA when EMS arrived at the scene, and 344 were witnessed by bystanders. In the multivariate analysis, Magill forceps use for OHCA with FBAO in larynx or pharynx was an independent predictor of neurologically favorable survival (16.4% [24/146] in the Magill forceps use group versus 4.3% [4/94] in the non-use group; adjusted odds ratio, 3.96 [95% confidence interval, 1.21-13.00], p = 0.023).Conclusions: From this large registry in Osaka, we revealed that prehospital Magill forceps use was associated with the improved outcome of bystander-witnessed OHCA patients with FBAO