Projection of future heat-related morbidity in three metropolitan prefectures of Japan based on large ensemble simulations of climate change under 2 °C global warming scenarios.

Recently, global warming has become a prominent topic, including its impacts on human health. The number of heat illness cases requiring ambulance transport has been strongly linked to increasing temperature and the frequency of heat waves. Thus, a potential increase in the number of cases in the future is a concern for medical resource management. In this study, we estimated the number of heat illness cases in three prefectures of Japan under 2 °C global warming scenarios, approximately corresponding to the 2040s. Based on the population composition, a regression model was used to estimate the number of heat illness cases with an input parameter of time-dependent meteorological ambient temperature or computed thermophysiological response of test subjects in large-scale computation. We generated 504 weather patterns using 2 °C global warming scenarios. The large-scale computational results show that daily amount of sweating increased twice and the core temperature increased by maximum 0.168 °C, suggesting significant heat strain. According to the regression model, the estimated number of heat illness cases in the 2040s of the three prefectures was 1.90 (95%CI: 1.35-2.38) times higher than that in the 2010s. These computational results suggest the need to manage ambulance services and medical resource allocation, including intervention for public awareness of heat illnesses. This issue will be important in other aging societies in near future.

The establishment and validation of efficient assays for anti-IIa and anti-Xa activities of heparin sodium and heparin calcium.

Heparin is used as an anticoagulant drug. The anticoagulation process is mainly caused by the interaction of heparin with antithrombin followed by inhibition of anticoagulant factor IIa and factor Xa. The anti-factor IIa and anti-factor Xa activities of heparin are critical for its anticoagulant effect; however, physicochemical methods that can reflect these activities have not been established. Thus, the measurements of anti-IIa and anti-Xa activities by biological assay are critical for the quality control of heparin products. Currently in the Japanese Pharmacopoeia (JP), the activities of heparin sodium and heparin calcium are measured by an anti-Xa activity assay (anti-Xa assay), but anti-IIa activity is not measured. Here, we established an anti-IIa activity assay (anti-IIa assay) and an anti-Xa assay having good accuracy and precision. When samples having a relative activity of 0.8, 1.0 and 1.2 were measured by the established anti-IIa and anti-Xa assays in nine laboratories, good accuracy (100.0-102.8% and 101.6-102.8%, respectively), good intermediate precision (1.9-2.1% and 2.4-4.2%, respectively) and good reproducibility (4.0-4.8% and 3.6-6.4%, respectively) were obtained. The established anti-IIa and anti-Xa assays have similar protocols, and could be performed by a single person without a special machine. The established assays would be useful for quality control of heparin.