Evaluation of shields and ventilation as a countermeasure to protect bus drivers from infection.

We evaluated the deposition of droplets and droplet nuclei-generated by simulated coughing and talking from three points in a bus-on the driver's face and on surfaces around the driver (e.g., the steering wheel), based on whether countermeasures were taken, and assuming that an infected passenger was talking to the driver. When a shield, such as acrylic boards or polyvinyl chloride (PVC) sheets, was used as the countermeasure, the deposition of artificial droplets (>4 µm), emitted from beside or behind the driver, on his eyes, mouth, and cheeks reduced by two to three orders of magnitude or more. Deposition on the surfaces around the driver was also reduced following the use of shields. For artificial droplet nuclei (1.3 µm of polystyrene latex (PSL)) emitted from atomizers beside the driver, the operation of the ventilation fan (VF) and air conditioner (AC), and defroster (DEF) greatly reduced the driver's exposure, while the use of the shield did not. The infection risk of the driver was estimated through exposure to the virus via transfer to the mucosa via hands or surface-to-finger, direct adhesion on the mucosa, and direct inhalation of droplets and droplet nuclei. This is under the assumption that the droplets and droplet nuclei measured in this study are 40% the diameter of those after immediately leaving the mouth of the infected person and are constant regardless of particle size. When using the shield, total infection risk via droplet, airborne, and contact transmission was decreased by 75.0-99.8%. When the shield was not installed, the infection risk decreased by 9.74-48.7% with the operation of the VF, AC, and/or DEF.

Air exchange rates and advection-diffusion of CO2 and aerosols in a route bus for evaluation of infection risk.

As COVID-19 continues to spread, infection risk on public transport is concerning. Air exchange rates (ACH) and advection-diffusion of CO2 and particles were determined in a route bus to evaluate the infection risk. ACH increased with bus speed whether windows were open or closed, and ACH were greater when more windows were open. With two open windows, ACH was greater when a front and rear window were open than when two rear windows were open. With both front and rear ventilation fans set to exhaust, ACH was more than double that when both were set to supply. With air conditioning (AC) off, CO2 and particles spread proportionally at the same rate from a source, whereas with the AC on, the spread rate of particles was about half that of CO2 , because particles might be trapped by a prefilter on the AC unit. Infection risk can be reduced by equipping AC unit with an appropriate filter. Calculations with a modified Wells-Riley equation showed that average infection risk was reduced by 92% in the moving bus with windows open comparing to with windows closed. When the bus was moving with windows closed, exhaust fan operation reduced the average risk by 35%.

Review of engagement activities to promote awareness of radiation and its associated risk amongst the Japanese public before and after the Fukushima Daiichi Nuclear Power Plant accident.

Following the Fukushima Daiichi Nuclear Power Plant accident in 2011, many radiation experts directly experienced a vast gap between ideal and real public understanding (PU) of radiation in risk communication. Therefore, this study collated and reviewed information about PU activities for radiation and its risk that six Japanese academic societies-which seem to be socially neutral expert communities-related to radiation and radiation risk conducted before and after the accident. Activities these radiation-related societies provided to the general public were discussed from the following perspectives: (a) difficulties in two-way communication due to resources, motivation and public interest and concerns; (b) balance between academic research and PU activities; (c) academic societies' building trust with the public while ensuring member experts' neutrality and independence; and (d) discussions among academic societies to prepare for public engagement. We hope that this paper encourages experts and academic societies in radiation protection to hold more national and international discussions about their roles in public communication and outreach.

Low dose of external exposure among returnees to former evacuation areas: a cross-sectional all-municipality joint study following the 2011 Fukushima Daiichi nuclear power plant incident.

There is little information on the radiation dose levels of returnees to areas once designated as legal no-go zones, after evacuation orders were lifted subsequent to the 2011 Fukushima Daiichi nuclear power plant incident. This study used individual radiation dosimeter monitoring and a location history survey to conduct the most recent dose assessment of external exposure among returnees to former no-go zones. We specifically determined correlation and agreement between external doses and the air dose rate in residential areas and quantified both uncertainty and population variability of the observed data using Monte Carlo (MC) simulation methods. A total of 239 voluntary participants across ten municipalities were analysed; their representativeness of all affected municipal populations was confirmed in terms of air dose rate distribution in residential areas. We found that individual doses were statistically significantly correlated with the air dose rate based on government airborne monitoring. This implies that airborne monitoring can provide sufficient information for understanding dose levels among such returnees. The MC simulations demonstrated that the mean of the annual dose in 2019 (including natural background doses) was 0.93 (95% uncertainty interval 0.53-1.76) mSv, with limited variation between municipalities. As of 2019, this implies that doses from external exposure were very low among returnees and would be associated with a very low likelihood of physical effects according to current scientific consensus. However, these results should be taken with caution due to several study limitations, including selection and participation biases. Regardless, its findings will enhance societal debates about how both individual-dose and government airborne monitoring practices should operate in the future and how the government can improve the public outlook for radiation doses in incident-affected areas.

Measuring and assessing individual external doses during the rehabilitation phase in Iitate village after the Fukushima Daiichi nuclear power plant accident.

After the Fukushima Daiichi nuclear power plant accident in 2011, Iitate village was placed under an evacuation order because the level of radioactive materials drifting from the nuclear plant to the village was above a government-set level for allowing residents to live in the area. The evacuation advisory for most of the village was lifted on 31 March 2017. For displaced residents deciding whether or not to return to their homes, it is important to correctly understand and estimate the realistic individual external doses they will receive after returning to the village. In this study, with the support of residents of the village, we used a personal dosimeter (D-Shuttle) coupled with a global positioning system device to measure and thus understand realistic individual external doses while the residents were in Iitate village and to project the individual external doses for different administrative districts as of 1 April 2017. The measured individual external doses measured by D-Shuttle for 38 study participants showed that the doses measured during time spent inside the village were higher and more widely distributed than the doses measured during time spent outside the village. The exposure ratio (ER) was defined as the ratio of additional individual external dose measured by D-Shuttle to the additional ambient dose based on an airborne monitoring survey. The medians of the average ERs were 0.13 (min-max 0.06-0.27) for time spent at home and 0.18 (min-max 0.08-0.36) for time spent outdoors. Projected additional annual individual external doses as of 1 April 2017 for different administrative districts in the village were calculated using ERs obtained in this study. Assuming that individuals spent 8 h per day on outdoor activities and 16 h on indoor activities, additional annual individual external doses were estimated to be below 3 mSv using the mean of the average ERs for most districts in the village, and these values were well below the individual external doses estimated using the approach taken by the central government. The results of this study provide valuable information both for understanding realistic radiological situations in the village and for those who want to know their future individual external dose in order to make a decision on whether or not to live in the village.

Assessing bioavailability levels of metals in effluent-affected rivers: effect of Fe(III) and chelating agents on the distribution of metal speciation.

To assess the effects of Fe(III) and anthropogenic ligands on the bioavailability of Ni, Cu, Zn, and Pb, concentrations of bioavailable metals were measured by the DGT (diffusive gradients in thin films) method in some urban rivers, and were compared with concentrations calculated by a chemical equilibrium model (WHAM 7.0). Assuming that dissolved Fe(III) (<0.45 µm membrane filtered) was in equilibrium with colloidal iron oxide, the WHAM 7.0 model estimated that bioavailable concentrations of Ni, Cu, and Zn were slightly higher than the corresponding values estimated assuming that dissolved Fe(III) was absent. In contrast, lower levels of free Pb were predicted by the WHAM 7.0 model when dissolved Fe(III) was included. Estimates showed that most of the dissolved Pb was present as colloidal iron-Pb complex. Ethylene-diamine-tetra-acetic acid (EDTA) concentrations at sampling sites were predicted from the relationship between EDTA and the calculated bioavailable concentration of Zn. When both colloidal iron and predicted EDTA concentrations were included in the WHAM 7.0 calculations, dissolved metals showed a strong tendency to form EDTA complexes, in the order Ni > Cu > Zn > Pb. With the inclusion of EDTA, bioavailable concentrations of Ni, Cu, and Zn predicted by WHAM 7.0 were different from those predicted considering only humic substances and colloidal iron.

Maximum proportion of masks worn: Collaborative efforts in Japanese professional football.

Mass gathering events in Japan have gradually mitigated their novel coronavirus disease (COVID-19) control regulations, along with a minimum infection risk. The Japan Professional Football League (J.League) conducted pilot surveys on holding events with chant cheers. In this commentary, we introduce the collaborative efforts based on scientific knowledge among experts, J.League, and their fans. We performed risk assessment in advance, by updating a previously developed model. We further observed the average proportion of masks worn, chant cheering time of participants, and CO2 levels in the stand. The number of new COVID-19 cases in an event with 5,000 chant cheering participants and 35,000 non-chant cheering participants was estimated to be 1.02 times of an event, with 40,000 non-chant cheering participants. The average proportion of masks worn during the game was 98.9 %, for chant cheer participants. The chant cheering participants spent 50.0-51.1 % of their time chant cheering. Monitored average CO2 levels were ≤ 540 ppm, suggesting high ventilation rates in the stand. The high proportion of masks worn represents the willingness of norm-conscious fans to cooperate in regular recovery of the sport. This has proved to be one of the successful models for future mass gathering events.

COVID-19 infection risk assessment and management at the Tokyo 2020 Olympic and Paralympic Games: A scoping review.

The Tokyo 2020 Olympic and Paralympic Games was one of the largest international mass-gathering events held after the beginning of coronavirus disease 2019 (COVID-19) pandemic. In this scoping review, we extracted papers discussing COVID-19 risk assessment or management at the Tokyo 2020 Games to determine the nature of studies that were conducted. Among the 75 papers obtained from two search engines (PubMed and ScienceDirect) and four papers collected from hand-searches, 30 papers were extracted. Only eight papers performed both COVID-19 prior risk assessment and quantitative evaluation of effectiveness measures, highlighting the importance of rapid, solution-focused risk assessment. Furthermore, this review revealed that the findings regarding the spread of COVID-19 infection to citizens in the host country were inconsistent depending on the assessment methods and that assessments of the spread of infection outside the host country were lacking.

Trust in governments, public health institutions, and other information sources as determinants of COVID-19 vaccine uptake behavior in Japan.

OBJECTIVES: Trust in governments and public institutions as a determinant of public health outcomes has gained increased attention since the COVID-19 pandemic. Provided historically low confidence in vaccines in Japan, investigating the role of trust in information sources and actual COVID-19 vaccination uptake behavior will be invaluable for future vaccine promotion policymaking. Therefore, the objective of this study was to elucidate the determinants of COVID-19 vaccination uptake and evaluate the relationship between trust in different information sources and COVID-19 vaccination behavior in Japan. METHODS: For this study, we leveraged a longitudinal series of web-based surveys of 19,174 individuals in Japan conducted between 2021 and 2022 which asked questions regarding a wide range of sociodemographic and psychographic characteristics related to the COVID-19 pandemic. Determinant analysis for vaccination (at least one dose of a COVID-19 vaccine) was conducted via multiple logistic regression, and odds ratios (OR) with 95% confidence intervals (CI) were estimated. RESULTS: After adjustment for sociodemographic determinants of vaccine uptake, aggregate trust in the systems and institutions of vaccine approval (OR: 1.42, 95% CI: 1.30-1.56), and trust in information about the COVID-19 pandemic coming from government sources (OR: 1.27, 95% CI: 1.12-1.44) were found to be consistently powerful predictors of COVID-19 vaccination. Trust in media sources including traditional media (OR: 1.21, 95% CI: 1.07-1.36), and the internet (OR: 0.77, 95% CI: 0.66-0.89) had significant and opposing effects. CONCLUSIONS: Our findings support the broader hypothesis that trust in governments and public health institutions remains a powerful determinant for COVID-19 vaccine uptake in Japan. We also found that vaccination decision-making is a multifactorial process that includes the synthesis of trust in public institutions and media, and its interaction with psychosocial determinants such as prosociality and health literacy. We hope to apply this study's findings towards future vaccine programs for contagious diseases.

Severe induction of aberrant DNA methylation by nodular gastritis in adults.

BACKGROUND: Nodular gastritis (NG) is characterized by marked antral lymphoid follicle formation, and is a strong risk factor for diffuse-type gastric cancer in adults. However, it is unknown whether aberrant DNA methylation, which is induced by atrophic gastritis (AG) and is a risk for gastric cancer, is induced by NG. Here, we analyzed methylation induction by NG. METHODS: Gastric mucosal samples were obtained from non-cancerous antral tissues of 16 NG and 20 AG patients with gastric cancer and 5 NG and 6 AG patients without, all age- and gender-matched. Genome-wide methylation analysis and expression analysis were conducted by a BeadChip array and RNA-sequencing, respectively. RESULTS: Clustering analysis of non-cancerous antral tissues of NG and AG patients with gastric cancer was conducted using methylation levels of 585 promoter CpG islands (CGIs) of methylation-resistant genes, and a large fraction of NG samples formed a cluster with strong methylation induction. Promoter CGIs of CDH1 and DAPK1 tumor-suppressor genes were more methylated in NG than in AG. Notably, methylation levels of these genes were also higher in the antrum of NG patients without cancer. Genes related to lymphoid follicle formation, such as CXCL13/CXCR5 and CXCL12/CXCR4, had higher expression in NG, and genes involved in DNA demethylation TET2 and IDH1, had only half the expression in NG. CONCLUSIONS: Severe aberrant methylation, involving multiple tumor-suppressor genes, was induced in the gastric antrum and body of patients with NG, in accordance with their high gastric cancer risk.

Gastric adenocarcinoma of fundic gland type with autoimmune gastritis.

An 87-year-old man with dysphagia presented to our hospital. He was diagnosed with autoimmune gastritis (AIG) with severe atrophy and hypergastrinemia. The patient was positive for parietal cell antibody (PCA) and anti-intrinsic factor antibody (IFA), without evidence of H. pylori infection. A flat elevated tumor was detected in the middle corpus, and therapeutic endoscopic submucosal dissection was performed. Histopathological examination revealed atypical cells mimicking the fundic glands, which were positive for pepsinogen-I and partially positive for MUC6 and H + /K + -ATPase, proliferating to the deep layer. The final diagnosis was gastric adenocarcinoma of the fundic gland type (GAFG). AIG is expected to be difficult to develop GAFG because the basal gastric glands are highly atrophic due to the production of PCA. However, some chief cells may remain and could have the potential to develop into malignancy during AIG progression. Therefore, careful observation is required in patients with AIG when considering the occurrence of GAFG.

Sensitivity of rapid antigen tests for COVID-19 during the Omicron variant outbreak among players and staff members of the Japan Professional Football League and clubs: a retrospective observational study.

OBJECTIVES: Rapid antigen tests have been used to prevent the spread of the COVID-19; however, there have been concerns about their decreased sensitivity to the Omicron variant. In this study, we assessed the sensitivity and specificity of the rapid antigen test compared with the PCR test among the players and staff members of the Japan Professional Football League and clubs. Furthermore, we evaluated the relationship between the sensitivity and the duration from the onset of symptoms to testing or vaccine status. DESIGN: This was a retrospective observational study. METHODS: We used 656 results from both the rapid antigen and PCR tests for COVID-19 using samples collected on the same day from 12 January to 2 March 2022, during the Omicron variant outbreak in Japan. RESULTS: The sensitivity of the rapid antigen test compared with the PCR test was 0.63 (95% CI: 0.53 to 0.73) and the specificity was 0.998 (95% CI: 0.995 to 1.000). There were no significant associations between the sensitivity and the duration from the onset of symptoms to testing (including asymptomatic cases in the category) or vaccination status (p>0.05) with small effect sizes (Cramer's V or φ: ≤0.22). CONCLUSIONS: Even during the Omicron outbreak, the sensitivity of the rapid antigen tests did not depend on the duration from the onset of symptoms to testing.

Estimation of microplastic emission and transfer into Tokyo Bay, Japan, using material flow analysis.

To reduce microplastic (MP) discharge into the aquatic environment, it is necessary to properly identify its sources and amounts. Here, specific MP sources, i.e., personal care products (PCPs), fibers from clothes, and tire-wear particles (TWPs) were focused, and MP generations from these sources in the Tokyo Bay watershed, Japan, were estimated based on statistical data on production and reported emission factors of the MP sources and executing considering uncertainty on the data. Potential annual MP emission into Tokyo Bay was estimated to be 10.2 ± 1.6, 38 ± 22, and 1500-1800 tons for PCPs, fibers, and TWPs, respectively. Emissions into Tokyo Bay by assuming MP density and diameter was estimated. For fiber, the fraction to potential emission was estimated at 1.0-2.8 %. This study contributes to determining potential discharge pathways. This will assist in the application of appropriate measures to reduce MP discharge into water bodies.

Quantifying the effect of isolation and negative certification on COVID-19 transmission.

Isolation of close contact people and negative test certification are used to manage the spread of new coronavirus infections worldwide. These effectively prevent the spread of infection in advance, but they can lead to a decline in socio-economic activity. Thus, the present study quantified the extent to which isolation and negative test certification respectively reduce the risk of infection. To this end, a discrete-time SEIR model was used as the infectious disease model, and equations for calculating the conditional probability of non-infection status given negative test results on two different days were derived. Then the respective non-infection probabilities with two negative PCR test results, and with one negative PCR test result and one antigen test result, were quantified. By substituting initial parameters of the SEIR model into these probabilities, the present study revealed the following: (1) isolating close contact individuals can reduce by [Formula: see text] the risk of infection during the first 5 days, but five more days are needed to reduce the risk [Formula: see text] more, and seven more days to reduce the risk [Formula: see text] more; and (2) if an individual with a negative PCR test result has a negative antigen test result the next day, then his or her infection probability is between 0.6 and [Formula: see text]. Our results show that 5-day isolation has a proportionally greater effect on risk reduction, compared to longer isolation; and thus, if an isolation period of longer than 5 days is contemplated, both the risk reduction and the negative effects from such increased isolation should be considered. Regarding negative test certification, our results provide those in managerial positions, who must decide whether to accept the risk and hold mass-gathering events, with quantitative information that may be useful in their decision-making.

A Unique Adverse Event of Radiotherapy in a Patient With IgG4-related Disease: A Case Report.

BACKGROUND/AIM: IgG4-related disease (IgG4RD) is a rare autoimmune proinflammatory condition that mimics other cancers and has unique pathological findings. The effects of radiotherapy in patients with IgG4RD remain unknown. CASE REPORT: A male patient in his seventies who received radiotherapy (68 Gy/39 fr) for bladder cancer 5 months prior, presented to our hospital with fatigue and swelling in both legs. The patient had a history of IgG4-related sclerosing cholangitis, a subtype of IgG4RD. Leg edema gradually worsened despite treatment with a diuretic agent. Computed tomography showed hyperdense soft-tissue lesions in the irradiated area. The serum level of IgG4 increased to 1,380 mg/dl. One month after administration of a corticosteroid (10 mg per day) as an ex juvantibus treatment for IgG4RD, leg edema disappeared. Soft-tissue lesions in the irradiated area decreased in size. The adverse event was ultimately diagnosed as the recurrence of IgG4RD in the irradiated area. To the best of our knowledge, this is the first case report of an adverse event of radiotherapy for a patient with IgG4RD. CONCLUSION: We experienced a unique adverse event of radiotherapy in a patient with IgG4RD. Caution is advised on radiotherapy administration in patients with IgG4RD.

Variation in chronic nickel toxicity to Daphnia magna among Japanese river waters and performance evaluation of bioavailability models in predicting the toxicity.

Nickel (Ni) ecotoxicity is dictated by water chemistry characteristics such as pH, water hardness, and amount of dissolved organic carbon. Bioavailability models have been developed to predict Ni toxicity and validated for European, Australian, and US natural waters. In this study, chronic toxicity tests in Ni-spiked Japanese river waters were conducted on a strain of Daphnia magna to test whether the chronic toxicity differs among Japanese natural waters with different water chemistries. Based on the results of chronic Ni toxicity tests, we assessed the performance of existing D. magna bioavailability models, which were developed in artificial waters (Model 1) and calibrated in European natural waters (Model 2), in terms of the accuracy and the bias of model predictions. Furthermore, we also calibrated the two models by using toxicity test results to develop a bioavailability model for Ni chronic toxicity to the strain of D. magna in Japanese river waters. The 10%, 20%, and 50% effect concentrations (EC10, EC20, and EC50) of dissolved Ni on reproduction of the D. magna strain were within ranges from 8.1 to 44.9 µg/L, 9.0 to 57.1 µg/L, and 10.9 to 86.1 µg/L, respectively. Results indicate that differences in water chemistry among Japanese river waters influenced chronic Ni toxicity to the model organism. Model 1predicted 43% of the observed EC10, EC20, and EC50 values within a factor of 2 and 100%, 100%, and 43% within a factor of 3, respectively. Model 2 predicted 14%, 14%, and 29% of the observed EC10, EC20, and EC50 values within a factor of 2 and 43% within a factor of 3. The values of model bias based on the geometric mean of ratios of EC10, EC20 and EC50 values predicted by each of the two models and observed EC10, EC20, and EC50 values were 0.71, 0.65, and 0.62 for Model 1 and 0.27, 0.26, and 0.29 for Model 2, respectively. After calibrating two models using the results of toxicity tests, refined Model 1 predicted 71%, 57%, and 57% of observed EC10, EC20, and EC50 values within a factor of 2 and 100%, 86%, and 100% within a factor of 3; refined Model 2 predicted 71% of observed EC10, EC20, and EC50 values within a factor 2 and 100%, 86%, and 86% within a factor of 3, respectively. Our results indicate that calibrating the Ni bioavailability models in Japanese natural waters increased their predictive capacity by a factor of up to approximately five.

Illustrating a Species Sensitivity Distribution for Nano- and Microplastic Particles Using Bayesian Hierarchical Modeling.

Environmental contamination with nano- and microplastic (NMP) particles is an emerging global concern. The derivation of species sensitivity distributions (SSDs) is an essential step in estimating a hazardous concentration for 5% of the species (HC5), and this HC5 value is often used as a "safe" concentration in ecological risk assessment, that is, predicted-no-effect concentration. Although properties of plastics such as particle size can affect toxic effect concentrations, such influences have not yet been quantitatively considered in estimating SSDs for NMP particles. We illustrate a log-normal SSD using chronic lowest-observed-effect concentrations (LOECs) of NMP particles from readily available toxicity data sets, considering the influence of particle size, polymer type, and freshwater or marine test media by adopting Bayesian hierarchical modeling techniques. Results of the hierarchical SSD modeling suggest that the SSD mean was negatively associated with particle size and was lower in marine media than in freshwater media. The posterior medians of the HC5 estimated from the LOEC-based SSD varied by a factor of 10 depending on these factors (e.g., 1.8-20 µg/L for the particle size range of 0.1-5000 µm in the marine environment). Hierarchical SSD modeling allows us to clarify the influences of important factors such as NMP properties on effect concentrations, thereby helping to guide more relevant ecological risk assessments for NMP. Environ Toxicol Chem 2022;41:954-960. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Assessment of COVID-19 risk and prevention effectiveness among spectators of mass gathering events.

There is a need to evaluate and minimize the risk of novel coronavirus infections at mass gathering events, such as sports. In particular, to consider how to hold mass gathering events, it is important to clarify how the local infection prevalence, the number of spectators, the capacity proportion, and the implementation of preventions affect the infection risk. In this study, we used an environmental exposure model to analyze the relationship between infection risk and infection prevalence, the number of spectators, and the capacity proportion at mass gathering events in football and baseball games. In addition to assessing risk reduction through the implementation of various preventive measures, we assessed how face-mask-wearing proportion affects infection risk. Furthermore, the model was applied to estimate the number of infectors who entered the stadium and the number of newly infected individuals, and to compare them with actual reported cases. The model analysis revealed an 86-95% reduction in the infection risk due to the implementation of face-mask wearing and hand washing. Under conditions in which vaccine effectiveness was 20% and 80%, the risk reduction rates of infection among vaccinated spectators were 36% and 96%, respectively. Among the individual measures, face-mask wearing was particularly effective, and the infection risk increased as the face-mask-wearing proportion decreased. A linear relationship was observed between infection risk at mass gathering events and the infection prevalence. Furthermore, the number of newly infected individuals was also dependent on the number of spectators and the capacity proportion independent of the infection prevalence, confirming the importance of considering spectator capacity in infection risk management. These results highlight that it is beneficial for organisers to ensure prevention compliance and to mitigate or limit the number of spectators according to the prevalence of local infection. Both the estimated and reported numbers of newly infected individuals after the events were small, below 10 per 3-4 million spectators, despite a small gap between these numbers.

COVID-19 testing systems and their effectiveness in small, semi-isolated groups for sports events.

In this study, we quantitatively assessed the effectiveness of systems for COVID-19 testing in small groups of sport teams that are semi-isolated from the general population by countermeasures against infection. Two types of group were assumed, and the dynamics of infection within each group was modeled by using a compartment model of infectious disease. One group (Group A) comprised domestic professional sports teams that play many games over a season while remaining within a relatively small region. Polymerase chain reaction (PCR) tests were routinely conducted once every 2 weeks, and the number of infected individuals that could not be quarantined after identification by testing or checking for symptoms was defined as the risk. The other group (Group B) comprised teams that travel across borders for mass-gathering events like the Olympic and Paralympic Games. The teams were isolated for 2 weeks at their destination; frequent testing and checking for symptoms was conducted, and any infected individuals were quarantined. The number of infected individuals participating in games after the isolation period was defined as the risk. In Group A, the number of infected individuals detected by routinely conducted PCR testing was lower than the number of infected individuals detected by checking for symptoms, indicating that routine testing every 2 weeks was not very effective. In Group B, daily PCR testing was the most effective, followed by daily antigen testing. Dual testing, in which individuals with a positive antigen test were given an additional PCR test, was the least effective with an effect equal to PCR testing every other day. These results indicate that repeated testing does not necessarily increase the detection of infected individuals.

Factors associated with reversals of COVID-19 vaccination willingness: Results from two longitudinal, national surveys in Japan 2021-2022.

Background: Research characterizing changes of heart with respect to vaccine intention is scarce, and very little research considers those who were initially vaccine willing but became hesitant. Here, we sought to assess the factors related to reversals of vaccine willingness. Methods: We conducted a longitudinal, national survey on vaccination intention among Japanese adults aged 20 years or older, with the first questionnaire performed in February-March 2021 (N = 30,053) and the follow-up in February 2022 (N = 19,195, response rate 63.9%). The study population comprised those who reported vaccine willingness in the first survey, with the outcome variable being development of vaccine hesitancy at follow-up. We performed a regression analysis of vaccination status using sociodemographic, health-related, psychologic/attitudinal, and information-related variables as predictors. We used the sparse group minimax concave penalty (MCP) to select the optimum group of covariates for the logistic regression. Findings: Of 11,118 (57.9%) respondents who previously expressed interest in vaccination, 10,684 (96.1%) and 434 (3.9%) were in the vaccine willing and hesitant groups, respectively. Several covariates were found to significantly predict vaccine hesitancy, including marital status, influenza vaccine history, COVID-19 infection/testing history, engagement in COVID-19 preventive measures, perceived risks/benefits of the COVID-19 vaccine, and attitudes regarding vaccination policies and norms. The use of certain information sources was also associated with vaccine hesitancy. Interpretation: Sociodemographic, health-related, psychologic/attitudinal, and information-related variables predicted the development of vaccine hesitancy among those with prior willingness. Most of these predictors were also associated with vaccination status. Funding: The present work was supported in part by a grant from the Kanagawa Prefectural Government of Japan and by AIST government subsidies.