The adjacent original home is a U-shaped structure with gardens housing Japanese pines, camellias, and weeping plum trees planted by the owner’s late father, and flowering agapanthus and ajuga cared for by his mother. Hook House completes this tableau, forming a gentle enclosure around the garden, shaped from a rich palette of various woods Its low lying form completes a pentagon at the farthest edge of the site all images by Hiroki Kawata This distinct geometry of obtuse angles softens the boundary between the old and new with natural intention and the shared courtyard within — now planted with new vegetation — becomes reimagined as a bridge between the two homes In dialogue with its natural context — backdropped by the contours of the Kawachi plains and the iconic Ikoma and Kongo mountains — House House exudes a quiet unassuming presence infuses the project with a raw natural character defined by Kumano cedar pillars The Osaka-based architects top the house with a striking pentagonal roof A single round pillar wrapped in black paper cords anchors it as a centerpiece in the living room frosted glass is fitted to maintain privacy while letting in soft The blurred silhouette of the crape myrtle tree beyond poetically creeps into the room creating a sense of connection to the outside world that enhances the calm within a distinct geometry of obtuse angles softens the boundary a single round pillar wrapped in black paper cords supports the roof a striking pentagonal roof transitions seamlessly into a hipped roof a raw natural character is defined by a material palette of various rich woods House House exudes a quiet unassuming presence the residence sits beside the owner’s birthplace architect: ninkipen! | @ninkipen structural engineer: Ippei Yasue / WORK SHOP garden landscaping: Youhei Miyake / NIWADUKURIMIYAKE photographer: Hiroki Kawata AXOR presents three bathroom concepts that are not merely places of function but destinations in themselves — sanctuaries of style Metrics details Povidone-iodine (PVP–I) is a broad-spectrum antiseptic reagent that has been used for over 50 years The purpose of this study is to look into the effect of gargling with PVP–I gargling on virus clearance and saliva infectivity in COVID-19 open-label trial of intervention with PVP–I was conducted at three quarantine facilities in Osaka enrolling adolescents and adults with asymptomatic-to-mild COVID-19 Patients were randomly allocated to the early and late intervention group at a 1:1 ratio The early group gargled with PVP–I from days 2 to day 6; the late group gargled with water first then with PVP–I from day 5 after sampling till day 6 The primary and secondary endpoints were viral clearance for SARS-CoV-2 using RT-qPCR at days 5 and 6 and the investigational endpoint was saliva infectivity clearance on day5 and 139 in the early group and 140 in the late had a positive saliva RT-qPCR test on day 2 the early group had a significantly higher RT-qPCR negative rate than that of the late group (p = 0.015) and the early had a significantly higher clearance rate of infectivity (p = 0.025) one participant reported oropharyngeal discomfort Gargling with PVP–I may hasten virus clearance and reduce viral transmission via salivary droplets and aerosols in patients with asymptomatic-to-mild COVID-19 (Clinical trial registration numbers: jRCT1051200078 and dateof registration: 24/11/2020) it is unknown whether gargling with PVP–I would eliminate salivary viral load and infectivity in COVID-19 patients in vivo there have been no prospective randomized intervention studies involving PVP–I gargling The purpose of this study was to see if gargling with PVP–I will reduce viral load and SARS-CoV-2 infectivity in patients with COVID-19 and open-label trial that looked at the efficacy and safety of gargling with PVP–I in asymptomatic-to-mild COVID-19 patients (aged ≥ 16 years) quarantined in three different locations The protocol was approved by the Medical Center Clinical Research Review Board (CRB5200005) which has been establishe in Osaka General Medical Center The first registration date is 24/11/2020 with the Japan Registry of Clinical Trials (number: jRCT1051200078) The study has been performed in accordance with the relevant guidelines and regulations and all study participants provided written informed consent The study has performed from 24/11/2020 to 22/4/2022 participants were recruited from three quarantine facilities in Osaka The following inclusion criteria were used to select subjects: (1) age ≥ 16 years on the date of consent acquisition and with parental consent for those aged 16–19 years; (2) either sex; (3) quarantined at an accommodation facility but not inpatient status; (4) meet all of the following requirements: asymptomatic-to-mild COVID-19 patients with at least one (RT-PCR) test positive for SARS-CoV-2 (either pharyngeal swab and willing to be quarantined for ≥ 6 days; and (5) voluntarily provided written consent to participate in the trial The following were exclusion criteria: (1)being on receiving thyroid hormone and (5) already mouth washing or gargling with PVP–I prior enrollment Patients were randomly assigned at a 1:1 ratio with Viedoc4 EDC ststem to either the early interventional group (started mouthwash and gargling with PVP–I on day 2 after saliva sampling at the time of waking up) or the late interventional group (started mouthwash and gargling with PVP–I on day 5 after sampling of saliva at the time of waking up); accommodation facility and gender were used as allocation adjusting factors Table 1 depicts the saliva sampling and the intervention schedule Mouth washing once and gargling twice with 20 mL of a 15-fold diluted solution containing PVP–I Gargle Solution 7% (Meiji Seika Pharma Co. Japan) or with the same volume of water constitute the intervention the early interventional group was instructed to perform the PVP-1 intervention four times per day (before saliva sampling at the time of waking up the intervention was performed with water from days 2 to 4 and then with PVP–I from days 5 following saliva sampling till day 6 The KANEKA Direct RT-qPCR Kit “SARS-CoV-2” was used for RT-qPCR testing at a centralized study laboratory as directed by the manufacturer (Kaneka Corporation A LightCycler 480 II was used to monitor amplified products (Roche Diagnostics The saliva was tested for viral infectivity in a biosafety level 3 laboratory at the Osaka Habikino Medical Center Vero E6 TMPRSS2 cells (JCRB1819) were obtained from JCRB bank at the National Institutes of Biomedical Innovation The cells were cultured according to the institution’s instruction and seeded into 96 well plates with 100 µL of medium and cultured for a day The cells were monitored for cytopathic effect (CPE) after a 3-day incubation period and SARS-CoV-2 infectivity was confirmed when CPE was detected in inoculated wells The study’s observation schedule is shown in Table 1 Salivary samples were collected daily from days 2 to 6 upon waking up in the morning before mouthwash and gargling; these were centrifuged to remove debris before being analyzed using RT-qPCR and CPE the participants’ body temperature and physical conditions (presence or absence of changes and light-headedness/loss of consciousness) were recorded twice a day The primary efficacy endpoint of this study was the clearance rate of SARS-CoV-2 viral load determined by RT-qPCR of saliva samples on day 5 the clearance rate in each group was calculated by dividing the number of RT-qPCR-negative participants on day 5 by the number of RT-qPCR-positive participants on day 2 The 95% confidence interval (CI) was also computed The chi-square test was used to compare the clearance rates of the early groups The viral clearance rate of saliva samples at day 6 was calculated and analyzed using the same methods as for the primary endpoint Safety was assessed based on adverse events that occurred during the study period by aggregating the number of cases and the number of cases by events in each group The rate of SARS-CoV-2 viral infectivity to Vero E6 TMPRSS2 cells in saliva samples at day 5 was the investigational endpoint of efficacy the rate in each group was calculated by dividing the number of infectivity-positive participants on day 5 by the number of RT-qPCR-positive participants on day 2 The chi-square test was used to compare rates of the early and late groups datasets for intention-to-treat (ITT) and safety analysis (SAF) were determined and analyzed all subjects who used the PVP–I was included in the ITT whereas all subjects who used the PVP–I were analyzed in the safety evaluation The name of the adverse event was changed to MedDRA/J ver The sample size was calculated based on the assumption that viral clearance of saliva could be observed by day 5 in 60% of participants in the early interventional group with PVP–I and 40% in the late interventional group With a power of ≥ 90% and a two-sided significance level of 0.05 this study required 203 participants in each group version 9.4 was used for statistical analyses (SAS Institute The study was centrally approved by the certified Medical Center Clinical Research Review Board (CRB5200005) which has been establishe in Osaka General Medical Center Japan and was registered on 24/11/2020 with the Japan Registry of Clinical Trials (number jRCT1051200078) Patient enrollment and intervention assignment Table 2 depicts the patient background in the efficacy analysis population The early intervention group had a mean age ± standard deviation was 45.2 ± 15.6 years and the late intervention group had a mean age standard deviation of 45.1 ± 15.2 years the proportion of people aged ≥ 50 years or older was the highest (43.4% and 43.7% in the early and intervention groups the early group comprised 56.7% males and 43.3% females Complications occurred in 23.3% of the subjects in the early group and 25.1%of subjects in the late group The proportion of subjects with fever during participation was 27.0% in the early group and 33.0% in the late group The proportion of subjects who had fever during the study was 27.0% in the early group and 33.0% in the late group there was no difference between the two groups in COVID-19-related subjective and objective symptoms The infectivity ratio of saliva on day 5 compared to SARS-CoV-2 PCR positive participants (139 in the early group and 140 in the late group, respectively) was 2.9% in the early gargling group and 9.3% in the late group (p = 0.025) (Table 4) The incidence of adverse events in the enrolled population was investigated by severity and casualty. During the study period, only one adverse event (oropharyngeal discomfort) was observed in the early interventional group (Table 5) Although a causal relationship between the oropharyngeal discomfort and the PVP–I intervention was identified in the case and the patient was removed from the study the severity was grade 1 and resolved 2 days after onset no deaths or serious adverse events were observed This randomized clinical trial of asymptomatic-to-mild COVID-19 patients found a significant difference in the viral load and infectivity at day 5 between those who gargled with PVP–I for 3 days those who gargled with water the early interventional group has a higher viral clearance than the late group the viral clearance rate in the late group was approaching that of the early interventional group on day 6 The only adverse event observed during the study period was oropharyngeal discomfort and the safety of PVP–I intervention in patients with asymptomatic or mild COVID-19 was confirmed The viral clearance effect of gargling with PVP–I on salivary viral load and of SARS-CoV-2 infectivity was demonstrated in this study the antiseptic effect of PVP–I may reduce viral load in saliva and viral transmission in the oral cavity of COVID-19 it is important to consider the potential adverse events and contraindications when using PVP–I in clinical practice The efficacy of PVP–I intervention on the infected patient was demonstrated in our study More findings should consider targeting either diseases spreaders or healthy populations to control disease transmission and overcome the pandemic Mouthwash and gargling with PVP–I for 3 days improved viral clearance in patients with asymptomatic or mild COVID-19 in this randomized trial After 3 days of mouthwash and gargling with water mouthwash and gargling with PVP–I in 1 day could catch up in terms of viral clearance rate to those who underwent 4 days of gargling with PVP–I This demonstrates that the late intervention with PVP–I is not inferior to early intervention indicating that it is recommended to gargle with PVP-I even in the late phase of the disease Our findings suggest that PVP–I reduce viral load in the saliva of the asymptomatic-to-mild COVID-19 patients COVID-19 transmission could be reduced if PVP–I intervention could convert super-spreaders into moderate Further research should be conducted to determine whether the effect translates into COVID-19 prevention in the general population and the treatment of individuals with the disease in the COVID-19 era The datasets used and/or analysed during the current study available from the corresponding author on reasonable request SARS-CoV-2 infection of the oral cavity and saliva Saliva: Potential diagnostic value and transmission of 2019-nCoV Oral antiseptics against coronavirus: In-vitro and clinical evidence Inactivation of SARS coronavirus by means of povidone-iodine Rapid and effective virucidal activity of povidone-iodine products against Middle East respiratory syndrome coronavirus (MERS-CoV) and modified vaccinia virus Ankara (MVA) Povidone-iodine demonstrates rapid in vitro virucidal activity against SARS-CoV-2 Martínez Lamas, L. et al. Is povidone iodine mouthwash effective against SARS-CoV-2? First in vivo tests. Oral Dis. https://doi.org/10.1111/odi.13526 (2020) Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: Randomized control trial in Singapore In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/mouthwash against respiratory and oral tract pathogens Rapid in-vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using povidone-iodine oral antiseptic rinse Coronavirus Disease 19 (COVID-19): Implications for clinical dental care Killingley, B. et al. Safety, tolerability and viral kinetics during SARS-CoV-2 human challenge. Nat. Med. https://doi.org/10.21203/rs.3.rs-1121993/v1 (2022) The influence of long-term treatment with povidone-iodine on thyroid function Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed COVID-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to improve patient outcomes and to protect healthcare workers treating them Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: An open-label randomized trial Just 2% of SARS-CoV-2-positive individuals carry 90% of the virus circulating in communities Download references We would like to thank DOT WORLD CO. LTD. Clinical Science Division for data management, and statistical analysis, and Clinical Operations Division for monitoring, respectively. This study was supported by a research fund from the Osaka Prefectural Hospital Organization and by AMED under Grant Number JP21bk0104131h0001. The authors would like to thank Enago (www.enago.com) for the English language review and plagiarism check This study was supported by a research fund from Osaka Prefectural Hospital Organization Present address: Japan Mutual Aid Association of Public School Teachers was responsible for the acquisition and analysis of data was responsible for the integrity of the data the accuracy of the data analysis and decided to publish the manuscript All authors contributed to conducting the trial The authors declare no competing interests Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Download citation DOI: https://doi.org/10.1038/s41598-022-24683-8 Anyone you share the following link with will be able to read this content: a shareable link is not currently available for this article Sign up for the Nature Briefing: Microbiology newsletter — what matters in microbiology research Serum thymus and activation-regulated chemokine (TARC) levels may identify some patients with atopic dermatitis that is resistant to therapy with dupilumab Such patients might need more intensive treatment or longer treatment with dupilumab head of dermatology at Osaka Habikino Medical Center Kataoka presented the finding at the International Society of Atopic Dermatitis (ISAD) 2021 Annual Meeting testing of serum TARC levels is reimbursable and is commercially available for monitoring atopic dermatitis in Japan TARC levels can indicate which patients are most likely to experience flares in symptoms, even after the signs and symptoms of the disease have resolved following treatment with topical corticosteroids or cyclosporine some Japanese clinicians monitor TARC levels to see which patients should continue therapy after symptoms have disappeared "Once the skin lesion disappears [with] topical treatment To see whether the monitoring of TARC levels could work the same way with regard to dupilumab Kataoka and her colleagues measured the TARC levels and determined Eczema Area and Severity Index (EASI) scores of 93 people with atopic dermatitis at baseline and after 4 months of treatment with dupilumab Thirty-four of the patients experienced improvement of ≥90% (EASI-90); 34 improved by 75% to 90% (EASI-75/90) Serum TARC levels decreased significantly in all three groups over the 4 months TARC levels did not differ significantly among the groups there was not a close correlation between the EASI score and TARC levels The correlation for most of the subgroups was weak as well the correlation was significant at baseline (r = 0.60 TARC levels would not be as useful in measuring the effectiveness of dupilumab as it is with older treatments The researchers did identify a subgroup of patients for whom TARC levels provided potentially useful information For seven patients in the EASI <75 group serum TARC levels were >1000 pg/mL after 4 months Some of these patients had the most severe atopic dermatitis They needed treatments such as cyclosporine in addition to dupilumab TARC levels at baseline might be useful to identify these patients Although the use of TARC levels in this study was not effective for identifying patients who would respond well and those who would respond less well to dupilumab overall, TARC levels still provide useful information for evaluating patients, said Lawrence Eichenfield, MD professor of dermatology and pediatrics at the University of California TARC levels may help determine which patients are the best candidates for which therapies "They may be useful in the future to help us assess clinical response and/or speed of response potentially to the different systemic agents as we start to hit an age of markedly dissimilar targets of therapy," he told Medscape Medical News Kataoka said she would like to study serum TARC levels in patients treated with Janus kinase inhibitors such as those now in the pipeline for the treatment of atopic dermatitis Kataoka has disclosed no relevant financial relationships International Society of Atopic Dermatitis (ISAD) 2021 Annual Meeting: Abstract PB3 Laird Harrison writes about science, health and culture. His work has appeared in magazines, newspapers , and online publications. He is at work on a novel about alternate realities in physics. Harrison has taught writing at San Francisco State University, UC Berkeley Extension and the Writers Grotto. Visit him at lairdharrison.com or follow him on Twitter: @LairdH Medscape Medical News © 2021  Send news tips to news@medscape.net Click the topic below to receive emails when new articles are available You will receive email when new content is published This website is using a security service to protect itself from online attacks The action you just performed triggered the security solution There are several actions that could trigger this block including submitting a certain word or phrase You can email the site owner to let them know you were blocked Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page Your browser does not support JavaScript, or it is disabled．Please check the site policy for more information National Report An unseasonable heat wave pushed temperatures up across the country on May 17 to record highs in some parts and also sent seven junior high school students to the hospital in Kurume Teachers called an ambulance just past noon on May 17 after the third-year students became sick and unresponsive while they were practicing outdoors for the school’s annual sports festival The area recorded a temperature of 28.9 degrees at noon Three students were rushed to the hospital at an elementary school in Habikino They were among nine sixth-graders who fell ill during gym class The heat wave resulted in summer-like temperatures surpassing 30 degrees at more than 290 locations This was the hottest day recorded for May in Ibigawa Records for the month’s highest temperature were also broken in Koshu It was also the hottest day of the year so far in Toyota The summer heat was brought by warm air from the south and the foehn effect where warm and dry winds descend a mountain Weather officials are also forecasting hot weather for May 18 particularly in the northern and eastern parts of the country (Takuya Miyano also contributed to this article.) Early pressure patterns causing record-setting heat in Japan Gunma records this year's high for Japan amid Kanto heat wave Heatstroke alert issued for 1st time for Tokyo Get the ice ready: Marathons in Sapporo face record heat wave High-pressure systems over Japan bring extreme heat Information on the latest cherry blossom conditions Please right click to use your browser’s translation function.) A series based on diplomatic documents declassified by Japan’s Foreign Ministry Here is a collection of first-hand accounts by “hibakusha” atomic bomb survivors chefs and others involved in the field of food introduce their special recipes intertwined with their paths in life A series about Japanese-Americans and their memories of World War II In-house News and Messages Copyright © The Asahi Shimbun Company. All rights reserved. No reproduction or republication without written permission. Notifications can be managed in browser preferences. Teenager seeks damages of about 2.2 million yen (£14,700) I would like to be emailed about offers, events and updates from The Independent. Read our Privacy notice A Japanese teenager who claims her public high school repeatedly forced her to dye her naturally-brown hair black or be banned from attending school, is suing the government of Osaka. The 18-year-old girl said her mother informed Kaifukan School in Habikino city upon her enrolment that she was born with brownish hair, as the school had a policy banning hair colouring, in a lawsuit filed in Osaka District Court. Educators, however, instructed her to colour her hair black, telling her repeatedly that the dye job was insufficient and forcing her to "either dye the hair black or quit school", the Kyodo news agency reported, citing the lawsuit. The girl has not attended school since September 2016, suffered pain and irritation from the hair dye, and is seeking damages of about 2.2 million yen (£14,700), local media reported, adding that Osaka prefecture is asking the court to reject the claim. Masahiko Takahashi, head of Kaifukan School, said he could not comment directly on the case, but noted the school's policy prohibiting students from dyeing or bleaching hair. He declined to say whether it was permissible to dye brown hair to black. The girl could not be reached for comment. In Japan, where conformity is the cultural norm, many schools have strict rules about hair colour, accessories, make-up and uniforms, including the length of skirts for girls. Join thought-provoking conversations, follow other Independent readers and see their replies Please view the main text area of the page by skipping the main menu. The page may not be displayed properly if the JavaScript is deactivated on your browser Japanese version An immunosuppressive drug for rheumatism shows encouraging signs of inhibiting severe pneumonia symptoms caused by COVID-19 Some patients severely affected by the new coronavirus underwent an improvement in their condition at a hospital in Osaka Prefecture after they were administered Actemra which is used to treat rheumatoid arthritis Actemra is designed to inhibit the activity of a cytokine protein called interleukin-6 (IL-6) that is associated with the immune system a specially appointed professor of immunology at Osaka University it triggers a phenomenon known as a cytokine storm where fever occasionally resulting in fatal shock or multiple organ failure Cytokine storms are believed to contribute to serious coronavirus cases China and other countries started administering Actemra for COVID-19 patients and one report said 19 of 20 people treated with the drug regained their health a team of researchers primarily attached to the University of Toronto in Canada said coronavirus patients with a significantly high level of IL-6 develop severe conditions more easily and that Actemra is helpful in treating serious symptoms The team pointed out that the safety and effectiveness of the immunosuppressive drug need to be evaluated through large-scale clinical trials including theses that have yet to be examined by referees for assessment At the Osaka Habikino Medical Center in Habikino a virus therapy team headed by infectious disease specialist Takayuki Nagai tested Actemra on seven patients with severe pneumonia An improvement of symptoms was reported in five of the test subjects as of April 13 although the health condition of the remaining two patients deteriorated The patients were carefully screened on the basis of inflammation test results progress of symptoms and the degree of hypoxia because Actemra has not been approved for use in treating pneumonia "Our next step is to figure out when to start administering the drug so as to maximize its effect,” said Toshio Tanaka said he believes controlling cytokine storms to allow a patient’s immune system to work properly will help those infected with the virus to recover from the disease but it may help save the lives of patients,” he said Pharmaceutical companies are forging ahead with plans for clinical trials to confirm the effectiveness and safety of the drug in the context of coronavirus treatment The Swiss-based Roche Group announced in March it will begin a clinical trial of Actemra which released Actemra as Japan’s first antibody drug is also planning a clinical study in Japan No reproduction or republication without written permission Japanese version Vox Populi Vox Dei is a daily column that runs on Page 1 of The Asahi Shimbun Next year marks the 1,400th anniversary of the death of Prince Umayado Anecdotes abound about this politician of the Asuka Period (592-710) who has been revered as a saint polygyny was common among men in positions of power Prince Shotoku’s spouses included a daughter and a granddaughter of Emperor Suiko as well as a daughter of Soga no Umako does not appear to have resulted from a marriage of political convenience “She was a daughter of a not-so-influential provincial clan," said Yoshiyuki Aihara an associate professor of archeology at Nara University “I presume that she was the love of the prince’s life.” and the two were eventually buried together Legend has it that Prince Shotoku started talking the moment he was born and that he was also capable of listening to 10 people simultaneously While his talent has often been exaggerated there is no question that he was a genius who helped build the foundations of Japan It was only fitting that his portraits have featured on bank notes seven times since the Showa Era (1926-1989) But even the greatest of all great men was just another mortal human He agonized over diplomacy with China’s Sui Dynasty Domestic political strife must have taken its toll his marriages to the emperor’s daughter and granddaughter Prince Shotoku traveled over long distances to work in the capital I came across a stone where he was said to have rested Imagining him heaving a sigh while he sat here whose face is all too familiar from bank notes felt like an anxious and tired “salaryman” goofing off at a train station Vox Dei is a popular daily column that takes up a wide range of topics the column provides useful perspectives on and insights into contemporary Japan and its culture Memorial held to mark death of Prince Shotoku 1,400 years ago VOX POPULI: This taxi service is blazing a trail for areas without public transport VOX POPULI: Makoto Kitajo’s lyrics epitomized the final decades of the Showa Era VOX POPULI: New CDP leader enters a political jungle teeming with danger VOX POPULI: ‘Oya-gacha’ is far more than just a new buzzword VOX POPULI: Being kind to a dog today could well save your life tomorrow Japanese version People in western Japan are celebrating after UNESCO listed the Mozu-Furuichi tumulus clusters in Osaka Prefecture as a World Cultural Heritage Site The decision came on Saturday at a meeting of the U.N Scientific and Cultural Organization in the Azerbaijani capital of Baku an event was held in Habikino City to celebrate the listing Mayor Tsuguo Kitagawa said he wants people to work together to protect their shared heritage The Mozu-Furuichi tumulus clusters span the cities of Sakai They consist of 49 ancient tombs that were built over 100 years or so from the latter half of the fourth century which the Imperial Household Agency considers to be the Mausoleum of Emperor Nintoku making it the largest burial mound in Japan It is also one of the largest ancient tombs in the world comparing favorably with the Pyramid of Khufu in Egypt and the tomb of Emperor Qin Shi Huangdi in China The Mozu-Furuichi tumulus clusters are characterized by the fact that the huge ancient tombs are surrounded by other tombs of differing dimensions It is believed that the size and the shape reflect the status of the person buried there The tombs are also thought to offer clues as to how royal authority developed in ancient Japan Along the way to securing the World Heritage registration they established ordinances that restrict the display of outdoor advertisements around the sites They made multi-language booklets and other materials to explain the importance and significance of the ancient structures They also came up with concrete plans for getting visitors to and around the sites and developed long-term plans for protecting and managing the tombs The project to support the application also led to the creation of some unusual promotional items Local restaurants started serving curry in the shape of a tomb and special postage stamps went on sale in Osaka the next step will be to address some practical problems One of the biggest is the fact that there is no way to view the entire area as there are practically no good observatories around any of the tombs Taking the biggest Mausoleum as an example but it's on the 21st floor of the Sakai City Office its characteristic keyhole shape is not visible from there anyway Sakai City joined hands with a private helicopter firm to conduct a trial sightseeing flight over the tumulus clusters The city is also working on a plan to build a 12-meter high observation deck beside the Mausoleum While it will clearly be a challenge to ensure the local area sees the benefits of the UNESCO registration the decision will also encourage people to think about how to protect their heritage The tombs reveal ancient construction skills and offer a valuable insight to the birth of a nation Japanese version