Qualitative study of barriers and facilitators encountered by individuals with physical diseases in returning and continuing to work.

BACKGROUND: The number of employees with physical diseases is increasing, and there is a need for support to help them return and continue to work. To provide effective support, it is important to identify barriers and facilitators for individuals in returning and continuing to work. Previous studies have reported barriers and facilitators for specific diseases. However, few reports have dealt with these issues across various diseases. To identify a range of barriers and facilitators that may apply to different physical diseases, we conducted a qualitative analysis by interviewing patients with diverse characteristics being treated for diseases. METHODS: We conducted semi-structured interviews based on the criteria for qualitative research. We investigated three disease groups to obtain details of barriers and facilitators: impairments that were visible to other people (mainly stroke); impairments invisible to others (mainly heart disease); and impairments that changed over time (mainly cancer). Interview transcripts were analyzed and the results reported using systematic text condensation. RESULTS: We extracted 769 meaning units from 28 patient interviews. We categorized barriers and facilitators that were generalizable to various diseases into three themes (personal factors, workplace factors, and inter-sectoral collaboration and social resources) and 10 sub-themes (work ability, psychological impacts, health literacy, social status, family background, workplace structure, workplace system, workplace support, inter-sectoral collaboration, and social resources). CONCLUSIONS: This study identified 10 sub-themes that can be applied for workers with physical diseases; those sub-themes may be used as a basis for communicating with those individuals about returning and continuing to work. Our results suggest that various barriers and facilitators for workers with physical diseases should be understood and addressed at medical institutions, workplaces, and support sites.

The Effectiveness of a Deep Learning Model to Detect Left Ventricular Systolic Dysfunction from Electrocardiograms.

Deep learning models can be applied to electrocardiograms (ECGs) to detect left ventricular (LV) dysfunction. We hypothesized that applying a deep learning model may improve the diagnostic accuracy of cardiologists in predicting LV dysfunction from ECGs. We acquired 37,103 paired ECG and echocardiography data records of patients who underwent echocardiography between January 2015 and December 2019. We trained a convolutional neural network to identify the data records of patients with LV dysfunction (ejection fraction < 40%) using a dataset of 23,801 ECGs. When tested on an independent set of 7,196 ECGs, we found the area under the receiver operating characteristic curve was 0.945 (95% confidence interval: 0.936-0.954). When 7 cardiologists interpreted 50 randomly selected ECGs from the test dataset of 7,196 ECGs, their accuracy for predicting LV dysfunction was 78.0% ± 6.0%. By referring to the model's output, the cardiologist accuracy improved to 88.0% ± 3.7%, which indicates that model support significantly improved the cardiologist diagnostic accuracy (P = 0.02). A sensitivity map demonstrated that the model focused on the QRS complex when detecting LV dysfunction on ECGs. We developed a deep learning model that can detect LV dysfunction on ECGs with high accuracy. Furthermore, we demonstrated that support from a deep learning model can help cardiologists to identify LV dysfunction on ECGs.

[Achievements and Future Challenges in the Support of the Balance of Work and Medical Treatment at the Hospital of the University of Occupational and Environmental Health, Japan, in 2018-2020].

The Japanese government is making full-scale efforts to support working people who suffer from cancer and/or other diseases, as it seeks to support a balance of work and receiving medical treatment. The Hospital of the University of Occupational and Environmental Health, Japan, opened its Support Center of Treatment and Work Balance in 2018. This is a multi-disciplinary department for supporting the balance of work and medical treatment. It also opened its Department of Occupational Medicine, the first such department in Japan to provide medical diagnosis and treatment dedicated to supporting that same balance. Our team has supported 704 patients through our activities over the past 3 years. The number of patients supported has increased each year, while the number of departments providing support has also trended upward. There has also been an increase in opinions by attending physicians regarding employment, as well as the number of cases covered by public medical insurance. Here we suggest two factors in our hospital's growth in these activities: (1) many of the clinicians are qualified as occupational physicians, and (2) the organizational strength of our team, which has a vision for balancing support and subsequently promotes that vision. We hope that this report will lead to the balance of support activities in Japan and contribute to the model internationally.

Development of Gentle Slope Light Guide Structure in a 3.4 µm Pixel Pitch Global Shutter CMOS Image Sensor with Multiple Accumulation Shutter Technology.

CMOS image sensors (CISs) with global shutter (GS) function are strongly required in order to avoid image degradation. However, CISs with GS function have generally been inferior to the rolling shutter (RS) CIS in performance, because they have more components. This problem is remarkable in small pixel pitch. The newly developed 3.4 µm pitch GS CIS solves this problem by using multiple accumulation shutter technology and the gentle slope light guide structure. As a result, the developed GS pixel achieves 1.8 e- temporal noise and 16,200 e- full well capacity with charge domain memory in 120 fps operation. The sensitivity and parasitic light sensitivity are 28,000 e-/lx·s and -89 dB, respectively. Moreover, the incident light angle dependence of sensitivity and parasitic light sensitivity are improved by the gentle slope light guide structure.

Single plasma mirror providing 104 contrast enhancement and 70% reflectivity for intense femtosecond lasers.

To efficiently eliminate picosecond pre-pulses that accompany ultrashort pulses emitted from high-power chirped-pulse-amplification laser systems, we have developed a high-performance plasma mirror system. By reducing the reflectivity of the antireflection coating on the substrate for the plasma mirror to the limit of current technology (∼0.006%), we achieved the highest pre-pulse contrast enhancement reported to date for a single plasma mirror of 104 at 1 ps before the pulse peak. By optimizing the laser incidence to the plasma mirror and the laser fluence, the reflectivity of the plasma mirror has been improved to 70%. The contrast improvement indicates extensibility to 100 PW class lasers by doubling this plasma mirror system. Contrast enhancement of 108 should be possible without a serious reduction in energy (no more than 50%).

Single plasma mirror providing 104 contrast enhancement and 70% reflectivity for intense femtosecond lasers: publisher's note.

This note points out a missed correction to the math on p. 5648 of [Appl. Opt.5, 5647 (2016)APOPAI0003-693510.1364/AO.55.005647].

Relationship Between Firm Size and Perceived Organizational Support and the Moderating Role of Supervisor Support: A Nationwide Cross-sectional Study.

OBJECTIVE: The study aims to explore the relationship between firm size and perceived organizational support (POS) and to investigate how supervisor support might moderate this relationship. METHODS: The study involved a cross-sectional questionnaire survey in Japan with 25,648 participants. Assessing POS through eight-question. Firm size was categorized into small (2-49 employees), medium (50-999), and large (1000 or more). Coefficients were estimated using multiple regression analyses. RESULTS: The analysis revealed that medium and large firms had lower POS compared to small firms, with the difference being more pronounced in medium firms. A positive interaction between firm size and supervisor support was observed for POS. CONCLUSIONS: This study found that although POS is more likely to be lower in medium and large firms than in small firms, the effect of supervisor support on improving POS is stronger.

The Individual and Work-Related Factors Associated with the Occupational Future Time Perspective: A Cross-Sectional Study of Older Workers in Japan.

OBJECTIVES: Occupational future time perspective (OFTP) is important concept for the successful career in older workers. The purpose of this study was to examine the associations between individual and work-related factors and OFTP. METHODS: We conducted a cross-sectional study via an online questionnaire survey. Respondents were stratified sampled according to the distribution of workers across Japan. To assess OFTP, we used the Japanese version of the OFTP scale. We included the factors such as sex, age, education, marital status, subjective health status, personal income, length of employment, industry, size of company, employment status, working days per week, and night shift. Multiple regression analysis was employed to calculate the regression coefficients for each factor, with OFTP serving as the dependent variable. RESULTS: We totally included 1,484 respondents. Our findings indicated that higher OFTP was associated with higher education, better subjective health status, higher personal income, and smaller size of company. Compared to the manufacturing, certain industries such as agriculture and forestry, transportation and postal services, and healthcare showed lower OFTP. In contrast to permanent workers, contract and part-time workers demonstrated lower OFTP, whereas owners of non-family businesses exhibited higher OFTP. Furthermore, individuals working 1-4 days per week showed lower OFTP compared to those working 5 days per week. CONCLUSIONS: Older workers facing limitations in resources, such as educational background, personal income, precarious employment, and health status, tend to have lower OFTP. Such individuals should be given priority for support and assistance.

Myocardial DNA Damage Predicts Heart Failure Outcome in Various Underlying Diseases.

BACKGROUND: Reliable predictors of treatment efficacy in heart failure have been long awaited. DNA damage has been implicated as a cause of heart failure. OBJECTIVES: The purpose of this study was to investigate the association of DNA damage in myocardial tissue with treatment response and prognosis of heart failure. METHODS: The authors performed immunostaining of DNA damage markers poly(ADP-ribose) (PAR) and γ-H2A.X in endomyocardial biopsy specimens from 175 patients with heart failure with reduced ejection fraction (HFrEF) of various underlying etiologies. They calculated the percentage of nuclei positive for each DNA damage marker (%PAR and %γ-H2A.X). The primary outcome was left ventricular reverse remodeling (LVRR) at 1 year, and the secondary outcome was a composite of cardiovascular death, heart transplantation, and ventricular assist device implantation. RESULTS: Patients who did not achieve LVRR after the optimization of medical therapies presented with significantly higher %PAR and %γ-H2A.X. The ROC analysis demonstrated good performance of both %PAR and %γ-H2A.X for predicting LVRR (AUCs: 0.867 and 0.855, respectively). There was a negative correlation between the mean proportion of DNA damage marker-positive nuclei and the probability of LVRR across different underlying diseases. In addition, patients with higher %PAR or %γ-H2A.X had more long-term clinical events (PAR HR: 1.63 [95% CI: 1.31-2.01]; P < 0.001; γ-H2A.X HR: 1.48 [95% CI: 1.27-1.72]; P < 0.001). CONCLUSIONS: DNA damage determines the consequences of human heart failure. Assessment of DNA damage is useful to predict treatment efficacy and prognosis of heart failure patients with various underlying etiologies.

Divergence-free transport of laser-produced fast electrons along a meter-long wire target.

We demonstrate that, from a 10-µm metal wire irradiated by a 10(19) W/cm2 laser pulse, fast electrons form a nearly perfect circular beam around the wire and propagate along it. The total charge and diameter of the electron beam are maintained over a propagation distance of 1 m. Moreover, the electron beam can be guided along a slightly bent wire. Numerical simulations suggest that a relatively weak steady electric field, which does not decay for several nanoseconds, is generated around the wire and plays a key role in the long-distance guidance.

Multivessel Coronary Artery Dissection in a Patient with Co-Occurrence of Aortic Dissection and Dilated Cardiomyopathy in the Postpartum Period.

The co-occurrence of dilated cardiomyopathy (DCM) and aortic dissection has been rarely reported. Here, we present the case of a patient with co-occurrence of DCM and aortic dissection, wherein multivessel coronary artery dissection eventually occurred, thereby leading to advanced heart failure. She suffered from co-occurrence of DCM and aortic dissection 6 years ago. After the heart failure had briefly stabilized, the myocardial infarction due to coronary artery dissection led to worsening mitral regurgitation and decreased right ventricular function, thereby worsening the status of her heart failure. In addition to cardiovascular abnormalities, the patient was also complicated by short stature (145 cm), mild scoliosis, nonfunctioning pituitary adenoma of 1 cm in size, and retinitis pigmentosa. Coronary artery dissection is a possible complication in patients with co-occurrence of DCM and aortopathy, which could dramatically affect the clinical course of advanced heart failure.

Autocorrelation measurement of fast electron pulses emitted through the interaction of femtosecond laser pulses with a solid target.

We report the first direct measurement of the emission duration of laser-accelerated fast electrons from the surface of a solid target irradiated by a high-intensity femtosecond laser pulse. The emission duration is determined by autocorrelation measurement using the Coulomb repulsive forces that act on two equivalent electron pulses. The emission duration depends on the laser pulse duration for laser pulses of 200-690 fs. Numerical modeling of three-dimensional charged particle dynamics indicates that the emission duration of fast electrons is almost equal to the duration of the laser pulse.

Relationship Between Psychosocial Work Environment Factors and Presenteeism Among Workers With Diarrhea/Constipation Symptoms: A Cross-Sectional Study.

OBJECTIVES: This study aimed to investigate the relationship of diarrhea/constipation symptoms with presenteeism and psychosocial work environment factors. METHODS: This study analyzed 16,975 workers of 10 Japanese companies. Presenteeism was measured using a work functioning impairment scale. Odds ratios (ORs) and 95% confidence intervals (cis) for the relationship between diarrhea/constipation and presenteeism were estimated using a logistic model, adjusting for the psychosocial work environment. RESULTS: Diarrhea/constipation symptoms were related to presenteeism. This relationship was weakened, but remained significant after adjusting for psychosocial work environment factors. CONCLUSIONS: Diarrhea and constipation, which are highly prevalent in the workplace, are important pathological factors for presenteeism. Presenteeism can be partially suppressed by improving the psychosocial work environment.

Occupational safety and health aspects of corporate social responsibility reporting in Japan: comparison between 2012 and 2020.

OBJECTIVE: To survey the content of occupational safety and health (OSH) disclosed in corporate social responsibility (CSR)-related reports and integrated reports in 2020 and to compare the changes between 2012 and 2020 according to industry and company size. RESULTS: Among all companies, 441 (20.3%) issued CSR-related reports and 590 (28.1%) issued integrated reports. The number (percentage) of companies that issued either CSR-related reports or integrated reports was 880 (40.5%). The percentages of both CSR-related reports and integrated reports increased with increased company size. The number (percentage) of companies reporting OSH in CSR-related reports was 391 (88.7%) and that in integrated reports was 493 (83.6%). The percentage of OSH reporting in CSR-related reports and integrated reports was high in secondary industries and low in tertiary industries.

Collimated fast electron emission from long wires irradiated by intense femtosecond laser pulses.

We have experimentally demonstrated that fast electrons emitted from a metallic wire irradiated by a 5 × 10(18) W/cm(2) laser pulse can be collimated along the wire, and that their intensity is significantly enhanced in the axial direction of the wire. As the wire length is increased up to 30 mm from the laser focal spot, the angular divergence of the emitted electrons with energies of hundreds of keV decreases to 65 mrad. Numerical simulations reveal that the electrons are trapped by the transient electric field surrounding the wire and guided along the axial direction.

Three-dimensional mapping discovered arrhythmic substrate missed in the initial diagnosis of idiopathic ventricular fibrillation.

During an initial diagnosis of IVF, an arrhythmic substrate may be missed for several reasons such as lack of information; thus, a careful follow-up is important. A three-dimensional mapping may identify a possible missed arrhythmic substrate in IVF.

Absolute response of a Fuji BAS-TR imaging plate to low-energy protons (<0.2 MeV) and carbon ions (<1 MeV).

This paper reports on the absolute response of a Fuji BAS-TR image plate to relatively low-energy protons (<0.2 MeV) and carbon ions (<1 MeV) accelerated by a 10-TW-class compact high-intensity laser system. A Thomson parabola spectrometer was used to discriminate between different ion species while dispersing the ions according to their kinetic energy. Ion parabolic traces were recorded using an image plate detector overlaid with a slotted CR-39 solid-state detector. The obtained response function for the protons was reasonably extrapolated from previously reported higher-ion-energy response functions. Conversely, the obtained response function for carbon ions was one order of magnitude higher than the value extrapolated from previously reported higher-ion-energy response functions. In a previous study, it was determined that if the stopping range of carbon ions is comparable to or smaller than the grain size of the phosphor, then some ions will provide all their energy to the binder resin rather than the phosphor. As a result, it is believed that the imaging plate response will be reduced. Our results show good agreement with the empirical formula of Lelasseux et al., which does not consider photo-stimulated luminescence (PSL) reduction due to the urethane resin. It was shown that the PSL reduction due to the deactivation of the urethane resin is smaller than that previously predicted.