Proposal of a 1-ampere-class deuteron single-cell linac for nuclear transmutation.

A 1-ampere-class high-intensity deuteron linac (ImPACT2017 model) is proposed for mitigating long-lived fission products (LLFPs) by nuclear transmutation. This accelerator consists of single-cell rf cavities with magnetic focusing elements to accelerate deuterons beyond 1 A up to 200 MeV/u.

Relationship between abdominal adiposity and incident chronic kidney disease in young- to middle-aged working men: a retrospective cohort study.

BACKGROUND: Obesity is a risk factor for the development of chronic kidney disease (CKD). However, it remains to be fully examined whether fatness is more useful in predicting incident CKD. We aimed this study to determine the association of body fat, body mass index and waist circumference (WC) with subsequent changes in estimated glomerular filtration rate (eGFR) and incident CKD in young- to middle-aged working men. METHODS: We analyzed data from annual health check-up in male workers aged from 20 to 60 years with basal eGFR of 60-90 mL/min/1.73 m2. Cut-off values of parameters and odds ratio (OR) for the incident CKD were calculated by receiver operator characteristics analysis andχ2 test, respectively. We also tested trends of changes in eGFR according to changes in WC in each age decade. RESULTS: There were 8,015 men participants. During the 5-year follow-up, 11.0% of the participants (N = 878) had developed to incident CKD. When basal WC was greater than 80.0 cm, which was decided by Youden's Index, there was a significantly higher risk of incident CKD [OR 1.57 (95% confident interval 1.35-1.84)]. Changes in WC over 5 years were significantly related to eGFR decline in young men (< 40 years old) with normal blood pressures and normoglycemia. CONCLUSIONS: These findings suggest that WC > 80.0 cm is a risk factor for incident CKD and strongly associated with a decline in eGFR in the young- to middle-aged working healthy men.

Impact of low-density lipoprotein cholesterol on decline in estimated glomerular filtration rate in apparently healthy young to middle-aged working men.

BACKGROUND: It remains to be fully clarified whether there is a relationship between uncontrolled dyslipidemia and decline in estimated glomerular filtration rate (eGFR) in the general population. Therefore, this study's aim was to test the association of dyslipidemia with changes in eGFR in apparently healthy working men. METHODS: We retrospectively examined the annual medical check-up list of 14,510 male workers aged 20-60 years with eGFR ≥ 60 mL/min/1.73 m2 at baseline, and then evaluated the association of the changes in the check-up parameters with a decline in eGFR during the 5-year observation period. RESULTS: Mean age and eGFR were 38.5 years and 82.3 mL/min/1.73 m2 at baseline, respectively. Evaluated low-density lipoprotein cholesterol (LDL-C) (≥140 mg/dL) was a strong indicator of CKD development in participants (basal eGFR 60-90 mL/min/1.73 m2) without hypertension [odds ratio (95% confidence interval): 1.46 (1.12-1.90)] or diabetes mellitus (DM) [1.49 (1.23-1.82)]. When LDL-C normalized under 140 mg/dL during follow-up, the decline in eGFR was smaller in non-hypertensive participants [-5.9 (-14.4 to -0.9) vs -13.4 (-18.4 to -4.5) mL/min/1.73 m2, p < 0.05]. There was an inverse correlation between change of LDL-C and decline in eGFR (p for trend <0.001). CONCLUSION: Increased LDL-C levels are associated with the development of incident CKD and eGFR decline in young to middle-aged working men without hypertension and/or DM.

Evaluation of validity of the urine dipstick test for identification of reduced glomerular filtration rate in Japanese male workers aged 40 years and over.

OBJECTIVES: We evaluated the validity of the urine dipstick test for identifying reduced glomerular filtration rate (GFR) in male workers. METHODS: This study was conducted in male workers aged ≥ 40 yr. Reduced GFR was categorized as either estimated GFR (eGFR) < 60 ml/min/1.73 m(2) (eGFR <60) or eGFR < 50 ml/min/1.73 m(2) (eGFR < 50). Four sets of criteria were used to evaluate the GFR on the basis of proteinuria excretion, as measured using the urine dipstick test. Receiver operating characteristic curves were created based on the sensitivity and specificity and used to calculate the area under the curve (AUC) and the 95% confidence intervals (CI). RESULTS: A total of 5,799 workers were included in this study. Use of an abnormal proteinuria criterion of 1+-3+ and a reduced GFR criterion of eGFR < 60 resulted in a sensitivity and specificity of 7.8% and 97.4%, respectively, while a reduced GFR criterion of eGFR < 50 resulted in a sensitivity and specificity of 37.8% and 97.4%, respectively. The AUC was 0.52 (95% CI, 0.48-0.55) for eGFR < 60 and 0.70 (95% CI, 0.59-0.80) for eGFR < 50. CONCLUSIONS: In this study, 92.2% of participants with an eGFR < 60 and 62.2% of participants with an eGFR < 50 were overlooked in the urine dipstick test. These results suggest that the urine dipstick test only is not sufficient enough to identify reduced GFR and that both a urine dipstick test and other measures of GFR are required to reliably identify reduced GFR.

Assessment of border control measures and community containment measures used in Japan during the early stages of Pandemic (H1N1) 2009.

BACKGROUND: In the early stages of Pandemic (H1N1) 2009, border control measures were taken by quarantine stations to block the entry of infected individuals into Japan and community containment measures were implemented to prevent the spreading. The objectives of this study were to describe these measures and the characteristics of infected individuals, and to assess the measures' effectiveness. METHODOLOGY/PRINCIPAL FINDINGS: Border control and community containment measures implemented from April to June (Period I: April 28-May 21, Period II: May 22-June 18) 2009 were described. Number of individuals identified and disease characteristics were analyzed. For entry screening, a health declaration form and an infrared thermoscanner were used to detect symptomatic passengers. Passengers indicated for the rapid influenza test underwent the test followed by RT-PCR. Patients positive for H1N1 were isolated, and close contacts were quarantined. Entry cards were handed out to all asymptomatic passengers informing them about how to contact a health center in case they developed symptoms. Nine individuals were identified by entry screening and 1 during quarantine to have Pandemic (H1N1) 2009. Health monitoring by health centers was performed in period I for passengers arriving from affected countries and in period II for those who had come into contact with the individuals identified by entry screening. Health monitoring identified 3 infected individuals among 129,546 in Period I and 5 among 746 in Period II. Enhanced surveillance, which included mandatory reporting of details of the infected individuals, identified 812 individuals, 141 (18%) of whom had a history of international travel. Twenty-four of these 141 passengers picked up by enhanced surveillance had been developing symptoms on entry and were missed at screening. CONCLUSION/SIGNIFICANCE: Symptomatic passengers were detected by the various entry screening measures put in place. Enhanced surveillance provided data for the improvement of public health measures in future pandemics.

Association between asymptomatic hyperuricemia and new-onset chronic kidney disease in Japanese male workers: a long-term retrospective cohort study.

BACKGROUND: Hyperuricemia is prevalent in patients with chronic kidney disease (CKD). We explored the hypothesis that asymptomatic hyperuricemia may be associated with new-onset CKD. METHODS: The participants were all male factory workers in Kanagawa, Japan (n = 1,285). All were over 40 years of age and had undergone annual health examinations from 1990 to 2007. Individuals with a history of gouty attacks were excluded from the study. A retrospective cohort study was conducted by following the estimated glomerular filtration rate (eGFR) for each participant over a maximum period of 18 years. The endpoint was new-onset CKD defined as eGFR < 60 mL/min/1.73 m2. The associations between new-onset CKD and the presence of hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension, diabetes, and obesity were analyzed. RESULTS: The mean (± standard deviation) follow-up period was 95.2 (± 66.7) months, and new-onset CKD was observed in 100 participants (7.8%) during this follow-up. Cox proportional hazards model revealed that the hazard ratio of new-onset CKD due to hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity were 3.99 (95% confidence interval: 2.59-6.15), 1.69 (1.00-2.86), 2.00 (1.29-3.11) and 1.35 (0.87-2.10), respectively. Concerning hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity, the log-rank tests showed P values of < 0.01, 0.01, < 0.01 and < 0.01, respectively. CONCLUSION: The results of this study suggest that asymptomatic hyperuricemia is a predictive factor for new-onset CKD for Japanese male workers.

Factors of working conditions and prolonged fatigue among teachers at public elementary and junior high schools.

Prolonged fatigue among elementary and junior high school teachers not only damages their health but also affects the quality of education. The aim of this study was to determine the factors of working conditions associated with prolonged fatigue among teachers at public elementary and junior high schools. We distributed a self-reported, anonymous questionnaire to 3,154 teachers (1,983 in elementary schools, 1,171 in junior high schools) working in public schools in a city in Japan. They were asked to assess 18 aspects of their working conditions using a seven-point Likert scale. Prolonged fatigue was measured using the Japanese version of the checklist individual strength questionnaire. Multiple regression analysis was used to examine the association between working conditions and prolonged fatigue. Gender, age, and school type were introduced as confounders. In all, 2,167 teachers participated in this study. Results showed that qualitative and quantitative workload (time pressure due to heavy workload, interruptions, physically demanding job, extra work at home), communication with colleagues (poor communication, lack of support), and career factors (underestimation of performance by the board of education or supervisors, occupational position not reflecting training, lack of prospects for work, job insecurity) were associated with prolonged fatigue.

Relationship between autonomic nervous system activity during sleep and fasting glucose in Japanese workers.

Although autonomic nervous system activity is reportedly related to diurnal glucose tolerance impairment, the relationship with glucose tolerance during sleep is unclear. Since work styles have recently diversified, it is important to assess the effect of sleep on workers' health. Elucidation of the relationship between autonomic nervous system activity during sleep and glucose tolerance in workers may facilitate preventive measures against diabetes using non-pharmacological means (e.g., sleep hygiene education, relaxation techniques and stress management). We examined whether autonomic nervous system activity during sleep is related to fasting glucose or glycated hemoglobin (HbA1c) in individuals with either normal or impaired fasting glucose tolerance. The subjects were 77 apparently healthy Japanese workers with normal or impaired fasting glucose. We used high frequency (HF) and the ratio of low frequency to high frequency (LF/HF) obtained by pulse wave analysis to estimate autonomic nervous system activity. The data were analyzed using a generalized estimating equation adjusted for potential confounders (age, gender, engagement in shift work, sleep duration, and body mass index). Fasting glucose was significantly negatively related to HF, the parasympathetic component during sleep. Our results suggest that parasympathetic activity during sleep is associated with fasting glucose in apparently healthy Japanese workers.

Work-family conflict and prolonged fatigue among Japanese married male physicians.

PURPOSE: Fatigue experienced by physicians may not only endanger their own health but may also affect the safety of patients. Such fatigue may be associated with the work environment and personal factors such as work-family conflict (WFC). This study aimed to determine the association between WFC and prolonged fatigue among Japanese married male physicians. METHODS: Physicians who graduated from a Japanese medical school answered a mailed anonymous self-report questionnaire. For assessment of WFC and prolonged fatigue, the Japanese versions of the WFC scale and the Checklist of Individual Strength questionnaire (CIS) were used. Prolonged fatigue was defined as the upper quartile of total CIS scores. The WFC scale comprises six dimensions. Total scores were divided into tertiles: low, intermediate, and high levels of WFC. A multiple logistic regression analysis was performed to examine the association between WFC and prolonged fatigue. RESULTS: A total of 540 male physicians answered the questionnaire, and the data of 444 married male physicians were analyzed. The data were then adjusted for age and work condition factors. Prolonged fatigue was significantly associated with high strain-based work interference with family (WIF; corrected odds ratio, 5.56; 95% confidence interval, 2.55-12.1), intermediate strain-based WIF (2.53, 1.25-5.10), high time-based family interference with work (FIW; 1.92, 1.08-3.40), and there was a weak association with high strain-based FIW (1.93, 0.98-3.83). CONCLUSIONS: Employers should take measures to improve working conditions in hospitals, and give physicians the opportunity to learn how to cope with WFC. These measures could ultimately help prevent prolonged fatigue.

Physician job satisfaction and working conditions in Japan.

OBJECTIVES: The aim of this study was to determine factors of working conditions associated with job satisfaction among physicians in Japan. METHODS: We sent a questionnaire to all the physicians who graduated from a medical school in Japan. Physicians who were satisfied with their job were determined as those who selected "very satisfied" and "satisfied" in response to the question: "Overall, are you satisfied with your job?" Working conditions were determined from 10 different aspects: income fairness, hospital resources, career satisfaction, difficulty in patient care, lack of personal time, administrative work, workload, and relationships with physician colleagues, staff and patients. Logistic regression analysis was used to explore the association between working conditions and job satisfaction. RESULTS: Among the respondents, 209 (55.4%) men and 62 (61.4%) women were determined to be satisfied with their job. Job satisfaction was associated with income fairness for both men (corrected odds ratio 1.31, 95% confidence interval 1.09 to 1.47) and women (1.35, 1.05 to 1.53). For men, job satisfaction was associated with good hospital resources (1.45, 1.29 to 1.57), high career satisfaction (1.41, 1.23 to 1.57), good relationships with physician colleagues (1.33, 1.12 to 1.49), and good relationships with hospital staff (1.28, 1.07 to 1.45). For women, job satisfaction was associated with good relationships with patients (1.41, 1.07 to 1.56). CONCLUSIONS: Certain working conditions were important factors for job satisfaction among physicians. These factors should be discussed for improving working conditions.

Predisposing factors of sleep-disordered breathing in Japanese male workers.

The aim of this study was to elucidate the usable predisposing factors of sleep-disordered breathing (SDB) in the workplace. A total of 353 male workers who complained of SDB related symptoms such as witnessed snoring, recurrent awakening from sleep, urination during the night, morning headache, and excessive daytime sleepiness were included in the analysis. We examined hyoid-mental distance (HMD), modified Mallampati score (MMS), and the narrowness of the pharynx with tonsillar hypertrophy as the predisposing physical findings of SDB. We used the number of 3% or more oxygen desaturation events per hour (ODI3) as the indicator of SDB. The mean values (S.D.) of all subjects were 44.3 (8.9) yr (19-66 yr) of age, and 25.9 (3.8) Kg/m(2) body mass index (BMI). A significant difference in ODI3 was found between the HMD classes, and also between the subjects with and without tonsillar hypertrophy. Mean ODI3 adjusted for age, BMI, and alcohol consumption on the day of monitoring was high in the group of short HMD and the group of tonsillar hypertrophy (+). For MMS, though ODI3 did not appear to be significantly different, mean ODI3 was high in the MMS-IV. In conclusion, short HMD and tonsillar hypertrophy are the important findings predicting SDB identified by pulse oximetry. These findings would be beneficial in the workplace for selection of subjects who should be encouraged to undergo pulse oximetry for detection of SDB.

A very low level of magnetic field exposure does not affect a participant's mental fatigue and stress as much as VDT work.

Exposure to Magnetic Fields (MF) may affect the health of workers in an occupational environment. However, there is no clear evidence that the emission of MF from the visual display terminals (VDT) affects workers'mental status or induces stress in office environments. The purpose of our study was to investigate whether exposure to the MF during VDT work affects mental fatigue or induces stress related to psycho-physiological changes in workers. Thirty-seven students were voluntarily recruited to participate in this study. We created experimental conditions that a pair of the liquid crystal display (LCD) terminals separated by screens was closely placed in front of the visual suface of the cathode ray tube (CRT) units. All participants were not able to recognize whether the power of the CRT Units was ON or OFF while they worked with the LCD terminals. When the CRT unit was ON, participants who worked with the LCD terminal were called CRT-ON group. On the other hand, when the CRT unit was OFF, participants who worked with the CLD terminal were called CRT-OFF group. Incredibly short profiles of mood states (ISP)and subjective symptom questionnaires were used as indices of the mental fatigue as well as psychological stress before and after VDT work. Furthermore, salivary chromogranin A and urinary 8-hydroxydeoxyguanosine (8-OH-dG) were collected to measure physiological changes before and after VDT work. The results of the questionnaires and salivary and urinary stress markers showed that the exposure to the MF during VDT work did not significantly induce mental fatigue or psychological stress in comparison with the CRT-OFF group. Contrary to the results from the exposure, mood states of vigor decreased greatly (P < 0.05) whereas the states of fatigue and confusion increased significantly (P < 0.001) after VDT work. In the questionnaires for subjective symptoms, participants complained remarkably regarding 14 out of 25 conditions after VDT work. Moreover, urinary 8-OH-dG excretion increased significantly after VDT work. Taken together, the results of this study did not detect any bad health effects of MF exposure on the VDT participants but suggested that VDT work itself affects their mental fatigue and psycho-physiological status.