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OBJECTIVES: This observational study aimed to determine how 1-year changes in work time control (WTC) have an impact upon objectively measured fatigue and sleep among employees. METHODS: Thirty-nine employees were divided into two groups according to whether or not their WTC increased from baseline to 1 year later. Psychomotor vigilance task (PVT) and wrist actigraphy were used to objectively measure fatigue and sleep, respectively. Self-reported outcomes were also measured. RESULTS: The increased WTC group showed gradual improvements in PVT performance and sleep quality over the course of the follow-up period compared with the not-increased WTC group. Between-group differences were statistically significant for PVT lapses and tended to be significant for PVT speed after 1 year. CONCLUSIONS: A progressive increase in WTC could play a crucial role in reducing fatigue and promoting sleep among employees. Language: en

Background: Schoolteachers are known to be faced with various stresses in their work. A simple, less onerous, and effective intervention technique that can enhance the stress management skills, particularly, cognitive flexibility, of schoolteachers is needed. Objective: This study aimed to determine whether stress management training using a Web-based cognitive behavioral therapy (CBT) program is effective for enhancing the cognitive flexibility of schoolteachers and alleviating their subjective distress. Methods: This study was conducted in a random controlled design covering public elementary schoolteachers. Teachers allocated to the intervention group received 120 min of group education and completed homework using a Web-based CBT program that lasted for 3 months. The items of outcome evaluation were cognitive flexibility and subjective distress, and the efficacy of intervention was evaluated at 3 months after intervention. Results: A total of 240 participants were randomly allocated to the intervention group (120 individuals) and the control group (120 individuals). On the basis of the principle of intention to treat, the intervention group and the control group were compared regarding the amount of change from before intervention to after intervention, using a general linear model. Scores of cognitive flexibility and subjective distress were significantly more improved in the intervention group than in the control group. Conclusions: The results of this study suggest that simple stress management training using a Web-based CBT program in elementary schoolteachers enhances cognitive flexibility and alleviates subjective distress. [JMIR Res Protoc 2018;7(1):e32]

SUMMARY This paper proposes optimal total planning for incinerator plants (IPs) in a typical urban area, which includes a method of determining the number of plants and the capacities of the IPs. Burnable municipal refuse is disposed of sanitarily by high-temperature incineration at the IPs. At the same time, power generation from waste (PGW) is being performed at many IPs to recover energy. At present, the amount of energy generated by PGW is greater than that of wind power or photovoltaic power generation. However, PGW has a limited generation efficiency and low generation output due to the smaller capacity of IPs. To overcome the above weakness, highly efficient PGW is necessary with total integration and scaling up of IPs. Regarding total integration and scaling up, operation in larger areas is favorable from the point of view of refuse volume and collection. In the planning stage, both the cost of IPs and refuse collection, which is important for refuse disposal, should be taken into account comprehensively. Optimal total planing for IPs can be performed in two stages. First, the disposal capacity Gk of an IP versus the number of plants K is decided by constraints. Gk is about the same for all K because of maintenance and refuse collection, and is greater than 300 tons per day in steps of 100 tons per day. Gk should be decided not only by refuse volume but also by cessation of operation at plants due to maintenance or faults. Second, the cost of each value of K is calculated based on the construction and operating costs of the IPs, income from selling the energy of PGW, and refuse collection costs. Therefore, the value of K with the minimum cost is selected as the optimal number of IPs. A numerical simulation of an area with a population of 3 million indicates that the optimal plant number is 4. At present there are eight or nine IPs in cities of 3 million people. The above cost reduction effect will be about 15% from the present value. Considering the situation of aging IPs, a decreasing trend in refuse volume, and the stringent financial conditions of local governments, the proposed method is very effective and realistic.

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.

We investigated whether there are significant differences in neck muscle mass, maximum peck force, pressure and maximum pull force between Jungle Crows Corvus macrorhynchos and Carrion Crows C. corone. The maximum peck force and pressure were measured using pressure sensitive film. The maximum pull force was measured with spring balances. For male Jungle Crows, neck muscle mass, maximum peck force, pressure and maximum pull force were 8.27 g, 26.8 N, 80.4 MPa and 9.54 N; for females they were 6.82 g, 22.3 N, 69.7 MPa and 8.25 N. Those values for male Carrion Crows were 6.69 g, 22.3 N, 59.7 MPa and 4.07 N;, whereas for females they were 4.50 g, 15.1 N, 53.2 MPa and 2.71 N. Furthermore, neck muscle mass, maximum peck force and maximum pull force were positively correlated with body mass in both species. There were no significant differences in the ratio between the cervical levator mass and the cervical depressor mass, and the maximum peck force exerted by one unit of the cervical depressor mass between Jungle and Carrion Crows. However, the maximum pull force exerted by one unit of the cervical lavator and depressor mass of Jungle Crows was significantly larger than that of Carrion Crows.

We studied the effects of intracarotid papaverine and prostaglandin E1 incorporated in lipid microsphere (Lipo-PGE1) in relation with transcranial Doppler parameters such as mean flow velocity (MFV) and pulsatile index (PI) of the proximal segment of the middle cerebral artery. Eighty patients with subarachnoid hemorrhage (SAH) were included in this study. In the case of angiographic vasospasm, papaverine at 7 mg/min with total dose below 300 mg per artery and 10-20 micrograms of Lipo-PGE1 were injected in the supraclinoid portion of the internal carotid artery. Vasospasm was improved in 24 patients (63%), however, it was unchanged in 14 patients (37%). The former patients had more favorable outcomes than the latter patients (p < 0.005). After intracarotid injection therapy, the correlation between MFV and PI was classified into three types: type 1, both MFV and PI decreased; type 2, MFV decreased but PI increased; and type 3, both MFV and PI fluctuated. The Glasgow Outcome Scale 3 months after SAH was as follows: type 1 (n = 15), good in 14 (93%) and moderate disability in one (7%); type 2 (n = 9), good in eight (89%) and vegetative state in one (11%); and type 3 (n = 14), moderate disability in five (36%), severe disability in seven (50%), and death in two (14%). Chi-square analysis showed significant differences between type 1 and type 3 (p < 0.005), and type 2 and type 3 (p < 0.005). In conclusion, intracarotid papaverine combined with Lipo-PGE1 was effective for vasospasm but type 3 patients require a different treatment protocol.

Near miss-based analysis has been recently suggested to be more important in the medical field than focusing on adverse events, as in the industrial field. To validate the utility of near miss-based analysis in the medical fields, we investigated whether or not predictors of near misses and adverse events were similar among nurses at teaching hospitals. Of the 1,860 nurses approached, 1,737 (93.4%) were included in the final analysis. Potential predictors provided for analysis included gender, age, years of nursing experience, frequency of alcohol consumption, work place, ward rotation, frequency of night shifts, sleepiness during work, frequency of feeling unskilled, nurses' job stressors, working conditions, and depression. Variables for multivariate analysis were determined by bivariable analysis. Ordinal logistic analysis showed that predictors of near misses and adverse events were markedly similar. Parameters that were significantly related to both near misses and adverse events were years of experience, frequency of night shifts, internal ward, and time pressure (p

Shift work, including night work, has been regarded as a risk factor for medical safety. However, few studies have investigated the difference in medical error risk between two- and three-shift systems. A total of 1,506 registered nurses working shifts at teaching hospitals participated in this study to evaluate the difference in medical error risk between two- and three-shift systems. After adjustment for potential confounding factors using a log Poisson generalized estimating equation model, the results showed significantly higher frequencies of perceived adverse events over 6 months in the three-shift than in the two-shift system, with estimated mean numbers of adverse events of 1.05 and 0.74, respectively. Shorter intervals after night shifts and greater frequency of night shifts in three-shift systems, which reduce the recovery time from night shift work, may be linked to increased medical errors by nurses.

Bird vocalizations are produced by contractions of syringeal muscles, which are controlled by the hypoglossal nucleus. In oscines, syringeal muscles are controlled by the hypoglossal nucleus ipsilaterally, whereas syringeal innervation is bilateral in non-oscines. We have determined the course of hypoglossal nerves in the jungle crow Corvus macrorhynchos. Our results indicate a cross-over of the hypoglossal nerve from the left side to the right side on the trachea 7 mm rostral to the Musculus sternotrachealis. We also investigated the innervation of the syringeal muscles of jungle crows from the hypoglossal nucleus using the horseradish peroxidase (HRP) method. After HRP was injected into the syringeal muscles on each side, HRP-labeled cells were found bilaterally in the hypoglossal nerve. These results suggest that the syringeal muscles of jungle crows are innervated bilaterally from the hypoglossal nucleus, although these birds are categorized as oscines.

Teratomas in an undescended testis are rare in infants. This report was the youngest case of immature teratoma originating in intra-abdominal undescended testis. A 3-month-old infant with cryptorchism was seen because of an asymptomatic palpable mass in the right abdomen. Ultrasonography and computed tomography revealed a multicystic large tumor with focal calcifications in the right side and serum tumor markers within normal limits. Complete resection of the tumor was performed and the histopathological diagnosis was made as immature teratoma of the right testis. Because retroperitoneal lymph nodes metastasis was observed in 3-month follow-up postoperatively, retroperitoneal lymphadenectomy and chemotherapy including bleomycin, etoposide, and cisplatin were performed. Presently, the infant has been free of recurrence for 3 years. We suggest that nonpalpable testis should undergo a careful evaluation and prompt resolution and that the subsequent finding of an intra-abdominal mass should make us think on the possibility of intra-abdominal testicular germ cell tumor. Postoperative adjuvant chemotherapy in combination with complete resection of the tumor is necessary for pediatric immature teratomas originating in intra-abdominal undescended testis.