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1.
Vaccine X ; 20: 100553, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39309610

RESUMO

Background: Understanding the waning of immunity after booster vaccinations is important to identify which immune-low populations should be prioritized. Methods: We investigated longitudinal cellular and humoral immunity after the third vaccine dose in both high- and low-cellular and humoral immunity groups at the peak immunity phase after the booster vaccination in a large community-based cohort. Blood samples were collected from 1045 participants at peak (T1: median 54 days post-third dose) and decay (T2: median 145 days post-third dose) phases to assess IgG(S), neutralizing activity, and ELISpot responses. Participants were categorized into high/low ELISpot/IgG(S) groups at T1. Cellular and humoral responses were tracked for approximately five months after the third vaccination. Results: In total, 983 participants were included in the cohort. IgG(S) geometric mean fold change between timepoints revealed greater waning in the >79 years age group (T2/T1 fold change: 0.27) and higher IgG(S) fold change in the low-ELISpot group at T1 (T2/T1 fold change: 0.32-0.33) than in the other groups, although ELISpot geometric mean remained stable. Conclusions: Antibody level of those who did not respond well to third dose vaccination waned rapidly than those who responded well. Evidence-based vaccine strategies are essential in preventing potential health issues caused by vaccines, including side-effects.

2.
Front Immunol ; 15: 1412918, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39238641

RESUMO

Patients undergoing hemodialysis are particularly vulnerable to severe outcomes of SARS-CoV-2 infection, with mortality rates higher than that of the general population. Vaccination reduces the risk of adverse outcomes, with booster doses being particularly beneficial. However, limited data are available on the effectiveness of subsequent vaccinations or their effect on increasing antibody levels. This single-center study aimed to investigate changes in SARS-CoV-2 IgG antibody titers following the fourth vaccination among 28 patients undergoing hemodialysis. Blood tests were conducted at various intervals post-vaccination, with a focus on identifying factors associated with antibody levels. The IgG antibody levels rapidly increased by Day 7 post-vaccination, with a median time to peak of 11 days. Antibody titers tended to be higher in male patients than in female patients. This study sheds light on the immune response to the fourth vaccination in patients undergoing hemodialysis. As this study included a small sample size, with a short observation period, further research is warranted to comprehensively understand the effectiveness of vaccination and the benefits of additional doses of vaccine.


Assuntos
Anticorpos Antivirais , Vacina BNT162 , COVID-19 , Imunoglobulina G , Diálise Renal , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Vacina BNT162/imunologia , Vacina BNT162/administração & dosagem , COVID-19/imunologia , COVID-19/prevenção & controle , População do Leste Asiático , Imunização Secundária , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Japão/epidemiologia , Glicoproteína da Espícula de Coronavírus/imunologia , Vacinação
4.
Front Public Health ; 12: 1406315, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39139673

RESUMO

Introduction: Vaccination has been implemented as a useful measure to combat the COVID-19 pandemic. However, there is a tendency for individuals to avoid vaccination due to the possibility of adverse events, making it important to investigate the relationship between COVID-19 vaccines and their adverse events. This study explored longitudinal adverse event patterns and factors that influence adverse events following the second to fourth doses of the COVID-19 vaccine through a latent class analysis. Methods: Participants were recruited from the Fukushima Prefecture and included individuals who had completed four doses of the COVID-19 mRNA vaccine. This study utilized data from questionnaire surveys and blood collection conducted between September 2021 and November 2022. In the questionnaire, factors such as sex, age, medical history, medication, type of vaccine administered, and adverse events following vaccination were recorded. Additionally, in the blood data, serological tests [IgG(S)] and cellular immune responses (T-spot) were measured. Descriptive statistics, latent class analysis, multivariable logistic regression, and multiple regression analyses were performed to identify the longitudinal adverse event patterns and influencing factors. By analyzing adverse events over time, we identified two distinct groups: those less prone to experiencing adverse events (Group 1) and those more susceptible (Group 2) to latent class analysis. Results: A total of 1,175 participants were included after excluding those without any adverse events. The median age of the participants in Group 1 was 70 years, and in Group 2 it was 51 years. The proportion of female participants was 298 in Group 1 and 353 in Group 2. Patients in Group 2 were significantly younger (p < 0.001) and more likely to be female (p < 0.001) than those in Group 1. Furthermore, the median IgG(S) value after the fourth vaccination was 3,233 AU/mL in Group 1 and 4,059.39 AU/mL in Group 2. The median T-spot value was 15.4 in Group 1 and 28.5 in Group 2. Group 2 showed significantly higher IgG(S) and T-spot values after the fourth vaccination (p < 0.001). Discussion: Our findings suggest that factors other than age, particularly sex and a history of allergies, significantly influence the likelihood of experiencing adverse events. Groups categorized by latent class analysis for longitudinal adverse events are expected to be valuable for optimizing vaccination strategies and formulating public health measures.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Vacinas contra COVID-19/administração & dosagem , Japão , Análise de Classes Latentes , Estudos Longitudinais , Inquéritos e Questionários , Vacinação/efeitos adversos
5.
J Toxicol Sci ; 49(8): 349-358, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39098044

RESUMO

Cadmium is a heavy metal that pollutes the environment and foods and is a risk factor for vascular disorders. We have previously demonstrated that pretreatment of vascular endothelial cells with zinc and copper protects the cells against cadmium cytotoxicity. In contrast, cadmium cytotoxicity was potentiated in cells following exposure to lead, thereby indicating that in vascular endothelial cells, cadmium cytotoxicity can be differentially modified by the co-occurrence of other heavy metals. In this study, we revealed that simultaneous treatment or pretreatment with manganese protects vascular endothelial cells against cadmium cytotoxicity. Intracellular accumulation of cadmium was observed to be reduced by simultaneous treatment with manganese, although not by pretreatment. The mRNA expression of metal transporters that regulate the uptake of both cadmium and manganese (ZIP8, ZIP14, and DMT1) remained unaffected by either simultaneous treatment or pretreatment with manganese, and simultaneous treatment with manganese suppressed the cadmium-induced expression of metallothionein but pretreatment with manganese did not exhibit such suppressive effect. Thus, the protection of vascular endothelial cells against cadmium cytotoxicity conferred by simultaneous treatment with manganese is assumed to be partially attributed to a reduction in the intracellular accumulation of cadmium, whereas the effects of pretreatment with manganese are independent of both the reduced intracellular accumulation of cadmium and the induction of metallothionein. These observations accordingly indicate that the protective effects of manganese are mediated via alternative (as yet unidentified) mechanisms.


Assuntos
Células Endoteliais , Manganês , Metalotioneína , Metalotioneína/metabolismo , Metalotioneína/genética , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Células Cultivadas , Manganês/toxicidade , Cádmio/toxicidade , Proteínas de Transporte de Cátions/genética , Proteínas de Transporte de Cátions/metabolismo , RNA Mensageiro/metabolismo , RNA Mensageiro/genética , Humanos , Animais , Sobrevivência Celular/efeitos dos fármacos
6.
BMC Nurs ; 23(1): 586, 2024 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-39183265

RESUMO

BACKGROUND: The Great East Japan Earthquake and the subsequent Fukushima nuclear power plant accident in 2011 posed significant challenges to the educational sector, particularly affecting nursing students in the disaster area. However, to the best of our knowledge, there are no reports on the effects of the natural disaster coupled with the nuclear accident on the nursing students. Therefore, this study aimed to determine the impact of the Fukushima disasters on rate of academic failure events in nursing education. METHODS: A retrospective cohort approach was conducted, focusing on 677 students from Soma Nursing School admitted between 2001 and 2017. Four failure events-failure to pass the national examination, student retention, suspension, and withdrawal from school-were compared between three time periods: pre-disaster, early peri-disaster, and later peri-disaster. This analysis was followed by a questionnaire survey among the students and an interview with faculty members to gain further insights. RESULTS: Of the student cohort, 17% had at least one failure event. Students in the later peri-disaster phase faced an elevated failure rate at 29%. Variables such as being male, admission during later peri-disaster period, and local pre-admission residence played a significant role in these failure events in multivariate logistic regression analysis (adjusted odds ratio [95% confidence interval, p value]; 2.63 [1.49-4.64, < 0.001], 3.207 [2.00-5.15, < 0.001], and 1.84 [1.12-3.02, 0.02], respectively). CONCLUSIONS: This study highlights the impact of the Great East Japan Earthquake and the following nuclear accident on nursing education. The elevated failure rates in the later peri-disaster period emphasize the challenges posed by continuing disaster phases. Thus, there is a need for intensified and tailored strategies in nursing education in disaster-affected regions.

7.
Front Public Health ; 12: 1394376, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39081351

RESUMO

Following the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi nuclear power plant accident in 2011, mandatory evacuation orders were issued to residents living near the nuclear power plant in Fukushima prefecture, including some patients receiving home oxygen therapy. Although the vulnerability of patients with home oxygen therapy (one of the population groups most vulnerable to disasters) has been noted, there is little information on the health effects of evacuation in the event of a radiation disaster. A 90-year-old man diagnosed with chronic obstructive pulmonary disease since the age of 70, and lived in a town located approximately 20 km south of the nuclear power plant, died 8 months after the disaster due to worsening health conditions. This case reveals the potential for both physical and psychological burdens experienced by vulnerable groups like patients undergoing home oxygen therapy during evacuations in times of disaster. Although it is only a case report and the information is limited, severe respiratory distress requiring home oxygen therapy may present a significant risk factor for disaster-related deaths, especially in cases where evacuations are prolonged, such as in nuclear disasters. Due to the challenge of obtaining prompt public support immediately after a disaster, home oxygen therapy patients may need to prioritize self-help and mutual assistance in their disaster preparedness efforts.


Assuntos
Acidente Nuclear de Fukushima , Serviços de Assistência Domiciliar , Oxigenoterapia , Humanos , Masculino , Idoso de 80 Anos ou mais , Japão , Doença Pulmonar Obstrutiva Crônica/terapia , Evolução Fatal
8.
Front Public Health ; 12: 1394308, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39015392

RESUMO

Objective: Evacuation, owing to a disaster, impacts various aspects of an individual's life, including health status. This study aimed to determine the prevalence of obesity among residents of Katsurao Village, Fukushima Prefecture, after the evacuation order due to the Fukushima nuclear disaster in 2011 was lifted in 2016 and to compare the prevalence of obesity by place of residence (inside or outside the village). Methods: The number of examinees, sex, age, place of residence, body mass index (BMI), exercise habits, smoking habits, drinking habits, and dietary status were extracted from the results of health checkups since 2016. We compared the BMI of the indigenes of Katsurao Village by place of residence (inside or outside the village) over time. Results: Although 7 years have passed since 2016, ~70% of the registered residents of Katsurao Village still live outside the village. The obesity rates have consistently been higher among people living outside the village compared to those inside, and the place of residence was the only factor significantly associated with obesity. Conclusion: The findings of this study suggest early intervention is necessary to prevent health risks associated with disaster evacuation if the evacuation period is prolonged.


Assuntos
Acidente Nuclear de Fukushima , Obesidade , Características de Residência , Humanos , Masculino , Seguimentos , Prevalência , Obesidade/epidemiologia , Japão/epidemiologia , Adulto , Pessoa de Meia-Idade , Idoso
9.
J Radiol Prot ; 44(2)2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38834049

RESUMO

It is crucial to anticipate nuclear emergency scenarios and implement effective measures. Japan's climate and topography make it vulnerable to natural disasters; thus, it is necessary to address compounding and cascading disaster scenarios involving the simultaneous occurrence of natural and nuclear disasters. On 1 January 2024, an earthquake hit the Noto region of Ishikawa Prefecture, resulting in damage to the area around the Shika Nuclear Power Plant, located 90 km from the epicenter. This earthquake revealed that, in the event of a complex disaster, it is possible that residents living within 30 km of the Shika Nuclear Power Plant will be completely unprepared for a nuclear disaster. In the event of a complex disaster, it is crucial to implement appropriate countermeasures while balancing responses to both nuclear and natural disasters and optimizing radiation disaster prevention measures.


Assuntos
Planejamento em Desastres , Japão , Humanos , Liberação Nociva de Radioativos/prevenção & controle , Terremotos , Desastres Naturais , Centrais Nucleares , Proteção Radiológica
10.
Vaccines (Basel) ; 12(5)2024 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-38793750

RESUMO

This online survey of unvaccinated people living in Japan aimed to identify the reasons for declining vaccination and to develop effective countermeasures. We conducted a hierarchical class analysis to classify participants, examine factors influencing their classification, and provide the information they needed about coronavirus disease 2019 (COVID-19) and trusted sources of COVID-19 information for each group. A total of 262 participants were classified into three groups: Group 1 with no specific reason (28 participants, 10.69%); Group 2 with clear concerns about trust in the vaccine (85 participants, 32.44%), and Group 3 with attitudinal barriers, such as distrust of the vaccine and complacency towards COVID-19, and structural barriers, such as vaccination appointments (149 participants, 56.87%). For each group, females tended to be classified in Group 2 more than Group 1 (Odds ratio (OR) [95% confidential intervals (95%CI)] = 1.64 (0.63 to 2.66), p = 0.001) and in Group 3 more than Group 1 (OR [95%CI] = 1.16 (0.19 to 2.12), p = 0.019). The information that the participants wanted to know about COVID-19 was different among each group (Safety: p < 0.001, Efficacy: p < 0.001, Genetic effects: p < 0.001). Those who did not receive the COVID-19 vaccine also had lower influenza vaccination coverage (8.02%). Additionally, 38 participants (14.50%) were subject to social disadvantages because they had not received the COVID-19 vaccine. Countermeasures should be carefully tailored according to the target population, reasons for hesitancy, and specific context. The findings of this study may help develop individualized countermeasures to address vaccine hesitancy.

11.
PLOS Digit Health ; 3(5): e0000497, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38701055

RESUMO

As we learned during the COVID-19 pandemic, vaccines are one of the most important tools in infectious disease control. To date, an unprecedentedly large volume of high-quality data on COVID-19 vaccinations have been accumulated. For preparedness in future pandemics beyond COVID-19, these valuable datasets should be analyzed to best shape an effective vaccination strategy. We are collecting longitudinal data from a community-based cohort in Fukushima, Japan, that consists of 2,407 individuals who underwent serum sampling two or three times after a two-dose vaccination with either BNT162b2 or mRNA-1273. Using the individually reconstructed time courses of the vaccine-elicited antibody response based on mathematical modeling, we first identified basic demographic and health information that contributed to the main features of the antibody dynamics, i.e., the peak, the duration, and the area under the curve. We showed that these three features of antibody dynamics were partially explained by underlying medical conditions, adverse reactions to vaccinations, and medications, consistent with the findings of previous studies. We then applied to these factors a recently proposed computational method to optimally fit an "antibody score", which resulted in an integer-based score that can be used as a basis for identifying individuals with higher or lower antibody titers from basic demographic and health information. The score can be easily calculated by individuals themselves or by medical practitioners. Although the sensitivity of this score is currently not very high, in the future, as more data become available, it has the potential to identify vulnerable populations and encourage them to get booster vaccinations. Our mathematical model can be extended to any kind of vaccination and therefore can form a basis for policy decisions regarding the distribution of booster vaccines to strengthen immunity in future pandemics.

12.
J Radiol Prot ; 44(2)2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38722300

RESUMO

When considering disaster preparedness, one challenge is mitigating the health impacts of evacuations. Nuclear disaster preparedness has evolved based on past experiences from numerous disasters, including the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. However, there is a lack of comprehensive reporting on the awareness of administrative staff, medical personnel, and residents in the areas surrounding nuclear power plants (NPPs). This study reports on a survey aimed at gaining insights into the understanding and current state of disaster preparedness and elucidating the differences in perceptions of nuclear disaster preparedness among the relevant stakeholders surrounding NPPs. Interview surveys were conducted from 14 to 16 September 2022 in the area surrounding Kyushu Electric Power's Genkai NPP in Saga Prefecture and from 11 to 13 January 2023 in the area around Shikoku Electric Power's Ikata NPP. The surveys targeted administrative, medical, and nursing care facilities and residents. Responses from 57 participants indicated a lack of awareness of natural and nuclear disasters, challenges in evacuation planning, and a gap between nuclear disaster training and residents' understanding of evacuation protocols. This study highlights inadequacies in nuclear disaster preparedness and the need for a better understanding among residents regarding evacuation procedures. This study identified three key issues: (1) a lack of awareness about disasters, including nuclear disasters; (2) concerns about complex disasters and the difficulties in creating evacuation plans; and (3) a discrepancy between nuclear disaster training and residents' understanding of evacuation procedures. To bridge this gap, it is important to deepen residents' understanding of nuclear disasters, continuously convey the lessons learned from the FDNPP accident, and regularly reassess and update nuclear disaster preparedness strategies.


Assuntos
Planejamento em Desastres , Acidente Nuclear de Fukushima , Centrais Nucleares , Humanos , Japão , Inquéritos e Questionários , Feminino , Masculino , Adulto
13.
Front Immunol ; 15: 1337520, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562937

RESUMO

This study investigates the neutralizing activity against the XBB1.5 variant and the ancestral strain in a population post-bivalent vaccination using a pseudo virus assay validated with authentic virus assay. While bivalent booster vaccination and past infections enhanced neutralization against the XBB 1.5 strain, individuals with comorbidities showed reduced responses. The study suggests the need for continuous vaccine updates to address emerging SARS-CoV-2 variants and highlights the importance of monitoring real-world immune responses.


Assuntos
COVID-19 , Humanos , Japão/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Vacinação , Inquéritos e Questionários , RNA Mensageiro
15.
J Toxicol Sci ; 49(4): 193-208, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38556355

RESUMO

Vascular endothelial cells serve as barriers between blood components and subendothelial tissue and regulate the blood coagulation-fibrinolytic system. Ionizing radiation is a common physical stimulant that induces a bystander effect whereby irradiated cells influence neighboring cells through signalings, including purinergic receptor signaling, activated by adenosine 5'-triphosphate (ATP), adenosine 5'-diphosphate (ADP), and adenosine as secondary soluble factors. Human vascular endothelial EA.hy926 cells were cultured and irradiated with γ-rays or treated with ATP, ADP, or adenosine under non-toxic conditions. RNA-seq, gene ontology, and hierarchical clustering analyses were performed. The transcriptome analysis of differentially expressed genes in vascular endothelial cells after γ-ray irradiations suggests that the change of gene expression by γ-irradiation is mediated by ATP and ADP. In addition, the expression and activity of the proteins related to blood coagulation and fibrinolysis systems appear to be secondarily regulated by ATP and ADP in vascular endothelial cells after exposure to γ-irradiation. Although it is unclear whether the changes of the gene expression related to blood coagulation and fibrinolysis systems by γ-irradiation affected the increased hemorrhagic tendency through the exposure to γ-irradiation or the negative feedback to the activated blood coagulation system, the present data indicate that toxicity associated with γ-irradiation involves the dysfunction of vascular endothelial cells related to the blood coagulation-fibrinolytic system, which is mediated by the signalings, including purinergic receptor signaling, activated by ATP and ADP.


Assuntos
Adenosina , Células Endoteliais , Humanos , Adenosina/metabolismo , Células Endoteliais/metabolismo , Trifosfato de Adenosina/metabolismo , Receptores Purinérgicos , Perfilação da Expressão Gênica , Difosfato de Adenosina/farmacologia , Células Cultivadas
17.
Sci Rep ; 14(1): 2946, 2024 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-38316846

RESUMO

The medical situation during disasters often differs from that at usual times. Disasters can lead to significant mortality that can be difficult to monitor. The types of disaster-related deaths are largely unknown. In this study, we conducted a survey to categorize the disaster-related deaths caused by a radiation disaster. A total of 520 people living in Minamisoma City, Fukushima Prefecture, at the time of the Fukushima Daiichi Nuclear Power Plant accident, who were certified to have died due to disaster-related causes were surveyed. We divided the participants into those who were at home at the time of the earthquake and those who were in hospitals or facilities when the disaster struck and conducted a hierarchical cluster analysis of the two groups. Disaster-related deaths could be divided into seven groups for those who were at home at the time of the disaster and five groups for those who were in hospitals or facilities at the time of the disaster. Each group showed different characteristics, such as "the group with disabilities," "the group receiving care," and "the group with depression," and it became evident that not only uniform post-disaster support, but support tailored to the characteristics of each group is necessary.


Assuntos
Desastres , Terremotos , Acidente Nuclear de Fukushima , Humanos , Hospitais , Análise por Conglomerados , Japão/epidemiologia , Centrais Nucleares
19.
Front Public Health ; 11: 1289552, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38074698

RESUMO

Introduction: Following the Great East Japan Earthquake, the living environment of socially isolated older adults has become a pressing concern. In response, Nagaya, a collective housing program, was established in Soma City, Fukushima, Japan to address social isolation among older adults and support their long-term health. This study aimed to identify characteristics of individuals in Nagaya and examine the sustainability of this initiative. Methods: We conducted a retrospective analysis of residents who were relocated to Nagaya, emphasizing their characteristics, the continuity of their stay in Nagaya, and their care certification levels, using data up to December 31, 2022. We employed Kaplan-Meier curves to analyze the duration for which residents continued to reside in Nagaya and the time leading up to the requiring care-level certification. Results: Of 65 people who moved to Nagaya after the disaster, 30 people (46.2%) continued to live there, 21 (32.3%) died during their stay, and 14 (21.5%) moved out. The overall duration of occupancy averaged 6.39 years (SD 3.83 years). The proportion of requiring care-level certification occurrences per person-year was 0.0577 for those without care certification and 0.3358 for those with requiring support level at the time of moving in. Conclusion: In summary, Nagaya-style communal housing may offer suitable living environments for older adults with diverse needs during disasters and serve as a valuable tool for developing public policies in aging societies.


Assuntos
Desastres , Terremotos , Humanos , Idoso , Habitação , Japão , Estudos Retrospectivos
20.
J Radiol Prot ; 43(4)2023 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-38052085

RESUMO

In nuclear disaster prevention, it is essential not only to make daily efforts to prevent accidents from occurring but also to properly apply lessons learnt from actual disasters. Although significant changes have been made to nuclear disaster preparedness in Japan since the Fukushima Daiichi Nuclear Power Plant accident, there is insufficient information on whether these changes have been evaluated as practical and appropriate for the needs of the Japanese public. In this survey, 20 officials of the Cabinet Office and Japan Atomic Energy Agency, in charge of planning nuclear disaster prevention policy, were asked to evaluate the current nuclear disaster prevention plan through a questionnaire, and compare it with that before the accident, and indicate what elements are lacking in the current plan. The survey results revealed that 30% of the participants (six respondents) had a positive view of the enhancement of resources, including physical and human assets. However, as many as 60% (12 respondents) expressed negative sentiments, primarily due to perceived deficiencies in organisational measures, particularly the coordination of these resources. Moreover, the participants expressed keen interest in obtaining health data during evacuation, along with information on the physical and mental effects on evacuees living in evacuation centres. These crucial insights can inform the formulation of effective future preparedness plans for evacuation and radiation protection.


Assuntos
Desastres , Acidente Nuclear de Fukushima , Humanos , Japão , Centrais Nucleares , Inquéritos e Questionários
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