Laser Direct Writing of Graphene Quantum Dots inside a Transparent Polymer.

Graphene quantum dots (GQDs) have emerged as a promising new class of environmentally friendly quantum dots with unique properties. However, the limitations of synthesis and patterning methods have hindered GQDs from displaying their true potentials to date. Here, we demonstrate the simultaneous synthesis and patterning of GQDs for the first time inside a transparent polymer, polydimethylsiloxane (PDMS), using femtosecond laser pulses. By focusing and scanning femtosecond laser pulses, arbitrary fluorescent patterns such as a concealed fluorescent QR code can be readily patterned without pre- and/or post-treatment. In addition, the proposed method is applied to the fabrication of fluorescent three-dimensional structures inside a transparent polymer via multiphoton interactions. The proposed method realizes single-stepped and spatially selective patterning of GQDs directly inside polymer substrates and expands the possibilities of GQDs for applications in novel flexible three-dimensional optoelectrical devices.

Long-term prognosis of enteral feeding and parenteral nutrition in a population aged 75 years and older: a population-based cohort study.

BACKGROUND: Enteral feeding and parenteral nutrition (PN) using gastrostomy (GS) and a nasogastric tube feeding (NGT) and PN should be initiated for older patients based on their prognoses. This study aimed to investigate the long-term prognosis of patients aged ≥75 years who underwent enteral feeding via GS and NGT as well as PN. METHODS: A population-based cohort study was conducted using Japan's universal health insurance claims in the Nara Prefecture. This study enrolled 3,548 patients aged ≥75 years who received GS (N=770), NGT (N=2,370), and PN (N=408) during hospital admissions between April 2014 and March 2016. The GS group was further categorized into secondary GS (N=400) with preceding NGT or PN within 365 days and primary GS (N=370) without preceding NGT or PN groups. In the secondary GS group, 356 (96%) patients received NGT (versus PN). The outcome was mortality within 730 days after receiving GS, NGT, and PN. Cox regression analyses in cases with or without malignant diseases, adjusted for sex, age, comorbidity, and hospital type, were performed to compare mortality in the groups. RESULTS: Of the 3,548 participants, 2,384 (67%) died within 730 days after the initiation of GS and NGT and PN. The 2-year mortality rates in the secondary GS, primary GS, NGT, and PN groups were 58%, 66%, 68%, and 83% in patients without malignancies and 67%, 71%, 74%, and 87% in those with malignancies, respectively. In the non-malignant group, Cox regression analysis revealed that secondary GS (hazard ratio (HR) = 0.43, 95% CI: 0.34-0.54), primary GS (HR = 0.51, 95% CI: 0.40-0.64), and NGT (HR = 0.71, 95% CI: 0.58-0.87) were statistically significantly associated with lower mortality compared with PN. CONCLUSIONS: Approximately 58% to 87% patients aged ≥75 years died within 730 days after initiation of nutrition through GS, NGT, or PN. Patients with non-malignant diseases who received secondary GS exhibited better 2-year prognosis than those who received NGT or PN. Healthcare professionals should be aware of the effectiveness and limitations of enteral feeding and PN when considering their initiation.

Dopamine Transporter Dynamics of N-Substituted Benztropine Analogs with Atypical Behavioral Effects.

Atypical dopamine transporter (DAT) inhibitors, despite high DAT affinity, do not produce the psychomotor stimulant and abuse profile of standard DAT inhibitors such as cocaine. Proposed contributing features for those differences include off-target actions, slow onsets of action, and ligand bias regarding DAT conformation. Several 3α-(4',4''-difluoro-diphenylmethoxy)tropanes were examined, including those with the following substitutions: N-(indole-3''-ethyl)- (GA1-69), N-(R)-2''-amino-3''-methyl-n-butyl- (GA2-50), N-2''aminoethyl- (GA2-99), and N-(cyclopropylmethyl)- (JHW013). These compounds were previously reported to have rapid onset of behavioral effects and were presently evaluated pharmacologically alone or in combination with cocaine. DAT conformational mode was assessed by substituted-cysteine accessibility and molecular dynamics (MD) simulations. As determined by substituted-cysteine alkylation, all BZT analogs except GA2-99 showed bias for a cytoplasmic-facing DAT conformation, whereas cocaine stabilized the extracellular-facing conformation. MD simulations suggested that several analog-DAT complexes formed stable R85-D476 "outer gate" bonds that close the DAT to extracellular space. GA2-99 diverged from this pattern, yet had effects similar to those of other atypical DAT inhibitors. Apparent DAT association rates of the BZT analogs in vivo were slower than that for cocaine. None of the compounds was self-administered or stimulated locomotion, and each blocked those effects of cocaine. The present findings provide more detail on ligand-induced DAT conformations and indicate that aspects of DAT conformation other than "open" versus "closed" may facilitate predictions of the actions of DAT inhibitors and may promote rational design of potential treatments for psychomotor-stimulant abuse.

Air Stabilization of Li7P3S11 Solid-State Electrolytes through Laser-Based Processing.

All-solid-state batteries (ASSBs) that employ solid-state electrolytes (SSEs) have the potential to replace more conventional batteries that employ liquid electrolytes due to their inherent safety, compatibility with lithium metal and reputable ionic conductivity. Li7P3S11 is a promising SSE with reported ionic conductivities in the order of 10 mS/cm. However, its susceptibility to degradation through oxidation and hydrolysis limits its commercial viability. In this work, we demonstrate a laser-based processing method for SSEs to improve humidity stability. It was determined that laser power and scanning speed greatly affect surface morphology, as well as the resulting chemical composition of Li7P3S11 samples. Electrochemical impedance spectroscopy revealed that laser treatment can produce SSEs with higher ionic conductivities than pristine counterparts after air exposure. Further examination of chemical composition revealed an optimal laser processing condition that reduces the rate of P2S74- degradation. This work demonstrates the ability of laser-based processing to be used to improve the stability of SSEs.

Risks of Myocarditis and Pericarditis Following Vaccination with SARS-CoV-2 mRNA Vaccines in Japan: An Analysis of Spontaneous Reports of Suspected Adverse Events.

OBJECTIVE: To identify the risks of myocarditis or pericarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines in Japan. METHODS: We conducted an observed-to-expected analysis (OE analysis) of spontaneous reports of suspected adverse events from pharmaceutical companies, calculating rate ratios with myocarditis and pericarditis after the vaccination of the mRNA vaccines Comirnaty (BNT162b2) and Spikevax (mRNA-1273) and expected rate of myocarditis and pericarditis in the population before the COVID-19 pandemic. These reports dated from 17/2/2021 to 14/11/2021 and from 22/5/2021 to 14/11/2021 for Comirnaty and Spikevax, respectively. The observed-to-expected ratios (OE ratios) for each vaccine were estimated by age groups and sex. RESULTS: We identified 281 and 195 cases of myocarditis or pericarditis for Comirnaty and Spikevax, respectively, which were administrated 163,059,502 and 31,768,352 doses for Comirnaty and Spikevax until the 14th of November 2021, respectively. The OE ratios were statistically significantly higher in adolescent and young adult males in their age of teens and twenties after the second dose in a two-dose series [Comirnaty in teens male: 6.15 (95% CI, 2.26-21.98), Comirnaty in twenties male: 2.86 (95% CI, 1.13-8.38), Spikevax in teens male: 41.59 (95% CI, 5.64-43,281.94), Spikevax in twenties male: 16.84 (95%CI, 6.77-57.49)]. CONCLUSIONS: Risks of myocarditis and pericarditis following SARS-CoV-2 mRNA vaccines in Japan seems to be significantly elevated for adolescent and young adult males.

Simultaneous laser-based graphitization and microstructuring of bamboo for supercapacitors derived from renewable resources.

Utilizing renewable resources for electrodes realizes the sustainable fabrication of a supercapacitor with high environmental friendliness. Laser-based graphitization of biomass has been emerging as a promising technique for patterning the electrodes of a supercapacitor with renewable resources. Herein, simultaneous patterning and microstructuring of laser-induced graphene (LIG) on a renewable biomass resource, bamboo, by a laser-based graphitization technique was demonstrated. By irradiating femtosecond laser pulses onto bamboo, graphitization and microstructuring were both induced simultaneously, forming conductive structures with high surface area. Furthermore, LIG patterned on bamboo by our method was used as the electrodes of supercapacitors. NaCl was selected as the electrolyte for the fabrication of supercapacitors. The proposed method realizes the fabrication of environmentally-friendly supercapacitors comprised of all renewable biomass resources.

Safety monitoring of COVID-19 vaccines in Japan.

The assessment of the efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines in actual practice is extremely important, and monitoring efforts are being implemented worldwide. In Japan, a joint council in the Ministry of Health, Labour and Welfare is held every two to three weeks to summarise information on the adverse events following COVID-19 vaccination, with careful assessment of individual case safety reports and comparison with background incidence rates. In 2021, the joint council mainly reviewed anaphylaxis, death, myocarditis/pericarditis, and thrombosis with thrombocytopenia syndrome. These activities resulted in several safety-related regulatory actions, including the revision of vaccine package inserts with warnings about myocarditis/pericarditis. International sharing of vaccine safety information, as well as details of the evaluation systems, is important for international discussion and decision-making on better safety monitoring of COVID-19 vaccines.

Synthesis of silicon carbide nanocrystals and multilayer graphitic carbon by femtosecond laser irradiation of polydimethylsiloxane.

Laser-based modification of polymer materials has been emerging as a versatile and efficient technique to simultaneously form and pattern electrically conductive materials. Recently, it has been revealed that native polydimethylsiloxane (PDMS) can be modified into electrically conductive structures using femtosecond laser irradiation; however, the details regarding the structures formed by this method have yet to be revealed. In this work, structures were fabricated by focusing and scanning femtosecond laser pulses onto the surface of PDMS. Raman Spectroscopy and Transmission Electron Microscopy (TEM) analyses revealed the formation of silicon carbide (SiC) nanocrystals, as well as multilayer graphitic carbon, in the modified regions of PDMS. The state of the formed material differed depending on the distance from the focal spot, suggesting that photo-thermal effects contributed to the degradation of PDMS into conductive material. Electrical conductivity measurements, in addition to Raman results, indicated that the amount of disorder in the formed graphitic carbon contributes to the electrical conductivity of the fabricated structures.

Retroperitoneal abscess due to Achromobacter xylosoxidans presenting as femoral pain.

We describe the case of a 65-year-old patient who presented to our hospital with femoral pain. MRI and CT scan revealed a retroperitoneal abscess. We treated him with early surgical drainage and antibiotic treatment. The urine and draining pus cultures grew Achromobacter xylosoxidans. An iliopsoas abscess may show unique signs depending on its volume. To the best of our knowledge, this is the second reported case of retroperitoneal abscesses due to A. xylosoxidans. Surgical drainage appears to be effective when abscess is large.

Variation in fracture risk by season and weather: A comprehensive analysis across age and fracture site using a National Database of Health Insurance Claims in Japan.

Although age- and season-specific effects on fracture risk have been reported, the effects of seasonality across different age groups and for different fracture sites have not yet been clarified. Therefore, our study aimed to comprehensively investigate the effects of seasonality on fracture risk across age and fracture sites using a large-scale population database of fracture incidence. Fracture data were accumulated over a 3-year period in the region of Tokyo and in surrounding areas, which accounts for a total population of 42 million. Information on fracture occurrence, fracture site, and patient demographics were obtained from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Over the study period, 508,051 fractures were identified across the following five age groups: 0-19, 20-39, 40-64, 65-79, and 80+ years. The incidence rate for fractures in 10 site groups was calculated. Fracture risk was the highest in the spring and autumn for children aged 0-19 years and was the highest in the winter for elderly individuals (65-79 and 80+ years). Toe fractures, which occurred more frequently in the summer, were the most notable exception. The risk of fracture of the distal radius and hip was associated with daily temperature and rainfall and was elevated on days with a mean temperature higher than that of the previous day. Fracture risk exhibited seasonal variations that differed between children and elderly individuals and between toe fractures and fractures at other sites. These findings can help us understand the epidemiology of fractures and develop preventive strategies, as well as aid in the allocation of healthcare resources.

[CLINICAL CONSIDERATION OF PERCUTANEOUS RENAL BIOPSY FOR ADVANCED RENAL TUMOR].

(Objective) Advanced renal tumors are often difficult to diagnose based on radiological findings. The preset study aimed to evaluate the diagnostic efficacy and safety of percutaneous renal tumor biopsy in patients with advanced renal tumors. (Methods) Thirteen patients (6 males and 7 females) with advanced renal tumors who underwent percutaneous renal tumor biopsy between January 2015 and May 2017 were reviewed retrospectively. (Results) The median patients age was 69 years (range=40-81 years). The median renal tumor size was 91 mm (53-195 mm). Four cases were diagnosed as clear cell renal cell carcinoma (CCRCC), 8 as non-CCRCC, and 1 as malignant lymphoma prior to biopsy. Histopathological diagnoses after biopsy were CCRCC in 3, urothelial carcinoma in 3, and papillary renal cell carcinoma in 2 cases; there was 1 case each of chromophobe renal cell carcinoma, spindle cell RCC, carcinoma of the collecting ducts of Bellini, and nephroblastoma. Diagnosis could not be made in 1 case due to sampling error. Adverse events developed after renal tumor biopsy, with microscopic hematuria in 2 and pyrexia in 1 case. These were Grade 1 events according to the Clavien-Dindo Classification. Disseminated tumors were not observed during the follow-up period. (Conclusion) Percutaneous tumor biopsy for patients with advanced renal tumor is a safe procedure and useful for confirming the diagnosis pathologically before starting medication.

Data regarding fracture incidence according to fracture site, month, and age group obtained from the large public health insurance claim database in Japan.

The National Database of Health Insurance Claims and Specific Health Checkups of Japan includes all health insurance claims submitted in Japan and is considered representative of almost all health claims in Japan. Data regarding fracture incidence, based on the documented diagnoses in the claims and relevant procedure codes, were extracted from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. This data paper includes fracture incidence according to fracture site, month, and age group for the population in Kanto area (Tokyo and surrounding areas), which consists of approximately 42 million people. These data provide supplementary material to be interpreted for the article "Variation in Fracture Risk by Season and Weather: A Comprehensive Analysis across Age and Fracture Site Using a National Database of Health Insurance Claims in Japan" Hayashi et al., and serve as one of the largest epidemiological datasets regarding seasonal differences in fracture incidence according to fracture site and age group.

Femtosecond Laser-Based Modification of PDMS to Electrically Conductive Silicon Carbide.

In this paper, we experimentally demonstrate femtosecond laser direct writing of conductive structures on the surface of native polydimethylsiloxane (PDMS). Irradiation of femtosecond laser pulses modified the PDMS to black structures, which exhibit electrical conductivity. Fourier-transform infrared (FTIR) and X-ray diffraction (XRD) results show that the black structures were composed of ß-silicon carbide (ß-SiC), which can be attributed to the pyrolysis of the PDMS. The electrical conductivity was exhibited in limited laser power and scanning speed conditions. The technique we present enables the spatially selective formation of ß-SiC on the surface of native PDMS only by irradiation of femtosecond laser pulses. Furthermore, this technique has the potential to open a novel route to simply fabricate flexible/stretchable MEMS devices with SiC microstructures.

Improved methods for ultracryotomy of CNS tissue for ultrastructural and immunogold analyses.

We examined each step of the protocol for ultracryotomy for central nervous system tissue in order to define and overcome some of the methodological difficulties. The following three steps emerged as critical for the method's success: (1) pretreatment of grids to render them hydrophilic immediately before use; (2) careful collection of ultrathin cryosections during ultracryotomy; (3) removal of the appropriate amount of excess poly(vinyl alcohol)-uranyl acetate (PVA-UA) prior to drying after staining with PVA-UA. By taking account of the three critical steps described above, we succeeded in obtaining ultrathin cryosections, including serial sections, with excellent preservation of ultrastructure, as well as semithin cryosections which are useful for evaluating the quality of the samples and for selecting areas of interest for ultrastructural analysis. Cytoplasmic organelles in neurons and glial cells, and the fine structure of synapses and myelinated fibers were well preserved. The localization of gold particles after immunostaining for astrocytic glutamate transporter (GLAST), metabotropic glutamate receptor 1 (mGluR1) and neurofilament protein was consistent with previous reports and ultrastructure was well-preserved in all cases. These findings should be helpful to researchers wishing to carry out ultrastructural and immunogold analyses of cryosections of nervous tissue.

A Laparoscopic Management Combined with a Flexible Ureteroscope for Ureteral Polyps of More Than 3 cm Length.

Ureteral polyps are benign tumors of the ureter, which are relatively rare. The etiology has proposed various hypotheses, involving chronic inflammation and congenital disease. Most of them are commonly diagnosed in the upper ureter including the ureteropelvic junction. Some studies have reported polypectomy using a holmium laser, but several studies presented laparoscopic ureteroureterostomy for patients in whom the mentioned procedure is difficult. We underwent laparoscopic ureteroureterostomy with a combination of flexible ureteroscope for ureteral polyps of more than 3 cm length. We used ureteroscopy with a laparoscopic approach to minimize the length of ureter resection. Using the light guide of ureteroscopy is useful to decide the exact and minimal excision range for ureteroureterostomy.

Duration of First-line Treatment with Molecular Targeted-Therapy Is a Prognostic Factor in Metastatic Renal Cell Carcinoma.

AIM: We investigated the prognostic factors associated with overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received molecular targeted-therapies. MATERIAL AND METHODS: A total of 66 patients underwent molecular targeted-therapies at the Kurume University between May 2008 and April 2014. Medical records were retrieved and analyzed retrospectively. RESULTS: The median OS was 25.9 [95% confidence interval (CI)=18.3-33.7] months. The median OS stratified by the Memorial Sloan Kettering Cancer Center risk classification was 49.3, 28.6 and 18.3 months for the favorable-, intermediate- and poor-risk groups, respectively. Univariate analyses for various factors revealed gender, pre-treatment C-reactive protein (CRP) level, best response to first-line treatment, the number of molecular targeted agents and the duration of first-line treatment with a median of 6 months, as prognostic variables. Multivariate analyses showed than two or more than three molecular targeted agents [two: hazard ratio (HR)=0.351, 95% CI=0.121-0.901; more than three: HR=0.193, 95% CI=0.069-0.495] and a duration of first-line treatment of more than 6 months (HR=0.203, 95% CI=0.078-0.498) to be independent prognostic factors. CONCLUSION: Our results suggest that the duration of first-line treatment with molecular targeted-therapies is the strongest prognostic factor in patients with mRCC.