Impact of number of functional teeth on independence of Japanese older adults.

AIM: To examine the relationship between the number of present and functional teeth at baseline and future incidence of loss of independence. METHODS: Participants were community-dwelling older individuals who participated in a comprehensive geriatric health examination conducted in Kusatsu town, Japan, between 2009 and 2015. The primary endpoint was the incidence of loss of independence among participants, defined as the first certification of long-term care insurance in Japan. The numbers of present and functional teeth at baseline were determined via an oral examination. Demographics, clinical variables (e.g., history of chronic diseases and psychosocial factors), blood nutritional markers, physical functions, and perceived masticatory function were assessed. RESULTS: This study included 1121 individuals, and 205 individuals suffered from loss of independence during the follow-up period. Kaplan-Meier estimates of loss of independence for participants with smaller numbers of present and functional teeth were significantly greater than for those with larger numbers of teeth. Cox proportional hazard analyses indicated that a smaller number of present teeth was not a significant risk factor after adjusting for demographic characteristics. However, the number of functional teeth was a significant risk factor after the adjustment (hazard ratio: 1.975 [1.168-3.340]). Additionally, higher hazard ratios were observed in other adjusted models, but they were not statistically significant. CONCLUSIONS: The number of functional teeth may be more closely related to the future incidence of loss of independence than the number of present teeth. This novel finding suggests that prosthodontic rehabilitation for tooth loss possibly prevents the future incidence of this life-event. Geriatr Gerontol Int 2022; 22: 1032-1039.

A One-Year-Old Girl With Human Parvovirus B19 Infection and Hypocomplementemia Mimicking Incomplete Kawasaki Disease.

Human parvovirus B19 (B19) is a single-stranded DNA virus that targets erythroid progenitor cells in the bone marrow. B19 causes erythema infectiosum in children, transient aplastic anemia, pure red cell aplasia, hydrops fetalis, and contributes to other illnesses. An association between B19 infection and hypocomplementemia and rheumatoid arthritis has been reported, but the underlying mechanisms remain unclear. We report the case of a 1-year-old Japanese girl with persistent fever, skin rash, transient edema of the extremities, hypoalbuminemia, and hypocomplementemia associated with B19 infection. We considered Kawasaki disease (KD) and collagen diseases, particularly systemic lupus erythematosus, in our differential diagnosis. B19 infection might be associated with serological features that suggest systemic lupus erythematosus and may present with clinical symptoms seen in KD. Especially during erythema infectiosum epidemics, we must consider B19 infection in the differential diagnosis of KD patients who demonstrate atypical clinical symptoms and unexplained laboratory findings.

An Immunoglobulin A Vasculitis Case Without Skin Symptoms Complicated With Severe Abdominal Symptoms.

Immunoglobulin A vasculitis (IgAV) primarily affects childhood and can be categorized as immune complex vasculitis. It typically presents with purpura, abdominal pain, arthritis, and nephritis. IgAV can be diagnosed without hesitation when the characteristic skin lesions appear at onset; however, in cases where the abdominal symptoms precede the skin rash or there is no purpura at all, diagnosis can be challenging. Delayed diagnosis of IgAV may be associated with serious abdominal complications, such as gastrointestinal perforation. Here, we describe a girl with IgAV complicated with severe abdominal symptoms and lacking purpura. Despite this lack, the patient's elevated levels of D-dimer and C-reactive protein (CRP), suggestive of vasculitis, and localized small bowel intestinal wall thickening suggested IgAV. After administration of steroids relieved the abdominal symptoms and hypoalbuminemia, treatment was discontinued. Given the limited reports of patients with IgAV complicated with severe abdominal symptoms and no skin symptoms, the diagnosis and management process remains unclear. Therefore, it is imperative to consider IgAV as a differential diagnosis in patients with severe abdominal symptoms. Furthermore, we suggest checking D-dimer, CRP, and coagulation factor XIII activity levels in these patients.

The impact of the coronavirus disease 2019 pandemic on pediatric hospitalization in Kitami, Japan.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has drastically changed the recommended activities and environment for patients worldwide. Our aim was to assess the impact of COVID-19 on pediatric hospitalizations in Kitami, Japan. METHODS: A retrospective, single-center study was conducted on hospitalized patients aged 0-14 years at the Japanese Red Cross Kitami Hospital. We compared the incidence of pediatric patients hospitalized in 2020 with those in 2017-2019. RESULTS: The number of pediatric hospitalized patients dropped significantly in 2020 compared to that in 2017-2019 (median 43.0 vs 78.5 per month, P < 0.001). The patients were significantly older in 2020 (4.3 vs 3.4 years, P < 0.001). Hospitalization from respiratory (8.5 vs 30.5, P < 0.001) and gastrointestinal infections (3.0 vs 6.0, P = 0.004) significantly decreased. Admission due to respiratory syncytial virus (0.0 vs 4.0, P < 0.001), human metapneumovirus (0.0 vs 1.0, P = 0.005), influenza (0.0 vs 0.0, P = 0.009), adenovirus (0.0 vs 1.0, P = 0.003), and rotavirus infection (0.0 vs 0.0, P = 0.025) also decreased significantly. The <1-5 age groups significantly decreased (<1 year old, 6.5 vs 12.5, P < 0.001; 1-3 years old, 13.0 vs 29.5, P < 0.001; 4-5 years old, 5.5 vs 11.5, P < 0.001). Hospitalization due to foreign body ingestions increased significantly in 2020 (1.0 vs 0.0, P = 0.010). CONCLUSIONS: The COVID-19 control measures inadvertently reduced the number of hospitalized pediatric patients, especially younger children with respiratory and gastrointestinal infections.

Atypical Familial Mediterranean Fever in a Japanese Boy with Heterozygous MEFV p.Ser503Cys Exon 5 Variant.

Periodic fever syndromes are heterogeneous diseases. Familial Mediterranean fever (FMF) is one of the hereditary periodic fever diseases caused by a Mediterranean fever (MEFV) gene abnormality. FMF can be categorized as typical or atypical, based on clinical findings and genetic screening. Atypical FMF has a wide variation of clinical findings and disease-causing mutations of MEFV. Therefore, it is sometimes difficult to diagnose an unknown fever as FMF. To date, a large number of various typical and atypical FMF cases have been reported in Japan. Here, we describe a Japanese boy with heterozygous MEFV p.Ser503Cys exon 5 variant who developed periodic fever. He was treated with colchicine; a complete eradication of his fever and various accompanying symptoms have been subsequently achieved for more than a year. Given that there have been a few reports about patients with this variant, little is known about the genetic and phenotypic role of heterozygous MEFV p.Ser503Cys exon 5 variant. It is therefore imperative to consider atypical FMF as a differential diagnosis when a periodic fever is encountered. Furthermore, we suggest that it is worthwhile to integrate MEFV gene analysis with the potential effects of colchicine treatment in patients with periodic fever.

A case of severe autosomal dominant spinal muscular atrophy with lower extremity predominance caused by a de novo BICD2 mutation.

BACKGROUND: Heterozygous variants in BICD2 cause autosomal dominant spinal muscular atrophy with lower extremity predominance. These variants are also identified in individuals with severe forms of congenital muscle atrophy representing arthrogryposis multiplex. CASE REPORT: A girl was born with severe muscle weakness and respiratory distress. A fetal ultrasound had detected polyhydramnios and multiple joint contractures in utero. She was born with severe muscle weakness and respiratory distress. Bilateral hip joint dislocation and multiple bone fractures were also present at birth. Although she depends on medical care, including assisted ventilation and tube feeding, she has reached eight years of age. Her motor developmental skills were reduced owing to muscle weakness and deformity of her lower extremities, whereas her cognitive development slowly but steadily grew. Whole exome sequencing revealed a novel de novo missense BICD2 variant (c.1625G > A, p.(Cys542Tyr)), which was evaluated as likely pathogenic. CONCLUSION: This is the first case report of a severe form of spinal muscular atrophy with lower extremity predominance caused by a de novo BICD2 variant in Japan.

Number of functional teeth more strongly predicts all-cause mortality than number of present teeth in Japanese older adults.

AIM: Previous studies on the association between intraoral conditions and mortality in community-dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community-dwelling Japanese older adults. METHODS: This study was a retrospective, observational and population-based follow-up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow-up period was 1697.0 ± 774.5 days. The primary outcome was all-cause mortality at follow-up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. RESULTS: Kaplan-Meier analysis, followed by a log-rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089). CONCLUSIONS: Current results suggest that the number of FT more strongly predicts all-cause mortality than the number of PT among community-dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status. Geriatr Gerontol Int 2020; ••: ••-••.

Synthesis of arbitrary pulse waveforms in QCL-seeded ns-pulse CO2 laser for optimization of an LPP EUV source.

One of the unique features of the quantum-cascade-laser-seeded, nanosecond-pulse CO2 laser, invented for the purpose of generation of extreme UV by laser-produced-plasma, is a robust synthesis of arbitrary pulse waveforms. In the present Letter we report on experimental results that are, to our best knowledge, the first demonstration of such functionality obtainable from nanosecond-pulse CO2 laser technology. An online pulse duration adjustment within 10-40 ns was demonstrated, and a few exemplary pulse waveforms were synthesized, such as "tophat," "tailspike," and "leadspike" shapes. Such output characteristics may be useful to optimize the performance of LPP EUV source.

Efficient multiline nanosecond pulse amplification in planar waveguide CO2 amplifier for extreme UV laser-produced plasma source.

In this Letter, we report on recent experimental results of a short pulse amplification at 10.6 µm wavelength required to drive a tin laser-produced plasma (LPP) extreme ultraviolet (UV) source. We report for the first time, to our best knowledge, a highly efficient pulsed amplification in a multipass amplifier built on RF-discharge-excited, diffusion-cooled CO2, planar waveguide industrial CO2 laser. About 2 kW of output average power was obtained from about 100 W input average power in ∼15 ns pulses at 100 kHz pulse repetition frequency. As much as 60% relative extraction efficiency, as compared to continuous-wave amplification in similar conditions, and 5.8% wall-plug efficiency was recorded and believed to be the highest reported so far. An improvement of extraction efficiency by ∼10% is reported when driving the amplifier with two lines of CO2 regular band in good agreement with expectations.

Multiline short-pulse solid-state seeded carbon dioxide laser for extreme ultraviolet employing multipass radio frequency excited slab amplifier.

In this Letter we describe in more detail a solid-state seeded, nanosecond pulse, multiline CO(2) oscillator designed and built for the extreme ultraviolet (EUV) laser-produced-plasma (LPP) source. Our oscillator featured quantum cascade laser seeders, a diffraction-type seed beam combiner, and a radio-frequency-discharge-excited, diffusion-cooled, slab-waveguide CO(2) gain cell in a compact multipass regenerative amplifier configuration. The oscillator generated pulses of exceptional stability in terms of envelope, energy, and spectrum. Excellent stability of output was achieved without any additional techniques. The output spectrum consisted of two laser lines of a 00(0)1-10(0)0 band of a CO(2) molecule, P20 and P22, with a target of four lines P18-P24. The pulse duration was electronically adjustable between 11 and 35 ns at a repetition frequency from a few hertz to hundreds of kilohertz. Electronic adjustment of the pulse duration was achieved by relative timing offsets of individual seeders, opening an avenue to a range of on-line adjustments of pulse shape and spectral content timing. The jitter-tolerant operation allows for easy synchronization with an external event, such as a droplet target in an EUV LPP source. A resistance to parasitic seeding of more than 40 dB was recorded. The oscillator produced up to 20 W of average output power at a repetition rate of 100 kHz in a near-diffraction-limited beam of M(2)<1.3 and a pointing stability below 50 µrad.

Wavefront measurement of single-mode quantum cascade laser beam for seed application in laser-produced plasma extreme ultraviolet system.

Quantum cascade laser (QCL) is a very attractive seed source for a multikilowatt pulsed CO2 lasers applied for driving extreme ultraviolet emitting plasmas. In this Letter, we investigate output beam properties of a QCL designed to address P18 and P20 lines of 10.6 micron band of CO2 molecule. In particular, output beam quality and stability are investigated for the first time. A well-defined linear polarization and a single-mode operation enabled a use of phase retrieval method for full description of QCL output beam. A direct, multi-image numerical phase retrieval technique was developed and successfully applied to the measured intensity patterns of a QCL beam. Very good agreement between the measured and reconstructed beam profiles was observed at distances ranging from QCL aperture to infinity, proving a good understanding of the beam propagation. The results also confirm a high spatial coherence and high stability of the beam parameters, the features expected from an excellent seed source.

Spectral characteristics of quantum-cascade laser operating at 10.6 µm wavelength for a seed application in laser-produced-plasma extreme UV source.

In this Letter, we investigate, for the first time to our knowledge, the spectral properties of a quantum-cascade laser (QCL) from a point of view of a new application as a laser seeder for a nanosecond-pulse high-repetition frequency CO(2) laser operating at 10.6 µm wavelength. The motivation for this work is a renewed interest in such a pulse format and wavelength driven by a development of extreme UV (EUV) laser-produced-plasma (LPP) sources. These sources use pulsed multikilowatt CO(2) lasers to drive the EUV-emitting plasmas. Basic spectral performance characteristics of a custom-made QCL chip are measured, such as tuning range and chirp rate. The QCL is shown to have all essential qualities of a robust seed source for a high-repetition nanosecond-pulsed CO(2) laser required by EUV LPP sources.

Platinum nanoflowers on scratched silicon by galvanic displacement for an effective SALDI substrate.

We report a new and facile method for synthesizing 3D platinum nanoflowers (Pt Nfs) on a scratched silicon substrate by electroless galvanic displacement and discuss the applications of the Pt Nfs in surface-assisted laser desorption/ionization-mass spectrometry (SALDI-MS). Surface scratching of n-type silicon is essential to induce Pt Nf growth on a silicon substrate (to obtain a Pt Nf silicon hybrid plate) by the galvanic displacement reaction. The Pt Nf silicon hybrid plate showed excellent SALDI activity in terms of the efficient generation of protonated molecular ions in the absence of a citrate buffer. We propose that the acidity of the Si-OH moieties on silicon increases because of the electron-withdrawing nature of the Pt Nfs; hence, proton transfer from the Si-OH groups to the analyte molecules is enhanced, and finally, thermal desorption of the analyte ions from the surface occurs. Signal enhancement was observed for protonated molecular ions produced from a titania nanotube array (TNA) substrate on which Pt nanoparticles had been photochemically deposited. Moreover, surface modification of the Pt Nf silicon hybrid plate by perfluorodecyltrichlorosilane (FDTS) (to obtain an FDTS-Pt Nf silicon hybrid plate) was found to facilitate soft SALDI of labile compounds. More interestingly, the FDTS-Pt Nf silicon hybrid plate acts 1) as a high-affinity substrate for phosphopeptides and 2) as a SALDI substrate. The feasibility of using the FDTS-Pt Nf silicon hybrid plate for SALDI-MS has been demonstrated by using a ß-casein digest and various analytes, including small molecules, peptides, phosphopeptides, phospholipids, carbohydrates, and synthetic polymers. The hybridization of Pt Nfs with a scratched silicon substrate has been found to be important for achieving excellent SALDI activity.