Neurological manifestations of SARS-CoV-2 infection in children in Taiwan: A cross-section, multicenter study.

BACKGROUND: The SARS-CoV-2 virus has been a global public health threat since December 2019. This study aims to investigate the neurological characteristics and risk factors of coronavirus disease 2019 (COVID-19) in Taiwanese children, using data from a collaborative registry. METHODS: A retrospective, cross-sectional, multi-center study was done using an online network of pediatric neurological COVID-19 cohort collaborative registry. RESULTS: A total of 11160 COVID-19-associated emergency department (ED) visits and 1079 hospitalizations were analyzed. Seizures were the most common specific neurological symptom, while encephalitis and acute disseminated encephalomyelitis (ADEM) was the most prevalent severe involvement. In ED patients with neurological manifestations, severe neurological diagnosis was associated with visual hallucination, seizure with/without fever, behavior change, decreased GCS, myoclonic jerk, decreased activity/fatigue, and lethargy. In hospitalized patients with neurological manifestations, severe neurological diagnosis was associated with behavior change, visual hallucination, decreased GCS, seizure with/without fever, myoclonic jerk, fatigue, and hypoglycemia at admission. Encephalitis/ADEM was the only risk factor for poor neurological outcomes at discharge in hospitalized patients. CONCLUSION: Neurological complications are common in pediatric COVID-19. Visual hallucination, seizure, behavior change, myoclonic jerk, decreased GCS, and hypoglycemia at admission are the most important warning signs of severe neurological involvement such as encephalitis/ADEM.

An Efficient Diazirine-Based Four-Armed Cross-linker for Photo-patterning of Polymeric Semiconductors.

A diazirine-based four-armed cross-linker (4CNN) with a tetrahedron geometry is presented for efficient patterning of polymeric semiconductors by photo-induced carbene insertion. After blending of 4CNN with no more than 3 % (w/w), photo-patterning of p-, n-, and ambipolar semiconducting polymers with side alkyl chains was achieved; regular patterns with size as small as 5 µm were prepared with appropriate photomasks after 365 nm irradiation for just 40 s. The interchain packing order and the thin film morphology were nearly unaltered after the cross-linking and the semiconducting properties of the patterned thin films were mostly retained. A complementary-like inverter with a gain value of 112 was constructed easily by two steps of photo-patterning of the p-type and n-type semiconducting polymers. The results show that 4CNN is a new generation of cross-linker for the photo-patterning of polymeric semiconductors for all-solution-processible flexible electronic devices.

The role of targeted gene panel in pediatric drug-resistant epilepsy.

About 10-30% of pediatric patients with epilepsy have drug-resistant epilepsy. Genetic panels may be useful in identifying etiology and guiding treatment in pediatric patients with drug-resistant epilepsy. In our tertiary center, we used two epilepsy panels, an initial 24-genes panel followed by a more comprehensive 122-genes panel to screen for genetic cause over recent 2 years. A total of 96 patients with drug-resistant epilepsy were evaluated using the 24-genes panel, which revealed 10 (10.4%) of the patients with pathogenic variants. Another 22 patients without causative genetic variants using first-gene panel were evaluated using the 122-genes panel. Out of the 22 patients, 4 had pathogenic variants, and 6 had variants of unknown significance. The total yield rate for the second panel was 18.2% (4/22). In conclusion, although whole exome sequencing has entered clinical practice, epilepsy gene panels may still play some roles because of lower cost and faster time, especially in those with fever-associated epilepsy.

Intracerebral large artery disease in Aicardi-Goutières syndrome with TREX1 mutation: a case report.

We report a patient diagnosed with Aicardi-Goutières syndrome (AGS) with homozygous TREX1 gene mutation. Her magnetic resonance angiography (MRA) showed intracerebral large artery disease, which was rarely reported in the past in TREX1 AGS patients. Her younger sister also had homozygous TREX1 gene mutation and died of necrotizing enterocolitis. Intracerebral large artery involvement has been seen as a particular feature of SAMHD1-related disease. Our patient also had arthropathy, which is a finding more commonly mentioned in SAMHD1-related diseases. The observations in our case may contribute to our understanding of the pathogenetic mechanism of TREX1 AGS, involving the intracerebral large arteries, arthropathy, and possibly the gastrointestinal tract.

From Skin Movement to Wearable Robotics: The Case of Robotic Gloves.

Previous research on wearable robotics focused on developing actuation mechanisms while overlooking influences of skin movement. During finger flexion, skins on the opisthenar and finger back are stretched. Impeding such skin movement will obstruct normal finger motions. In this research, a statistical study on skin movement is proposed and conducted to quantify skin movement on human hands. Results of 30 subjects (15 men and 15 women) reveal that skin at the finger back extends by an average of 29.3 ± 7.2% in fist clenching. Based on this study, design guidelines for robotic gloves are proposed, and nominal strain values at different hand regions are tabulated for references in robotic glove design. To explore the influence of skin movement on wearable robotics, an elastomer-constrained flat tube actuator is proposed based on which two prototype robotic gloves are developed: one with an ergonomic strap interface that has small constraint to skin motion, and the other based on the commonly used fabric glove that is supposed to have large constraint to skin motion. With the same power input to the robotic gloves, the strap-based design achieves a finger motion range of 2.5 times and a gripping force of 4.3 times that of the conventional fabric glove.

A clinical-information-free method for early diagnosis of lung cancer from the patients with pulmonary nodules based on backpropagation neural network model.

Lung cancer is the main cause of cancer-related deaths worldwide. Due to lack of obvious clinical symptoms in the early stage of the lung cancer, it is hard to distinguish between malignancy and pulmonary nodules. Understanding the immune responses in the early stage of malignant lung cancer patients may provide new insights for diagnosis. Here, using high-through-put sequencing, we obtained the TCRß repertoires in the peripheral blood of 100 patients with Stage I lung cancer and 99 patients with benign pulmonary nodules. Our analysis revealed that the usage frequencies of TRBV, TRBJ genes, and V-J pairs and TCR diversities indicated by D50s, Shannon indexes, Simpson indexes, and the frequencies of the largest TCR clone in the malignant samples were significantly different from those in the benign samples. Furthermore, reduced TCR diversities were correlated with the size of pulmonary nodules. Moreover, we built a backpropagation neural network model with no clinical information to identify lung cancer cases from patients with pulmonary nodules using 15 characteristic TCR clones. Based on the model, we have created a web server named "Lung Cancer Prediction" (LCP), which can be accessed at http://i.uestc.edu.cn/LCP/index.html.

Nonhalogenated Solvent Processable and High-Density Photopatternable Polymer Semiconductors Enabled by Incorporating Hydroxyl Groups in the Side Chains.

Polymer semiconductors hold tremendous potential for applications in flexible devices, which is however hindered by the fact that they are usually processed by halogenated solvents rather than environmentally more friendly solvents. An effective strategy to boost the solubility of high-performance polymer semiconductors in nonhalogenated solvents such as tetrahydrofuran (THF) by appending hydroxyl groups in the side chains is herein presented. The results show that hydroxyl groups, which can be easily incorporated into the side chains, can significantly improve the solubility of typical p- and n-types as well as ambipolar polymer semiconductors in THF. Meanwhile, the thin films of these polymer semiconductors from the respective THF solutions show high charge mobilities. With THF as the processing and developing solvents these polymer semiconductors with hydroxyl groups in the side chains can be well photopatterned in the presence of the photo-crosslinker, and the charge mobilities of the patterned thin films are mostly maintained by comparing with those of the respective pristine thin films. Notably, THF is successfully utilized as the processing and developing solvent to achieve high-density photopatterning with ≈82 000 device arrays cm-2 for polymer semiconductors in which hydroxyl groups are appended in the side chains.

Investigation of Fluidic Universal Gripper for Delicate Object Manipulation.

The compliance of conventional granular jamming universal grippers is limited due to the increasing friction among particles when enveloping an object. This property limits the applications of such grippers. In this paper, we propose a fluidic-based approach for universal gripper which has a much higher compliance compared to conventional granular jamming universal grippers. The fluid is made of micro-particles suspended in liquid. Jamming transition of the dense granular suspension fluid from a fluid (hydrodynamic interactions) to solid-like state (frictional contacts) in the gripper is achieved by external pressure from the inflation of an airbag. The basic jamming mechanism and theoretical analysis of the proposed fluid is investigated, and a prototype universal gripper based on the fluid is developed. The proposed universal gripper exhibits advantageous compliance and grasping robustness in sample grasping of delicate objects, such as plants and sponge objects, where the traditional granular jamming universal gripper fails.

Direct conversion of chitin derived N-acetyl-D-glucosamine into 3-acetamido-5-acetylfuran in deep eutectic solvents.

3-Acetylamino-5-acetylfuran (3A5AF) is an important nitrogen-containing fine chemical with broad application prospects and high research value. Herein, we report a novel method for the conversion of N-acetyl-d-glucosamine (NAG) to 3A5AF in the choline chloride-based deep eutectic solvents (DESs). The catalytic activities of various DESs have been smoothly screened, and DES 2 (choline chloride/PEG-200/boronic acid = 1/1/0.5) displayed the best catalytic performance. In the absence of any additional solvent, catalyst and additive, product 3A5AF was obtained in 18.3% yield after reacting at 180 °C for 15 min under atmospheric condition. In addition, DES 2 showed a good reusability. The possible reaction pathway was elucidated on the basis of the results of LC-MS and 13C NMR spectra. This study provided a new perspective for the application of DES in the conversion of chitin biomass.

An Untethered Soft Robotic Dog Standing and Fast Trotting with Jointless and Resilient Soft Legs.

Soft robots are compliant, impact resistant, and relatively safe in comparison to hard robots. However, the development of untethered soft robots is still a major challenge because soft legs cannot effectively support the power and control systems. Most untethered soft robots apply a crawling or walking gait, which limits their locomotion speed and mobility. This paper presents an untethered soft robot that can move with a bioinspired dynamic trotting gait. The robot is driven by inflatable soft legs designed on the basis of the pre-charged pneumatic (PCP) actuation principle. Experimental results demonstrate that the developed robot can trot stably with the fastest speed of 23 cm/s (0.97 body length per second) and can trot over different terrains (slope, step, rough terrain, and natural terrains). The robotic dog can hold up to a 5.5 kg load in the static state and can carry up to 1.5 kg in the trotting state. Without any rigid components inside the legs, the developed robotic dog exhibits resistance to large impacts, i.e., after withstanding a 73 kg adult (46 times its body mass), the robotic dog can stand up and continue its trotting gait. This innovative robotic system has great potential in equipment inspection, field exploration, and disaster rescue.

Benefits and risks of drug combination therapy for diabetes mellitus and its complications: a comprehensive review.

Diabetes is a chronic metabolic disease, and its therapeutic goals focus on the effective management of blood glucose and various complications. Drug combination therapy has emerged as a comprehensive treatment approach for diabetes. An increasing number of studies have shown that, compared with monotherapy, combination therapy can bring significant clinical benefits while controlling blood glucose, weight, and blood pressure, as well as mitigating damage from certain complications and delaying their progression in diabetes, including both type 1 diabetes (T1D), type 2 diabetes (T2D) and related complications. This evidence provides strong support for the recommendation of combination therapy for diabetes and highlights the importance of combined treatment. In this review, we first provided a brief overview of the phenotype and pathogenesis of diabetes and discussed several conventional anti-diabetic medications currently used for the treatment of diabetes. We then reviewed several clinical trials and pre-clinical animal experiments on T1D, T2D, and their common complications to evaluate the efficacy and safety of different classes of drug combinations. In general, combination therapy plays a pivotal role in the management of diabetes. Integrating the effectiveness of multiple drugs enables more comprehensive and effective control of blood glucose without increasing the risk of hypoglycemia or other serious adverse events. However, specific treatment regimens should be tailored to individual patients and implemented under the guidance of healthcare professionals.

A multi-model ensemble digital twin solution for real-time unsteady flow state estimation of a pumping station.

This paper proposes a digital twin solution for unsteady flow state estimation in a pumping station. Digital twin is expected to accurately estimate the real-time hydraulic parameters of blind spots of the pumping station system even under some adverse conditions including the interference of observation noise and model parameters drift. To solve these challenges, a digital twin framework integrating the model-driven method, control theory and data-driven method is presented. In this framework, an unsteady flow state estimation method combining frequency domain analysis and generalized predictive control theory is developed for the first time, which is superior to traditional time-domain numerical discrete methods in terms of computational efficiency and anti-noise interference. In the model parameter calibration process, the novelty concerns modeling of the optimization problem considering the dynamic operation control of the station and unsteady flow of pipelines. And this process is accomplished through the comprehensive application of the model-free adaptive control algorithm, the transient flow model and the particle swarm optimization algorithm. This work is applied to a pumping station in a product pipeline to verify its effectiveness in estimating the transient flow state of data blind spots and map the dynamic operation behavior under the interference of colored noise and parameter drift.

Double-Acting Soft Actuator for Soft Robotic Hand: A Bellow Pumping and Contraction Approach.

When compressing a soft bellow, the bellow will contract and pump out the fluid inside the bellow. Utilizing this property, we propose a novel actuation method called compressing bellow actuation (CBA), which can output fluidic power and tendon-driven force simultaneously. Based on the CBA method, a double-acting soft actuator (DASA) combining fluidic elastomer actuator (FEA) and tendon-driven metacarpophalangeal (MCP) joint is proposed for robotic finger design. The proposed DASA exhibits both compliance and adaptiveness of FEAs, and controllability and large output force of the tendon-driven methods. The fluid in the bellow can be either air or water or even integration of the two, thus constituting three different actuation modes. Mathematical modeling of the relationship between bellow compression displacement and DASA's bending angle is developed. Furthermore, experimental characterizations of DASA's bending angle and blocking force are conducted at different actuation modes. The double-acting method can availably promote the bending angle of an FEA by up to 155%, and the blocking force by up to 132% when the FEA is water-filled. A soft robotic hand with a forearm prototype based on the DASA fingers is fabricated for the demonstration of finger motion and gripping applications.

Study on the fluorescence of double-emission carbon quantum dots by improved intercept method.

The fluorescence mechanism of dual-emission carbon quantum dots (DCQDs) is investigated by the improved intercept method, of which the DCQDs with high quantum yield are synthesized by hydrothermal method by using the precursor of sulfadiazine. The research of the morphology, chemical properties and fluorescence properties on DCQDs, shows that DCQDs have graphene-like structure and well-resolved lattice fringes, and that DCQDs fluorescence emission as well intensity has reversibility between acid and alkaline. Based on the ultraviolet absorption spectrum (UV-vis) of the DCQDs, the band gap of DCQDs is estimated by the improved intercept method. Then, the change law of DCQDs emission wavelength at different excitation wavelengths is studied by using the estimated band gap. It is found that the improved intercept method is well consisted with the emission change law of DCQDs at different excitation wavelengths. In addition, the influence of different concentration of Fe3+on the estimated band gap of DCQDs shows that the Fe3+has big influence on the band gap of 3.99 eV and 3.06 eV but almost no effect on band gap of 4.93 eV and 3.67 eV. It indicates that the quenching of Fe3+to DCQDs may be due to the band gap caused by surface defect is changed by Fe3+. Also, DCQDs are used as probe to detect Fe3+and used as spray ink. Thereby, the improved intercept method may provide a new direction for researching the fluorescence mechanism of carbon quantum dots.

Simultaneous Incorporation of Two Types of Azo-Groups in the Side Chains of a Conjugated D-A Polymer for Logic Control of the Semiconducting Performance by Light Irradiation.

A new design strategy for photoresponsive semiconducting polymer with tri-stable semiconducting states is reported by simultaneous incorporation of tetra-ortho-methoxy-substituted azobenzene (mAzo) and arylazopyrazole (pAzo) in the side chains. The trans-to-cis transformations for mAzo and pAzo groups can sequentially occur within the polymer thin film after sequential 560 and 365 nm light irradiation. Remarkably, the trans-cis isomerization of mAzo and pAzo groups can modulate the thin film crystallinity. Accordingly, the performances of the resulting field-effect transistors (FETs) can be reversibly modulated, leading to tri-stable semiconducting states after sequential 560, 365, and 470 nm light irradiation. Therefore, the device performance can be logically controlled by light irradiation at three different wavelengths. In addition, with light irradiation and device current as the input and output signals, the three-value logic gate by using single FET device can be successfully mimicked.

Effect of Root Canal Therapy on the Success Rate of Teeth with Complete Roots in Autogenous Tooth Transplantation.

BACKGROUND: Autogenous tooth transplantation is a reliable method for repairing missing teeth. Although it recently became a recognized and feasible treatment method in dentistry, the long-term efficacy of root canal therapy (RCT) has not been well confirmed. This study is aimed at determining whether RCT has a good effect on the success rate of teeth with complete roots in autogenous tooth transplantation. MATERIALS AND METHODS: Data were collected from the Korea University Guro Hospital. Data of patients who underwent autogenous tooth transplantation within 9 years were collected. We selected 29 teeth with complete roots as the research subjects in our study. None of the patients had any systemic diseases. All cases in this study were obtained with patient permission. RESULTS: According to the tooth vitality test, the autogenous teeth tested negative in dental pulp test and function. Nine of the 29 teeth with autogenous tooth transplantation were treated with RCT and survived throughout the observation period. However, 20 autogenous teeth were not treated with RCT, and eight of them did not survive. All statistical analyses were performed using IBM SPSS 20.0. The null hypothesis was rejected (p < 0.05). CONCLUSION: For complete root teeth, the success rate after autogenous tooth transplantation after RCT is higher than that of teeth not treated with RCT.

Randomized Controlled Trial of Probiotic PS128 in Children with Tourette Syndrome.

Tourette syndrome results from a complex interaction between social-environmental factors, multiple genetic abnormalities, and neurotransmitter disturbances. This study is a double-blinded, randomized controlled trial using probiotics Lactobacillus plantarum PS128 as an intervention to examine if probiotics improve symptoms of children with Tourette syndrome. This study enrolled children aged 5 to 18 years old who fulfilled DSM-V diagnostic criteria for Tourette syndrome. Patients were assessed before initiating the trial, at one month, and at two months after randomization. The primary outcome was evaluated by Yale Global Tic Severity Scale (YGTSS), and the secondary outcome studied the possible comorbidities in these children. The results revealed no significant difference in improvement in YGTSS between the control group and the PS128 group. As for secondary endpoints, an analysis of Conners' Continuous Performance Test (CPT) showed improvement in commission and detectability in the PS128 group. In conclusion, although probiotics may not have tic-reducing effects in children with Tourette syndrome, it may have benefits on comorbidities such as attention deficit and hyperactivity disorder (ADHD). Further studies are needed to clarify the effects of probiotics on the comorbidities of Tourette syndrome children.

Synthesis, Insecticidal Evaluation, and 3D-QASR of Novel Anthranilic Diamide Derivatives Containing N-Arylpyrrole as Potential Ryanodine Receptor Activators.

To cope with the global food shortage and insect pest, there is an urgent need to discover new pesticides with novel modes of actions. Ryanodine receptor (RyR) insecticides showed great promise in integrated pest management. Herein, we report the synthesis of novel anthranilic diamide derivatives incorporating pyrrole moieties targeting at insect RyRs. The structures were confirmed by 1H NMR, 13C NMR, 19F NMR, and high-resolution mass spectrometry. The preliminary bioassay results indicated that most of the title compounds showed good to excellent insecticidal activities against the oriental armyworm (Mythimna separata) and diamondback moth (Plutella xylostella). For the oriental armyworm, Ij displayed the same level of larvicidal activity as the positive control chlorantraniliprole, with an LC50 value of 0.21 mg/L. For the diamondback moth, In, Io, Ip, and Iq exhibited higher insecticidal activities than chlorantraniliprole. In particular, In had 50% larvicidal activity at 0.00001 mg/L. The calcium imaging technique was applied to study the effect of Ij, In, and Ip on the intracellular calcium ion concentration ([Ca2+]i) in central neurons isolated from the oriental armyworm. The results indicated that the tested compounds, such as chlorantraniliprole, could activate the insect RyRs. Furthermore, comparative molecular field analysis and density functional theory calculations were carried out to study the structure-activity relationship.

Novel Anthranilic Diamide Scaffolds Containing N-Substituted Phenylpyrazole as Potential Ryanodine Receptor Activators.

To discover potent insecticides targeting ryanodine receptors (RyRs), a series of novel anthranilic diamides analogues (12a-12u) containing N-substituted phenylpyrazole were designed and synthesized. These compounds were characterized by (1)H NMR, (13)C NMR, and HRMS, and the structure of compound 12u was confirmed by X-ray diffraction. Their insecticidal activities indicated that these compounds displayed moderate to excellent activities. In particular, 12i showed 100 and 37% larvicidal activities against oriental armyworm (Mythimna separata) at 0.25 and 0.05 mg L(-1), equivalent to that of chlorantraniliprole (100%, 0.25 mg L(-1); and 33%, 0.05 mg L(-1)). The activity of 12i against diamondback moth (Plutella xylostella) was 95% at 0.05 mg L(-1), whereas the control was 100% at 0.05 mg L(-1). The calcium-imaging technique experiment results showed that the effects of 12i on the intracellular calcium ion concentration ([Ca(2+)]i) in neurons were concentration-dependent. After the central neurons of Helicoverpa armigera were dyed by loading with fluo-5N and treated with 12i, the free calcium released in endoplasmic reticulum indicated the target of compound 12i is RyRs or IP3Rs. The activation of RyRs by natural ryanodine completely blocked the calcium release induced by 12i, which indicated that RyRs in the central neurons of H. armigera third-instar larvae is the possible target of compound 12i.