Kawasaki Disease Hospitalizations in the United States 2016-2020: A Comparison of Before and During the Coronavirus Disease 2019 Era.

BACKGROUND: Kawasaki disease (KD) is an acute vasculitis of young children. A comparison of US hospitalization rates and epidemiologic features of KD in 2020 to those of precoronavirus disease years has yet to be reported. METHODS: Using a large, inpatient database, we conducted a retrospective cohort study and analyzed data for patients with (1) diagnosis coding for KD, (2) IV immunoglobulin treatment administered during hospitalization and (3) discharge date between January 1, 2016, and December 30, 2020. Severe cases were defined as those requiring adjunctive therapy or IV immunoglobulin-resistant therapy. RESULTS: The annual number of KD hospitalizations were stable from 2016 to 2019 (n = 1652, 1796, 1748, 1692, respectively) but decreased in 2020 (n = 1383). KD hospitalizations demonstrated seasonal variation with an annual peak between December and April. A second peak of KD admissions was observed in May 2020. The proportion of KD cases classified as severe increased to 40% in 2020 from 33% during the years 2016-2019 (P < 0.01). Median age in years increased from 2.9 in subjects hospitalized from 2016 to 2019 to 3.2 in 2020 (P = 0.002). CONCLUSIONS: Compared with the previous 4 years, the annual number of pediatric KD admissions decreased, and children discharged with diagnostic codes for KD in 2020 were generally older and more likely to have severe morbidity possibly reflective of misdiagnosed multisystem inflammatory syndrome in children. Clinicians should be wary of a possible rise in KD rates in the postcoronavirus disease 2019 era as social distancing policies are lifted and other viruses associated with KD return.

Communicating through Touch: Macro Fiber Composites for Tactile Stimulation on the Abdomen.

Research into sensory substitution systems has expanded, as alternative senses are utilized in real-time to afford object recognition or spatial understanding. Tactile stimulation has long shown promise as a communicatory strategy when applied unobtrusively to the redundant surface areas of the skin. Here, a novel belt, integrating a matrix of macro fiber composites, is purposed to deliver tactile stimuli to the abdomen. The design and development of the belt is presented and a systematic experimental study is conducted to analyze the impact of frequency and duty cycle. The belt is a beta precursor to a soft haptic feedback device that will enable situational awareness and obstacle avoidance through the localization of tactile stimulation relative to a body-centric frame of reference in a local environment.

Closed-loop control of zebrafish behaviour in three dimensions using a robotic stimulus.

Robotics is continuously being integrated in animal behaviour studies to create customizable, controllable, and repeatable stimuli. However, few systems have capitalized on recent breakthroughs in computer vision and real-time control to enable a two-way interaction between the animal and the robot. Here, we present a "closed-loop control" system to investigate the behaviour of zebrafish, a popular animal model in preclinical studies. The system allows for actuating a biologically-inspired 3D-printed replica in a 3D workspace, in response to the behaviour of a zebrafish. We demonstrate the role of closed-loop control in modulating the response of zebrafish, across a range of behavioural and information-theoretic measures. Our results suggest that closed-loop control could enhance the degree of biomimicry of the replica, by increasing the attraction of live subjects and their interaction with the stimulus. Interactive experiments hold promise to advance our understanding of zebrafish, offering new means for high throughput behavioural phenotyping.

Influence of robotic shoal size, configuration, and activity on zebrafish behavior in a free-swimming environment.

In animal studies, robots have been recently used as a valid tool for testing a wide spectrum of hypotheses. These robots often exploit visual or auditory cues to modulate animal behavior. The propensity of zebrafish, a model organism in biological studies, toward fish with similar color patterns and shape has been leveraged to design biologically inspired robots that successfully attract zebrafish in preference tests. With an aim of extending the application of such robots to field studies, here, we investigate the response of zebrafish to multiple robotic fish swimming at different speeds and in varying arrangements. A soft real-time multi-target tracking and control system remotely steers the robots in circular trajectories during the experimental trials. Our findings indicate a complex behavioral response of zebrafish to biologically inspired robots. More robots produce a significant change in salient measures of stress, with a fast robot swimming alone causing more freezing and erratic activity than two robots swimming slowly together. In addition, fish spend more time in the proximity of a robot when they swim far apart than when the robots swim close to each other. Increase in the number of robots also significantly alters the degree of alignment of fish motion with a robot. Results from this study are expected to advance our understanding of robot perception by live animals and aid in hypothesis-driven studies in unconstrained free-swimming environments.

Fish and robots swimming together in a water tunnel: robot color and tail-beat frequency influence fish behavior.

The possibility of integrating bioinspired robots in groups of live social animals may constitute a valuable tool to study the basis of social behavior and uncover the fundamental determinants of animal functions and dysfunctions. In this study, we investigate the interactions between individual golden shiners (Notemigonus crysoleucas) and robotic fish swimming together in a water tunnel at constant flow velocity. The robotic fish is designed to mimic its live counterpart in the aspect ratio, body shape, dimension, and locomotory pattern. Fish positional preference with respect to the robot is experimentally analyzed as the robot's color pattern and tail-beat frequency are varied. Behavioral observations are corroborated by particle image velocimetry studies aimed at investigating the flow structure behind the robotic fish. Experimental results show that the time spent by golden shiners in the vicinity of the bioinspired robotic fish is the highest when the robot mimics their natural color pattern and beats its tail at the same frequency. In these conditions, fish tend to swim at the same depth of the robotic fish, where the wake from the robotic fish is stronger and hydrodynamic return is most likely to be effective.