Signal Quality Analysis of Single-Arm Electrocardiography.

The number of people experiencing mental stress or emotional dysfunction has increased since the onset of the COVID-19 pandemic, as many individuals have had to adapt their daily lives. Numerous studies have demonstrated that mental health disorders can pose a risk for certain diseases, and they are also closely associated with the problem of mental workload. Now, wearable devices and mobile health applications are being utilized to monitor and assess individuals' mental health conditions on a daily basis using heart rate variability (HRV), typically measured by the R-to-R wave interval (RRI) of an electrocardiogram (ECG). However, portable or wearable ECG devices generally require two electrodes to perform bipolar limb leads, such as the Einthoven triangle. This study aims to develop a single-arm ECG measurement method, with lead I ECG serving as the gold standard. We conducted static and dynamic experiments to analyze the morphological performance and signal-to-noise ratio (SNR) of the single-arm ECG. Three morphological features were defined, RRI, the duration of the QRS complex wave, and the amplitude of the R wave. Thirty subjects participated in this study. The results indicated that RRI exhibited the highest cross-correlation (R = 0.9942) between the single-arm ECG and lead I ECG, while the duration of the QRS complex wave showed the weakest cross-correlation (R = 0.2201). The best SNR obtained was 26.1 ± 5.9 dB during the resting experiment, whereas the worst SNR was 12.5 ± 5.1 dB during the raising and lowering of the arm along the z-axis. This single-arm ECG measurement method offers easier operation compared to traditional ECG measurement techniques, making it applicable for HRV measurement and the detection of an irregular RRI.

Successful treatment of acute encephalitis and hepatitis in a child with COVID-19 infection.

We present the case of a 6-year-old Taiwanese boy with a fulminant course of COVID-19 manifesting as high fever, acute consciousness changes, and status epilepticus. Brain MRI showed restricted diffusion in the bilateral hemisphere. Electroencephalogram showed diffuse slow waves with few spikes. CSF study was clear without evidence of common pathogens. He received treatment with antiviral agents, corticosteroids, intravenous immunoglobulins, and anti-IL-6 monoclonal antibodies. However, progressive fulminant hepatitis, hyperammonaemia, and disseminated intravascular coagulopathy developed. Rescue therapy with hybrid continuous renal replacement therapy and plasma exchange were performed in the first 11 days. The patient improved and was extubated on the 11th day. After physical therapy, his neurological function improved significantly. The patient was discharged under rehabilitation after 1 month of hospitalization. Viral sequencing confirmed infection with the Omicron BA.2.3 variant, one of the dominant strains in Taiwan and Hong Kong. Whole-exome sequencing revealed heterozygous uncertain significance variants in TICAM-1, RNF 31, and mitochondrial MT-RNR1, which provide additional support for the fulminant course. To the best of our knowledge, this is the first reported case of COVID-19 in a child with a fulminant course of acute encephalitis and hepatitis who successfully recovered by hybrid continuous renal replacement therapy and plasma exchange.

Comparison of the PCB serum levels among mother-child pairs in areas of Eastern Japan and Central Taiwan.

Polychlorinated biphenyls (PCBs) have been prohibited for two decades in Japan and Taiwan. The aim of this study was to compare the PCB congeners in maternal and cord serum between two countries. Our study subjects were 248 and 100 mother-child pairs in Japan and Taiwan. The measured levels of 23 serum PCB congeners between two countries were analyzed using gas chromatography-electron capture negative ionization quadrupole mass spectrometry (GC-NICI-qMS). The statistical comparisons were conducted by Student's t-test and principal component analysis with further stratification by maternal age and parity. The maternal total PCBs levels in Japan (426 ± 244 pg/g wet wt) were significantly higher than those in Taiwan (254 ± 155 pg/g wet wt), and the similar results were found in cord total PCBs levels (97 ± 76 and 58 ± 87 pg/g wet wt). It showed different distributions of PCB congeners between two countries. Whether in maternal or cord serum, the CB138, CB153 and CB180 were the highest detectable congeners whether in Japan or Taiwan. And, the CB66, CB99, CB206 and CB209 were only detected in maternal serum of Taiwan. The women of advanced maternal age had higher levels of PCB congeners, especially in Taiwan, and the primiparous women had higher levels of PCB congeners in two countries. In summary, the PCB congeners in Japan's mother-child pairs were with higher levels and different distributions when compared to those in Taiwan, and the maternal age and parity were important factors associated with the PCB levels.

New Inverse Emulsion-Polymerized Iron/Polyaniline Composites for Permanent, Highly Magnetic Iron Compounds via Calcination.

The hydrophilic initiator potassium persulfate (KPS) was converted into a hydrophobic molecule by complexing with cetyltrimethylammonium bromide (CTAB) at both ends of the molecule (CTAPSu). Inverse emulsion polymerization thus proceeded inside micelles dispersed in the affluent toluene with CTAPSu as the initiator. Polyaniline (PANI) formed inside the micelles and entangled with Fe3O4 nanoparticles already esterified with oleic acid (OA). Iron composites consisted of OA-esterified Fe3O4 nanoparticles covered with PANI after de-emulsification. After calcination at 950 °C in an argon atmosphere, the resultant iron compound was a mixture of α-Fe (ferrite) and Fe3C (cementite), as determined by X-ray diffraction. Eventually, the calcined iron compounds (mixtures) demonstrated superparamagnetic properties with a high saturation magnetization (Ms) of 197 emu/g, which decayed to 160 emu/g after exposure to the atmosphere for four months.

Acute Necrotizing Encephalopathy in a Four-Year-Old Boy.

Acute necrotizing encephalopathy is a devastating clinico-radiological syndrome characterized by fulminant neurological deterioration after an antecedent febrile illness, as well as the imaging hallmark of bilateral thalamic involvement. Herein, we describe a 4-year-old boy with typical clinical and neuroimaging features of acute necrotizing encephalopathy. The bithalamic swelling led to a block of cerebrospinal fluid circulation at the foramen of Monro, thereby causing the mild dilatation of lateral ventricles. The periventricular areas could, therefore, have been potentially affected by the acute necrotizing encephalopathy per se and/or transependymal edema secondary to obstructive hydrocephalus. The information from diffusion imaging allows for differentiation between these two pathophysiological processes.

Detection of respiratory viruses in adults with respiratory tract infection using a multiplex PCR assay at a tertiary center.

BACKGROUND: Respiratory viruses (RVs) are among the most common pathogens for both upper and lower respiratory tract infections (RTIs). However, the viral epidemiology of RV-associated RTIs in adults has long been under-recognized. Through a sensitive molecular assay, it would be possible to have a better understanding of the epidemiology of RV-associated RTIs. MATERIAL AND METHODS: Respiratory tract (RT) specimens from adults hospitalized due to RTIs were tested for RVs, using the multiplex PCR-based Luminex xTAG® Respiratory Viral Panel assay. A total of nineteen RVs, including influenza viruses and non-influenza respiratory viruses (NIRVs) were detected. Positive rates were compared using a chi-square test. RESULTS: A total of 2292 samples from adult patients hospitalized with RTIs were screened for RVs. The overall positive rate was 22%, with 17.8% samples positive for at least one NIRV. NIRVs had a higher positive rate in non-winter seasons. As many as 12.7% (46/363) of the samples collected through broncho-alveolar lavage and 20.5% (176/859) of the samples collected in ICUs were positive for RVs. Distribution of corona virus (CoV), human metapneumovirus (hMPV) and parainfluenza virus (PIV) demonstrated seasonal variation. Also, temperature was associated with the positive rates of specific viruses, including CoV, respiratory syncytial virus (RSV), hMPV and PIV. CONCLUSION: Respiratory viruses, notably NIRVs, were frequently detected in adults hospitalized with RTIs. Several RVs were detected with distinctive seasonal variations. A substantial number of RVs were identified in lower RT specimens or from patients admitted to ICU, highlighting their important role in causing severe respiratory infection.

Emission-related Heavy Metal Associated with Oxidative Stress in Children: Effect of Antioxidant Intake.

Heavy metals, the common pollutants emitted from industrial activities, are believed to cause harmful effects, partially through the mechanism of elevated oxidative stress, and antioxidant intake has been hypothesized to provide a potential protective effect against oxidative stress. This study aims to investigate the heavy metal exposure and the associated oxidative damage of young children living near a petrochemical complex and to assess the protective effect of antioxidant intake. There were 168 children recruited from the kindergartens near a huge petrochemical complex, with 87 as the high exposure group and 81 as the low exposure group. Urinary concentrations of eleven metals were detected by inductively coupled plasma mass spectrometry, and four biomarkers of oxidative stress were measured in urine by liquid chromatography-tandem mass spectrometry. The food frequency questionnaire was collected to assess participants' intake of antioxidants. Multiple linear regression was performed to determine the predictors of metals for oxidative stress and to measure the beneficial effect of antioxidants. Weighted quantile sum regression was performed to determine the contributors among metals to the oxidative stress. Results showed that high exposure group had significantly higher concentrations of chromium, manganese, nickel, arsenic, strontium, cadmium, and lead when compared to those in low exposure group. There was no obviously difference on the total antioxidant intake and dietary profile between two groups. The elevated levels of two oxidative stress markers were significantly associated with most of the urinary metal concentrations in all study subjects after adjusting confounders, while no significant association was found between oxidative stress and antioxidant intake. Among the metals, mercury and strontium showed the dominated contributions for elevated levels of oxidative stress. It concluded that higher metal exposure was associated with elevated oxidative stress but with no protective effect by antioxidant intake among the young children residents near a petrochemical industry.

Melting and Recrystallization of Copper Nanoparticles Prepared by Microwave-Assisted Reduction in the Presence of Triethylenetetramine.

The small sized copper nanoparticles (Cu-NPs), prepared in the presence of triethylene tetramine (TETA) and assisted with microwave irradiation, have an extremely low melting temperature. Melting of the small sizezd Cu-NPs can be triggered by the heat generated from the e-beam irradiation during SEM and TEM image construction. The dispersed Cu atoms around the agglomerated big Cu particles can undergo recrystallization immediately due to the strong driving force of the huge temperature difference to normal melting temperature (Tm = 1085 °C). Some of the Cu-NPs with bigger sizes also recrystallize and agglomerate into dense, big particles. According to X-ray diffraction patterns, these particles can agglomerate into compact, ordered Cu crystals in less than five minutes at 60 °C. The melting and recrystallization related endothermic and exothermic phase transitions of Cu-NPs can be found from differential scanning calorimeter (DSC) thermograms and optical microscopic pictures.

Clinical predictors and outcome impact of community-onset polymicrobial bloodstream infection.

OBJECTIVES: Very few studies have characterised community-onset polymicrobial bloodstream infections (BSIs). This study determined the incidence, risk factors, and outcomes of polymicrobial BSI as compared with monomicrobial BSI in a cohort of patients with community-onset BSIs. METHODS: This prospective cohort study enrolled consecutive patients with laboratory confirmed BSIs who were admitted to two tertiary emergency departments in Taiwan between 1 January 2015 and 31 December 2016. It assessed the independent impact of polymicrobial BSIs on survival by a propensity score weighting method. Subsequently, independent clinical predictors were identified with multivariate logistic regression model analysis with internal validation by 10-fold cross validation. RESULTS: Among 1166 patients with community-onset BSI, 133 (10.9%) episodes of polymicrobial BSIs occurred. Anaerobe, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus spp., and Candida spp. were the most common isolated microorganisms in polymicrobial BSI. Polymicrobial BSIs were associated with an increased 90-day mortality rate (OR 2.20, 95% CI 1.98-2.60). A prediction model was built to predict polymicrobial BSI with moderate predictability (c statistic = 0.78). Significant predictors included biliary tract infection, nosocomial infection, nursing home residence, stroke, and afebrile presentation. CONCLUSIONS: Polymicrobial BSI occurred in approximately 1 in 10 episodes of community-onset BSI and was independently associated with excess mortality. Clinical predictors identified in this study may help guide the prescription of empiric broad-spectrum antibiotics.

Two-Stage Plasma-Thermal Nitridation Processes for the Production of Aluminum Nitride Powders from Aluminum Powders.

The synthesis of aluminum nitride (AlN) powders is traditionally done via the thermal nitridation process, in which the reaction temperature reaches as high as 960 °C, with more than several hours of reaction time. Moreover, the occurrence of agglomeration in melting Al particles results in poor AlN quality and a low efficiency of nitridation. In this study, an atmosphere-pressure microwave-plasma preceded the pre-synthesis process. This process operates at 550 °C for 2⁻10 min with the addition of NH4Cl (Al: NH4Cl = 1:1) for generating a hard AlN shell to avoid the flow and aggregation of the melting Al metals. Then, the mass production of AlN powders by the thermal nitridation process can be carried out by rapidly elevating the reaction temperature (heating rate of 15 °C/min) until 1050 °C is reached. X-Ray Diffractometer (XRD) crystal analysis shows that without the peak, Al metals can be observed by synthesizing AlN via plasma nitridation (at 550 °C for 2 min, Al: NH4Cl = 1:1), followed by thermal nitridation (at 950 °C for 1 h). Moreover, SEM images show that well-dispersed AlN powders without agglomeration were produced. Additionally, the particle size of the produced AlN powder (usually < 1 µm) tends to be reduced from 2⁻5 µm (Al powders), resulting in a more efficient synthesizing process (lower reaction temperature, shorter reaction time) for mass production.

Synergistic effect of PANI-ZrO2 composite as antibacterial, anti-corrosion, and phosphate adsorbent material: synthesis, characterization and applications.

The increasing number of bacteria-related problems and presence of trace amounts of phosphate in treated wastewater effluents have become a growing concern in environmental research. The use of antibacterial agents and phosphate adsorbents for the treatment of wastewater effluents is of great importance. In this study, the potential applications of a synthesized polyaniline (PANI)-zirconium dioxide (ZrO2) composite as an antibacterial, phosphate adsorbent and anti-corrosion material were systematically investigated. The results of an antibacterial test reveal an effective area of inhibition of 14 and 18 mm for the Escherichia coli and Staphylococcus aureus bacterial strains, respectively. The antibacterial efficiency of the PANI-ZrO2 composite is twice that of commercial ZrO2. In particular, the introduction of PANI increased the specific surface area and roughness of the composite material, which was beneficial to increase the contact area with bacterial and phosphate. The experimental results demonstrated that phosphate adsorption studies using 200 mg P/L phosphate solution showed a significant phosphate removal efficiency of 64.4%, and the maximum adsorption capacity of phosphate on the solid surface of PANI-ZrO2 is 32.4 mg P/g. Furthermore, PANI-ZrO2 coated on iron substrate was tested for anti-corrosion studies by a natural salt spray test (7.5% NaCl), which resulted in the formation of no rust. To the best of our knowledge, no works have been reported on the synergistic effects of the PANI-ZrO2 composite as an antibacterial, anti-corrosion, and phosphate adsorbent material. PANI-ZrO2 composite is expected to be a promising comprehensive treatment method for water filters in the aquaculture industry and for use in water purification applications.

Green Fabrication of Supported Platinum Nanoparticles by Supercritical CO2 Deposition.

Pt nanoparticles were successfully deposited on uncatalyzed carbon paper by the supercritical CO2 deposition (SCD) method using platinum (II) acetylacetonate as a precursor followed by thermal conversion. A full 24 factorial design (four factors, each with two levels) was used to investigate the main effect of four factors (deposition temperature, deposition time, reduction temperature, and reduction time) and the interaction effects between them. The morphological structures and surface properties of the Pt/carbon paper composite were analyzed by X-ray diffraction (XRD), scanning electron microscope (SEM)/energy-dispersive X-ray spectroscopy analyzer (EDS), and high-resolution transmission electron microscopy (HR-TEM). The results of the 24 factorial design showed that Pt loading on the substrate correlated significantly with deposition time, while Pt aggregation slightly increased with the thermal reduction temperature. Data obtained from both XRD and HR-TEM were in good agreement and showed that Pt nanoparticles were homogeneously dispersed on the substrate with diameters of 7.2⁻8.7 nm.

Preparation of sub 3 nm copper nanoparticles by microwave irradiation in the presence of triethylene tetramin.

The preparation of sub 3 nm copper nanoparticles (CuNPs) in ethylene glycol (EG) using triethylene tetramine (TETA) as chelating and reducing agents via a rapid microwave (MW) irradiation is reported. The sub 3 nm CuNPs after MW irradiation are clearly seen from the electronic micrographs. The firm chelation of Cu2+ by TETA is illustrated by the dark blue color of Cu2+/TETA/EG solution and the redox reaction is confirmed by the appearance of red color of the mixtures. The optimal mole ratio of TETA/Cu 2+ is found to be 2.5/1 for preparing sub 3 nm CuNPs under the MW irradiation, operated at 800 W for 1 min. The plasmonic absorption λ max demonstrated in UV-vis spectra are found to close to 200 nm for sub 3 nm CuNPs, comparing to 500 âˆ¼ 600 nm for regular, larger CuNPs. The extremely low Tm around 30 °C and the fusion/recrystallization sequence of sub 3 nm CuNPs can be directly measured by their differential scanning calorimetry thermograms.

Characterization of the products attained from a thermal treatment of a mix of zinc-carbon and alkaline batteries.

This study applies a thermal separation process (TSP) to recover Fe, Mn, and Zn from hazardous spent zinc-carbon and alkaline batteries. In the TSP, the batteries were heated together with a reducing additive and the metals in batteries, according to their boiling points and densities, were found to move into three major output materials: slag, ingot (mainly Fe and Mn), and particulate (particularly Zn). The slag well encapsulated the heavy metals of interest and can be recycled for road pavement or building materials. The ingot had high levels of Fe (522,000 mg/kg) and Mn (253,000 mg/kg) and can serve as an additive for stainless steel-making processes. The particulate phase had a Zn level of 694,000 mg/kg which is high enough to be directly sold for refinement. Overall, the TSP effectively recovered valuable metals from the hazardous batteries.

Assessment of urinary thiodiglycolic acid exposure in school-aged children in the vicinity of a petrochemical complex in central Taiwan.

BACKGROUND: School-aged children living in the vicinity of vinyl chloride (VCM)/polyvinyl chloride (PVC) factories may have an increased risk of exposure to hazardous air pollutants. OBJECTIVES: We aimed to evaluate the urinary thiodiglycolic acid (TDGA) level, as TDGA is a major metabolite of VCM, for students at elementary schools near a petrochemical complex in central Taiwan. METHODS: We recruited 343 students from 5 elementary schools based on distance to the VCM/PVC factory. First-morning urine and blood samples were obtained from our subjects from October 2013 to September 2014. Urine samples were analyzed for urinary creatinine and TDGA using LC/MS-MS. Hepatitis virus infection were assessed using blood samples. We determined their vitamin consumption, resident location, parent's employment, and other demographic or lifestyle characteristics using a questionnaire. RESULTS: Median urinary TDGA levels for 316 students at 5 elementary schools from the closest (<.9km) to the farthest (∼8.6km) with respect to the petrochemical complex were 147.6, 95.5, 115.5, 86.8, and 17.3µg/g creatinine, respectively. After adjusting for age, gender, hepatitis virus infection, vitamin B consumption, passive smoking, and home to source distance, we found that urinary TDGA levels for the closest students was significantly higher than those at other schools. Further, median urinary TDGA levels for students during school time were 4.1-fold higher than those during summer vacation. CONCLUSIONS: After adjusting for confounders, urinary TDGA levels for the school-aged children decreased with increasing distances between the elementary schools and the petrochemical complex.

Size distribution of airborne fungi in vehicles under various driving conditions.

Circulation or air conditioning (AC) system was proven to improve the air quality inside the vehicles; however, the quantified study was limited. In this study, fungal concentration under various driving mode inside the vehicle was proposed. The driving conditions were classified into 4 states: (1) window closed without AC and circulation, (2) window open without AC and circulation, (3) window closed with only circulation on, and (4) window closed with only AC on. Results show that at state 4, the mean respirable fraction was 83.3%, with a number median diameter of the fungi being 1.73 µm. More attention should be paid for these smaller fungi easily penetrating into the alveoli and probably lead to allergic alveolitis. Turning on AC for reducing the normalized concentration for each size range of fungi was suggested; however, the respirable fraction increased. Those who are prone to allergies or asthma are suggested to switch between AC and the circulation mode while driving a long time.

α2ß1 integrin and RhoA mediates electric field-induced ligament fibroblast migration directionality.

Guided cell migration is important in tissue development, repair, and engineering. We have previously demonstrated that applied electric fields (EFs) enhanced and directed ligament fibroblast migration and collagen production, depending on EF parameters. Electrical stimulation is widely used for the treatment of pain and to promote wound healing. In orthopaedic practices, applied EFs promote bone healing and ligament repair in vivo. In the current study, stimulation waveforms used in physical therapy for promoting tissue repair were adapted to examine their effects on ACL fibroblast migration. Using different waveform and field strengths, we discovered a decoupling of cell motility and directionality, which suggests disparate mechanisms. Integrin, a major extracellular matrix receptor, polarized in response to applied EFs and controlled cell directionality and signaling. Furthermore, we demonstrated that RhoA is a mediator between integrin aggregation and directed cell migration. Polarization is essential in directed cell migration and our study establishes an outside-in signaling mechanism for EF-induced cell directionality.

AFM membrane roughness as a probe to identify oxidative stress-induced cellular apoptosis.

The morphological change of cellular apoptosis initiates from the change of membrane roughness. In order to identify cellular apoptosis in its early stage, atomic force microscope was adapted to reveal the change of membrane roughness in unprecedented details, providing an image in nanometer-scaled resolution. The mouse monocyte/macrophage cell line RAW 264.7 was the subject studied and subjected to apoptotic induction by hydrogen peroxide. A finding of the qualitative correlation between cell membrane roughness and oxidative stress level is disclosed stating that roughness is increasing with the increasing level of oxidative stress.

Seroprevalence of antibodies to pandemic (H1N1) 2009 influenza virus among hospital staff in a medical center in Taiwan.

BACKGROUND: The pandemic (H1N1) 2009 influenza emerged in April 2009 and spread rapidly and broadly all over the world. In addition to specific antiviral agents, massive vaccination is thought to be the most effective way of controlling the transmission. To understand the prevaccination status of certain risk groups, this study compared the baseline sero-prevalence of antibodies to the pandemic (H1N1) 2009 influenza virus among hospital staff with different contact risks and that of the general population. METHODS: A total of 295 serum samples from hospital staff and 244 control serum samples from people who came for physical check-up (control group) were collected between October 2009 and November 2009 before the massive vaccination campaign. The hospital staff was divided into first-line risk personnel (group 1) and second-line risk personnel (group 2) according to their potential contact risks. Hemagglutination-inhibition (HI) tests were conducted to determine the individual serological status. The seropositive rate (SPR, defined as the proportion with HI titer >/= 1:40) of antibodies to H1N1 influenza virus and its geometric mean titer (GMT) were calculated and compared among the different groups. RESULTS: The mean ages and sex ratio (% male) of the hospital staff and control groups were 36.9 +/- 10.6 years and 52.0 +/- 12.6 years, and 24.4% and 57.6%, respectively. The SPR of the antibodies to H1N1 influenza virus of the hospital staff was significantly higher than that of the control group (20.0%vs. 2.9%, p < 0.001). Furthermore, the SPR antibodies to H1N1 influenza virus of group 1 were significantly higher than that of group 2 (30.8%vs. 12.6%, p < 0.001). However, the GMT of antibodies to H1N1 influenza virus of the hospital staff was not significantly different from that of the control group (p = 0.925). CONCLUSION: The SPR of antibodies against the pandemic (H1N1) 2009 virus in the hospital staff was higher than that in the general population, reflecting a higher contact risk. Prevaccination surveillance of the immune status of different risk groups may help to prioritize which groups should be vaccinated first.