Tough, Antifreezing, and Piezoelectric Organohydrogel as a Flexible Wearable Sensor for Human-Machine Interaction.

Piezoelectric hydrogel sensors are becoming increasingly popular for wearable sensing applications due to their high sensitivity, self-powered performance, and simple preparation process. However, conventional piezoelectric hydrogels lack antifreezing properties and are thus confronted with the liability of rupture in low temperatures owing to the use of water as the dispersion medium. Herein, a kind of piezoelectric organohydrogel that integrates piezoelectricity, low-temperature tolerance, mechanical robustness, and stable electrical performance is reported by using poly(vinylidene fluoride) (PVDF), acrylonitrile (AN), acrylamide (AAm), p-styrenesulfonate (NaSS), glycerol, and zinc chloride. In detail, the dipolar interaction of the PVDF chain with the PAN chain facilitates the crystal phase transition of PVDF from the α to ß phase, which endows the organohydrogels with a high piezoelectric constant d33 of 35 pC/N. In addition, the organohydrogels are highly ductile and can withstand significant tensile and compressive forces through the synergy of the dipolar interaction and amide hydrogen bonding. Besides, by incorporating glycerol and zinc chloride, the growth of ice crystals is inhibited, allowing the organohydrogels to maintain stable flexibility and sensitivity even at -20 °C. The real-time monitoring of the pulse signal for up to 2 min indicates that the gel sensor has stable sensitivity. It is believed that our organohydrogels will have good prospects in future wearable electronics.

Soft, Super-Elastic, All-Polymer Piezoelectric Elastomer for Artificial Electronic Skin.

Piezoelectric sensors are widely used in wearable devices to mimic the functions of human skin. However, it is considerably challenging to develop soft piezoelectric materials that can exhibit high sensitivity, stretchability, super elasticity, and suitable modulus. In this study, a soft skin-like piezoelectric polymer elastomer composed of poly(vinylidene fluoride) (PVDF) and a novel elastic substrate polyacrylonitrile is prepared by combining the radical polymerization and freeze-drying processes. Dipole-dipole interaction results in the phase transition of PVDF (α phase to ß phase), which enhances the electrical and mechanical performances. Thus, we achieve a high piezoelectric coefficient (d33max = 63 pC/N), good stretchability (211.3-259.3%), super compressibility (subjected to 99% compression strain without cracking), and super elasticity (100% recovery after extreme compression) simultaneously for the elastomer. The soft composite elastomer produces excellent electrical signal output (Vocmax = 253 mV) and responds rapidly (15 ms) to stress-induced polarization effects. In addition, the elastomer-based sensor accurately detects various physiological signals such as gestures, throat vibrations, and pulse waves. The developed elastomers exhibit excellent mechanical properties and high sensitivity, which helps facilitate their application as artificial electronic skin to sense subtle external pressure in real time.

Environmental Determinants for Snail Density in Dongting Lake Region: An Ecological Study Incorporating Spatial Regression.

This study explored the environmental determinants of different months on snail density measured in April at different types of snail habitats (marshlands, inner embankments, and hills) by considering spatial effects. Data were gathered from surveys on snails that were conducted in Hunan Province in April 2016, and information was collected on environmental variables. To investigate the environmental factors influencing snail density in various types of snail habitats, the ordinary least square model, spatial lag model, and spatial error model were all used. The environmental determinants for snail density showed different effects in the three types of snail habitats. In marshlands, snail density measured in April was associated positively with the normalized difference vegetation index (NDVI) and was associated negatively with flooding duration and annual hours of sunshine. Extreme temperatures correlated strongly to snail density measured in April (P < 0.05). In areas inside embankments, snail density measured in April increased with a decreased distance between snail habitat and the nearest river (P < 0.05). In hills, extreme heat, annual hours of sunshine, NDVI in September, and annual average land surface temperature (LST) were associated negatively with snail density measured in April, whereas index of moisture (IM) was associated positively with snail density measured in April (P < 0.05). The effects of LST and hours of sunshine on snail density measured in April varied with months of the year in the three different types of snail habitats (P < 0.05). Our study might provide a theoretical foundation for preventing snail transmission and subsequent spread of schistosomiasis.

A case of severe hookworm infection. / 临床极重症钩虫感染1例.

With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.

Machine learning algorithms to predict the 1 year unfavourable prognosis for advanced schistosomiasis.

Short-term prognosis of advanced schistosomiasis has not been well studied. We aimed to construct prognostic models using machine learning algorithms and to identify the most important predictors by utilising routinely available data under the government medical assistance programme. An established database of advanced schistosomiasis in Hunan, China was utilised for analysis. A total of 9541 patients for the period from January 2008 to December 2018 were enrolled in this study. Candidate predictors were selected from demographics, clinical features, medical examinations and test results. We applied five machine learning algorithms to construct 1 year prognostic models: logistic regression (LR), decision tree (DT), random forest (RF), artificial neural network (ANN) and extreme gradient boosting (XGBoost). An area under the receiver operating characteristic curve (AUC) was used to evaluate the model performance. The important predictors of the optimal model for unfavourable prognosis within 1 year were identified and ranked. There were 1249 (13.1%) cases having unfavourable prognoses within 1 year of discharge. The mean age of all participants was 61.94 years, of whom 70.9% were male. In general, XGBoost showed the best predictive performance with the highest AUC (0.846; 95% confidence interval (CI): 0.821, 0.871), compared with LR (0.798; 95% CI: 0.770, 0.827), DT (0.766; 95% CI: 0.733, 0.800), RF (0.823; 95% CI: 0.796, 0.851), and ANN (0.806; 95% CI: 0.778, 0.835). Five most important predictors identified by XGBoost were ascitic fluid volume, haemoglobin (HB), total bilirubin (TB), albumin (ALB), and platelets (PT). We proposed XGBoost as the best algorithm for the evaluation of a 1 year prognosis of advanced schistosomiasis. It is considered to be a simple and useful tool for the short-term prediction of an unfavourable prognosis for advanced schistosomiasis in clinical settings.

Prevalence and incidence of advanced schistosomiasis and risk factors for case fatality in Hunan Province, China.

Advanced schistosomiasis has become a major public health problem in areas with a heavy burden of schistosomiasis infection. Our objective was to determine the incidence and prevalence of advanced schistosomiasis and risk factors associated with case fatality of advanced schistosomiasis. Data were abstracted from hospitalization records of patients with advanced schistosomiasis from Hunan Province, China. The incidence and prevalence of advanced schistosomiasis were determined and the risk factors for death in advanced patients were assessed using logistic regression analysis. A total of 10,362 patients with advanced schistosomiasis were recruited into our study and 65% of them were categorized as the ascites type. There were 1249 deaths between 2005 and 2018 and the case fatality was 12.05%. The incidence of advanced schistosomiasis increased from 2002 to 2010, peaked in 2010 and then leveled off. The prevalence of advanced schistosomiasis increased from 2005 to 2014, and was stable afterwards. HBV was a risk factor for death in advanced patients (adjusted odds ratio (aOR=1.93, 95% confidence interval (CI: 1.55 to 2.41). Patients without splenectomy had a higher risk of death (aOR=1.29, 95%CI: 1.08 to 1.56). Upper gastrointestinal bleeding was positively associated with the risk of death (aOR=1.42, 95% CI: 1.15 to 1.76). Besides, abnormal ALT, ascites and anemia were also significantly associated with the risk of death in advanced patients. Advanced schistosomiasis was effectively controlled in recent years. Splenectomy could reduce the case fatality of advanced patients. HBV infection, abnormal ALT, upper gastrointestinal bleeding and anemia also predicted the risk of death for advanced patients.

Spatio-temporal variations of emerging sites infested with schistosome-transmitting Oncomelania hupensis in Hunan Province, China, 1949-2016.

BACKGROUND: Constant emerging sites infested with Oncomelania hupensis (O. hupensis) impede the goal realization of eliminating schistosomiasis. The study assessed the spatial and temporal distributions of new Oncomelania snail habitats in Hunan Province from 1949 to 2016. METHODS: We used the data from annual snail surveys throughout Hunan Province for the period from 1949 to 2016. Global Moran's I, Anselin local Moran's I statistics (LISA) and a retrospective space-time permutation model were applied to determine the spatial and temporal distributions of emerging snail-infested sites. RESULTS: There were newly discovered snail-infested sites almost every year in 1949-2016, except for the years of 1993, 2009 and 2012. The number of emerging sites varied significantly in the five time periods (1949-1954, 1955-1976, 1977-1986, 1986-2003 and 2004-2016) (H = 25.35, p < 0.05). The emerging sites lasted 37.52 years in marshlands, 30.04 years in hills and 24.63 at inner embankments on average, with the values of Global Moran's I being 0.52, 0.49 and 0.44, respectively. High-value spatial clusters (HH) were mainly concentrated along the Lishui River and in Xiangyin County. There were four marshland clusters, two hill clusters and three inner embankment clusters after 1976. CONCLUSIONS: Lower reaches of the Lishui River and the Dongting Lake estuary were the high-risk regions for new Oncomelania snail habitats with long durations. Snail surveillance should be strengthened at stubborn snail-infested sites at the inner embankments. Grazing prohibition in snail-infested grasslands should be a focus in marshlands. The management of bovines in Xiangyin County is of great importance.

[Diagnosis and treatment of schistosomiasis japonica-concensuses among ex- perts in Hunan, Hubei and Jiangxi provinces].

In order to further standardize the diagnosis and treatment of schistosomiasis japonica in China, on the basis of evidence-based medicine, the experts on schistosomiasis control from Hunan, Hubei and Jiangxi provinces summarized their consensuses on the disease after the discussion on the current situation and progress of clinical diagnosis and treatment of schistosomiasis in China, with the reference to the Diagnostic Criteria for Schistosomiasis (WS261-2006), which aimed to establish the therapeutic standards or guideline of schistosomiasis in China.

[Multi-disciplinary treatment for advanced schistosomiasis].

OBJECTIVE: To assess the efficiency of multi-disciplinary treatment (MDT) for advanced schistosomiasis. METHODS: A total of 173 advanced schistosomiasis patients who received MDT were selected from January 2010 to December 2011. These patients included 75 splenomegaly cases and 98 ascites cases. Other 193 advanced schistosomiasis patients who received single-discipline treatment (SDT) from January 2007 to December 2009 were also selected, and of them 84 cases were splenomegaly and 109 were ascites. The clinical efficiencies of the two different treatments were analyzed and assessed. RESULTS: Compared to the SDT group, the splenomegaly cases treated by MDT showed a shorter pre-operative preparation time and less days in hospitalization (both P < 0.01), less operation duration, decreased post-operative complications, lower hospitalization costs (all P < 0.05), and less patient complaints (P > 0.05). The ascites cases treated by MDT, compared to the SDT group, had less pre-treatment time, shorter ascites-disappearing time (both P <0.01), and less hospitalization duration, decreased post-treatment complications, lower hospitalization costs and less patient complaints (all P < 0.05). Conclusion MDT has a better efficiency in the treatment of advanced schistosomiasis, and it reduces the operation complications and improves the life quality of the patients.

[Splenectomy and esophagogastric devascularization for advanced schistosomiasis with cavernous transformation of portal vein].

OBJECTIVE: To explore a surgical treatment of advanced schistosomiasis with cavernous transformation of the portal vein. METHOD: The clinical data of 18 patients who suffered from advanced schistosomiasis with cavernous transformation of the portal vein were collected and analyzed retrospectively in the Affiliated Xiangyue Hospital of Hunan Institute of Parasitic Diseases. RESULTS: Two cases were undertaken the endoscopic variceal ligation, and the upper gastrointestinal bleeding happened 32 months and 40 months after the treatment respectively, and they received the splenectomy and esophagogastric devascularization again; 16 cases were undertaken the splenectomy and esophagogastric devascularization. During the follow-up of 6-72 months, no esophageal and gastric varices were found. CONCLUSION: Splenectomy and esophagogastric devascularization is effective in the treatment of advanced schistosomiasis with cavernous transformation of the portal vein.

[Recommendation of a new clinical classification of advanced schistosomiasis].

OBJECTIVE: To recommend a new clinical classification of advanced schistosomiasis for improving the diagnosis and evaluation of therapeutic effect of advanced schistosomiasis. METHODS: The medical records of 11 092 cases of advanced schistosomiasis from the Xiang-Yue Hospital from January 1990 to January 2010 and the medical aid centre for advance schistosomiasis in Hunan Province from January 2004 to January 2010 were collected and classified with the current and new clinical classification methods and the results were statistically analyzed and compared. RESULTS: Based on the current classification method, there were huge splenomegaly (5 710 cases), ascites (2 993 cases), colon proliferative (834 cases), and dwarf (54 cases). However, 1 501 cases were excluded from the current classification. Based on the new classification method, there were 8 types: huge splenomegaly (2 870 cases), ascites (1 885 cases), colon proliferative (425 cases), dwarf (38 cases), universal (1 281 cases), bleeding (1 857 cases), hepatic coma (553 cases), and miscellaneous (1 759 cases). Totally 424 cases were classified into chronic schistosomiasis. CONCLUSION: The new classification method can present a more comprehensive picture for clinical features, severe complications and prognosis of advanced schistosomiasis, and is useful for the diagnosis and treatment of advanced schistosomiasis.

[Discussion on clinical pathways of schistosomiasis].

According to the long-term clinical experience on schistosomiasis control of Hunan Institute of Schistosomiasis and the latest clinical guidelines, this paper makes a discussion on the clinical pathways of 3 types of schistosomiasis, and establishes the pathway management including diagnosis, therapy, hospital stays, and treatment after discharge, nursing, recovery, follow-up and so on, aiming to formulate a standardized flow or a pathway for schistosomiasis treating.