Pre-placement of adhesive tape around wound sites can prevent air leakage in negative pressure wound therapy procedures

The introduction of negative pressure wound therapy has revolutionized the management of complicated wounds.However,the maintenance of an effective negative pressure environment is difficult in some instances,such as wounds in close proximity to an intestinal stoma or wounds surrounded by external fixations.We found that adhesive tape adheres more easily to itself than to wet skin or uneven surfaces.Therefore,we placed adhesive tape around surgical wounds prior to covering them with foam and sealing them with more tape.As a result of the strong adhesive force between pieces of tape,this method could provide a better environmental seal,even in situations where space is limited.Pre-placed adhesive tape around the wound site prior to foam placement could provide sufficient adhesion to maintain a continuous negative pressure environment during treatment.

Transposition Flaps for Reconstruction of Perianal Skin Defects After Tumor Resection

Objective To investigate the application of transposition flaps in the reconstruction of perianal skin defects after tumor resection.Methods From September 2018 to December 2019,16 cases of perianal skin defects were repaired with unilateral or bilateral transposition flaps.The wound size before closure ranged from 4 cm×8 cm to 7 cm×10 cm.Fourteen patients achieved primary healing.Wound dehiscence occurred in one patient at the flap tip,whereas a slight infection occurred in another patient,which healed after a dressing change.During the follow-up period of 3–6 months,all patients were satisfied with the perianal area both aesthetically and functionally.Conclusion Transposition flaps are a promising option for the repair of perianal skin defects after tumor removal.Owing to the simplicity of the flap design,the wide popularity of this flap type among surgeons is anticipated.

Expert perspective on technological choice for cooking energy transition in Nepal

Solid biomass dominates as the primary source of cooking energy,especially in rural households of Nepal.The use of solid biomass has a detrimental effect on health,exacerbates the burden of biomass collection,and hampers access to clean energy.Understanding the factors influencing the choice of modern cooking fuels is crucial to improving energy security and resilience and easing the transition to clean fuels.This study evaluates technological choices for the transition in cooking energy from the perspective of experts working in the government,non-government,and academia sectors.A structured questionnaire survey was prepared with five criteria and nine cooking technology options.Fifty-one experts responded to the survey,and their responses were analyzed using the analytical hierarchy process.The study reveals that efficiency and capital cost are the primary criteria for selecting cooking technology.The most suitable clean cooking technology is an induction stove followed by a hot plate,while the least preferred technology is a Bayupankhi stove followed by two-pothole mud improved cooking stoves.To ensure the robustness of the method,sensitivity analysis was performed on the two primary criteria efficiency and capital cost of the cooking technology.The analysis revealed robust and consistent rankings of technologies.This study should help create a conducive environment for relevant stakeholders and policymakers to formulate and implement relevant policies and strategies to accelerate the cooking energy transition in Nepal.

Field assessment of straw pellet combustion in improved heating stoves in rural Northeast China

Straw pellets are widely promoted and expected to be a cleaner alternative fuel to unprocessed crop residues and rawcoal in rural China.However,the effectiveness of these dissemination programs is not well evaluated.In this field study,emission characteristics of burning strawpellets,rawcoal,and unprocessed corn cobs in heating stoveswere investigated in a pilot village in Northeast China.Emission measurements covering the whole combustion cycle(ignition,flaming,and smoldering phases)shows the promotion of improved heating stoves and straw pellets could reduce pollutant emissions(e.g.,SO_(2) and CO),but increase NO_(X) and PM_(2.5) emissions compared to the initial stove-fuel use pattern in the studied area.There is a significant variance in emission characteristics between different combustion phases.The normalized emission concentrations of the different stove-fuel combinations were higher than the limits in the Chinese national standard for heating stoves,indicating that the standard is not met for real-world emissions.Coal consumption was lower than official data.Household surveys were conducted to identify the barriers to fuel and stove access associated with existing promotion strategies,management,and policies.The pilot program was of the typical“subsidy-and-policy-dependence”pattern and was unlikely to be implemented on a large scale.Technological innovation,operational optimization,and proper policies considering the local socioeconomic factors are needed to sustain the promotion of biomass straw pellets and stoves.

Metformin promotes angiogenesis by enhancing VEGFa secretion by adipose-derived stem cells via the autophagy pathway

Human adipose tissue-derived stem cell(ADSC)derivatives are cell-free,with low immunogenicity and no potential tumourigenicity,making them ideal for aiding wound healing.However,variable quality has impeded their clinical application.Metformin(MET)is a 5′adenosine monophosphate-activated protein kinase activator associated with autophagic activation.In this study,we assessed the potential applicability and underlying mechanisms of MET-treated ADSC derivatives in enhancing angiogenesis.We employed various scientific techniques to evaluate the influence of MET on ADSC,assess angiogenesis and autophagy in MET-treated ADSC in vitro,and examine whether MET-treated ADSC increase angiogenesis.We found that low MET concentrations exerted no appreciable effect on ADSC proliferation.However,MET was observed to enhance the angiogenic capacity and autophagy of ADSC.MET-induced autophagy was associated with increased vascular endothelial growth factor A production and release,which contributed to promoting the therapeutic efficacy of ADSC.In vivo experiments confirmed that in contrast to untreated ADSC,MET-treated ADSC promoted angiogenesis.Our findings thus indicate that the application of MET-treated ADSC would be an effective approach to accelerate wound healing by promoting angiogenesis at wound sites.

Pathogenic roles of long noncoding RNAs in melanoma: Implications in diagnosis and therapies

Melanoma is one of the most dangerous types of cutaneous neoplasms,which are pigment-producing cells of neuroectodermal origin found all over the body.A great deal of research is focused on the mechanisms of melanoma to promote better diagnostic and treatment options for melanoma in its advanced stages.The progression of melanoma involves alteration in different levels of gene expression.With the successful implementation of next-generation sequencing technology,an increasing number of long noncoding RNAs(lncRNAs)sequences have been discovered,and a significant number of them have phenotypic effects in both in vitro and in vivo studies,implying that they play an important role in the occurrence and progression of human cancers,particularly melanoma.A number of evidence indicated that lncRNAs are important regulators in tumor cell proliferation,invasion,apoptosis,immune escape,energy metabolism,drug resistance,epigenetic regulation.To better understand the role of lncRNAs in melanoma tumorigenesis,we categorize melanomaassociated lncRNAs according to their cellular functions and associations with gene expression and signaling pathways in this review.Based on the mechanisms of lncRNA,we discuss the possibility of lncRNA-target treatments,and the application of liquid biopsies to detect lncRNAs in melanomadiagnosisandprognosis.

Air pollution and inhalation exposure to particulate matter of different sizes in rural households using improved stoves in central China

Household air pollution is considered to be among the top environmental risks in China.To examine the performance of improved stoves for reduction of indoor particulate matter（PM） emission and exposure in rural households, individual inhalation exposure to size-resolved PM was investigated using personal portable samplers carried by residents using wood gasifier stoves or improved coal stoves in a rural county in Central China.Concentrations of PM with different sizes in stationary indoor and outdoor air were also monitored at paired sites. The stationary concentrations of size-resolved PM in indoor air were greater than those in outdoor air, especially finer particles PM0.25. The daily averaged exposure concentrations of PM0.25, PM1.0, PM2.5 and total suspended particle for all the surveyed residents were 74.4 ± 41.1, 159.3 ± 74.3, 176.7 ± 78.1 and 217.9 ± 78.1 μg/m3,respectively. Even using the improved stoves, the individual exposure to indoor PM far exceeded the air quality guideline by WHO at 25 μg/m3. Submicron particles PM1.0 were the dominant PM fraction for personal exposure and indoor and outdoor air. Personal exposure exhibited a closer correlation with indoor PM concentrations than that for outdoor concentrations. Both inhalation exposure and indoor air PM concentrations in the rural households with gasifier firewood stoves were evidently lower than the reported results using traditional firewood stoves. However, local governments in the studied rural areas should exercise caution when widely and hastily promoting gasifier firewood stoves in place of improved coal stoves, due to the higher PM levels in indoor and outdoor air and personal inhaled exposure.