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Abstract Background Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier’s gangrene (FG). Methods Data of patients surgically treated for FG were retrospectively analyzed. Results Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28–74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ2 = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively. Conclusion VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.

Abstract Background Spinal manipulative therapy (SMT) is a guideline-recommended treatment option for spinal pain. The recommendation is based on multiple systematic reviews. However, these reviews fail to consider that clinical effects may depend on SMT “application procedures” (i.e., how and where SMT is applied). Using network meta-analyses, we aim to investigate which SMT “application procedures” have the greatest magnitude of clinical effectiveness for reducing pain and disability, for any spinal complaint, at short-term and long-term follow-up. We will compare application procedural parameters by classifying the thrust application technique and the application site (patient positioning, assisted, vertebral target, region target, Technique name, forces, and vectors, application site selection approach and rationale) against: 1. Waiting list/no treatment; 2. Sham interventions not resembling SMT (e.g., detuned ultrasound); 3. Sham interventions resembling SMT; 4. Other therapies not recommended in clinical practice guidelines; and 5. Other therapies recommended in clinical practice guidelines. Secondly, we will examine how contextual elements, including procedural fidelity (whether the SMT was delivered as planned) and clinical applicability (whether the SMT is similar to clinical practice) of the SMT. Methods We will include randomized controlled trials (RCT) found through three search strategies, (i) exploratory, (ii) systematic, and (iii) other known sources. We define SMT as a high-velocity low-amplitude thrust or grade V mobilization. Eligibility is any RCT assessing SMT against any other type of SMT, any other active or sham intervention, or no treatment control on adult patients with pain in any spinal region. The RCTs must report on continuous pain intensity and/or disability outcomes. Two authors will independently review title and abstract screening, full-text screening, and data extraction. Spinal manipulative therapy techniques will be classified according to the technique application and choice of application sites. We will conduct a network-meta analysis using a frequentist approach and multiple subgroup and sensitivity analyses. Discussion This will be the most extensive review of thrust SMT to date, and will allow us to estimate the importance of different SMT application procedures used in clinical practice and taught across educational settings. Thus, the results are applicable to clinical practice, educational settings, and research studies. PROSPERO registration: CRD42022375836.

Engaging the public and community organizations in local health actions greatly assists disease prevention and control. However, it remains unclear how organization-public relationships (OPR) and communication networks within communities contribute to community health actions. To fill this gap, a survey was conducted among community members in Shanghai, China, who were challenged by the Omicron wave of the COVID-19 pandemic. Results revealed that integrated connectedness to a storytelling network (ICSN) was a significant predictor of residents' community engagement. Trust, control mutuality, commitment, and ICSN were positively associated with community engagement intentions through the sense of community and organizational efficacy. This study is a step toward understanding how organizations and members collectively respond to health crises at the community level. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) can lead to multiple complications. T2DM‐related bone damage has been linked to abnormal bone turnover, but it cannot fully explain the mechanisms of T2DM bone disease. This study attempts to elucidate the underlying mechanisms of poor bone quality in T2DM. Hence, T2DM model was induced by a high‐fat diet combined with a single streptozotocin injection in 7‐week‐old male SD rats. Osteoblasts derived from SD rats were cultured in high glucose to mimic hyperglycemia. Low bone turnover was observed in T2DM bone with elevated levels of advanced glycation end‐products (AGEs) and receptor for AGEs (RAGE). Additionally, higher levels of oxidative stress and inflammatory factors were found in T2DM bone. AGEs content in bone was pairwise correlated with RAGE, hydrogen peroxide, and inflammatory factors. Serum levels of RAGE, oxidative stress, and inflammatory factors were higher in T2DM, while AGEs content tended to be lower. Besides, 35 differentially expressed metabolites were screened in T2DM serum. Osteoblasts exposed to high glucose displayed analogous abnormal changes in these biomarkers. Thus, low bone turnover in T2DM might be partially due to excess oxidative stress and inflammation induced by AGE‐RAGE signaling. Furthermore, these biomarker levels in serum were mostly consistent with bone, demonstrating their possibility for predicting bone quality in T2DM. [ABSTRACT FROM AUTHOR]

Crop diseases and pests are important factors restricting agricultural production. Traditional pest detection methods are mainly targeted at a single pest species, which is difficult to meet the needs of multi-target identification and rapid response in real scenes. Therefore, this paper improves the YOLOv8n model for efficient multi-target pest detection. Two feature enhancement modules, EMSFEM and AFEM_SIE, are proposed in this paper. The EMSFEM module enriches the model's receptive field through the combination of multi-scale asymmetric convolution kernel and different expansion rates and can better extract the width, height, texture, and edge information of the target. The AFEM_SIE module captures the similarities and differences between upper and lower features through spatial information exchange and enhances feature representation through inter-feature information exchange. In addition, an improved feature fusion operation, Concat_Weighting, is proposed on the basis of Concat. The module uses the learned weights to carry out channel weighting and feature graph weighting for input features, which realizes more flexible and effective feature fusion. The results of experiments conducted on the publicly available large-scale crop pest and disease dataset IP102 show that the performance of the AEC-YOLOv8n model is significantly improved compared with the original YOLOv8n model, with mAP50 increased by 8.9%, accuracy increased by 6.8%, and recall rate increased by 6.3%. The AEC-YOLOv8n model proposed in this study can effectively identify and deal with a variety of crop pests and has achieved the best detection accuracy on the IP102 dataset, which has high application value. [ABSTRACT FROM AUTHOR]

WeChat interest-based group chats (IGCs) are becoming popular among China's elderly migrants. Previous domestication research paid little attention to mobile services that highlighted shared goals and teamwork beyond familial boundaries. To reconsider the approach of domestication in the emerging mediascape, this study employs the concept of "collective domestication" to analyze how elderly migrants in the W community of Xiamen, China, use and make sense of WeChat IGCs. Nonparticipatory observation of four IGCs and in-depth interviews with 21 elderly migrants indicate that IGCs are effective supplements to offline activities; they serve the role of a gateway to an acquaintance community in elderly migrants' lives. Implications for Chinese elderly migrants' digital inclusion and the domestication approach are discussed. [ABSTRACT FROM AUTHOR]