Risk factors for postoperative bleeding following endoscopic submucosal dissection in early gastric cancer: A systematic review and meta-analysis.

BACKGROUND: Early gastric cancer (EGC) presents a significant challenge in surgical management, particularly concerning postoperative bleeding following endoscopic submucosal dissection. Understanding the risk factors associated with postoperative bleeding is crucial for improving patient outcomes. METHODS: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review and meta-analysis were conducted across PubMed, Embase, Web of Science, and the Cochrane Library without publication date restrictions. The inclusion criteria encompassed observational studies and randomized controlled trials focusing on EGC patients undergoing endoscopic submucosal dissection and their risk factors for postoperative bleeding. The Newcastle-Ottawa Scale was utilized for quality assessment. The effect size was calculated using random or fixed-effects models based on the observed heterogeneity. We assessed the heterogeneity between studies and conducted a sensitivity analysis. RESULTS: In our meta-analysis, 6 studies involving 4868 EGC cases were analyzed. The risk of postoperative bleeding was notably increased with intraoperative ulcer detection (odds ratio: 1.97, 95% confidence interval [CI]: 1.03-3.76, I2 = 61.0%, P = .025) and antithrombotic medication use (odds ratio: 2.02, 95% CI: 1.16-3.51, I2 = 57.2%, P = .039). Lesion resection size showed a significant mean difference (5.16, 95% CI: 2.97-7.98, P < .01), and longer intraoperative procedure time was associated with increased bleeding risk (mean difference: 11.69 minutes, 95% CI: 1.82-26.20, P < .05). Sensitivity analysis affirmed the robustness of these findings, and publication bias assessment indicated no significant bias. CONCLUSIONS: In EGC treatment, the risk of post-endoscopic submucosal dissection bleeding is intricately linked to factors like intraoperative ulcer detection, antithrombotic medication use, the extent of lesion resection, and the length of the surgical procedure. These interwoven risk factors necessitate careful consideration and integrated management strategies to enhance patient outcomes and safety in EGC surgeries.

Why and when surface acting interferes with family functioning: The role of psychological detachment and family-supportive supervisor behaviors.

Emotional labor is a well-documented work stressor that may have important implications for preschool teachers. Integrating conservation of resources theory and the stressors-detachment model, this study seeks to develop a moderated mediation model in which two forms of surface acting (i.e., faked positive emotions and suppressed negative emotions) would be indirectly associated with poor family functioning via psychological detachment, and the indirect association would be moderated by family-supportive supervisor behaviors. This study was investigated among 411 preschool teachers in Chinese society. Results revealed that both faked positive emotions and suppressed negative emotions led to impaired family functioning, and lack of psychological detachment mediated the detrimental effects. The moderated mediation analyses further showed that the mediated path became weaker for preschool teachers received more family-supportive supervisor behaviors. These findings deepen our practical and theoretical understanding of why and when surface acting impacts preschool teachers' family lives.

Workplace Surface Acting and Employee Insomnia: A Moderated Mediation Model of Psychological Detachment and Dispositional Mindfulness.

This study adopted a process-oriented approach to explore the mediating and moderating mechanisms surrounding the association between surface acting at work and sleep quality. Drawing on the stressor-detachment and transactional stress models, the current study proposed a moderated mediation model to examine whether surface acting would be associated indirectly with employee insomnia via lack of psychological detachment, and whether this indirect linkage is moderated by dispositional mindfulness. The study was conducted among 516 full-time employed hospital nurses in China over a one-year period. Results revealed that suppressed negative emotions, but not faked positive emotions, had a significant influence on employee insomnia over time, and lack of psychological detachment mediated the effect of suppressing negative emotions on insomnia. Tests of moderated mediation indicated that the mediated path was weaker for employees with higher levels of dispositional mindfulness. These findings advance our understanding of how and when surface acting negatively influences employee sleep, as well as point to implications for individual and organizational interventions.

Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study.

There is currently an outbreak of respiratory disease caused by a novel coronavirus. The virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes has been named coronavirus disease 2019 (COVID-19). More than 16% of patients developed acute respiratory distress syndrome, and the fatality ratio was 1%-2%. No specific treatment has been reported. Herein, we examined the effects of favipiravir (FPV) versus lopinavir (LPV)/ritonavir (RTV) for the treatment of COVID-19. Patients with laboratory-confirmed COVID-19 who received oral FPV (Day 1: 1600 mg twice daily; Days 2-14: 600 mg twice daily) plus interferon (IFN)-α by aerosol inhalation (5 million international unit (IU) twice daily) were included in the FPV arm of this study, whereas patients who were treated with LPV/RTV (Days 1-14: 400 mg/100 mg twice daily) plus IFN-α by aerosol inhalation (5 million IU twice daily) were included in the control arm. Changes in chest computed tomography (CT), viral clearance, and drug safety were compared between the two groups. For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms. A shorter viral clearance median time was found for the FPV arm versus the control arm (4 d (interquartile range (IQR): 2.5-9) versus 11 d (IQR: 8-13), P < 0.001). The FPV arm also showed significant improvement in chest CT compared with the control arm, with an improvement rate of 91.43% versus 62.22% (P = 0.004). After adjustment for potential confounders, the FPV arm also showed a significantly higher improvement rate in chest CT. Multivariable Cox regression showed that FPV was independently associated with faster viral clearance. In addition, fewer adverse events were found in the FPV arm than in the control arm. In this open-label before-after controlled study, FPV showed better therapeutic responses on COVID-19 in terms of disease progression and viral clearance. These preliminary clinical results provide useful information of treatments for SARS-CoV-2 infection.

Recovery experiences buffer against adverse well-being effects of workplace surface acting: A two-wave study of hospital nurses.

AIMS: To test the direct effects of different surface acting strategies and the interactive effects of surface acting and recovery experiences on nurses' well-being. DESIGN: A two-wave study design. METHODS: Chinese hospital nurses (N = 372; 47.3% of initial sample) reported on their levels of surface acting, recovery experiences and well-being using a paper and pencil survey in November 2017 and November 2018. FINDINGS: Surface acting has long-term effects on nurses' well-being. Compared with positive expression, negative suppression generally tends to show more negative effects. Recovery experiences play a buffering role in the surface acting - nurses' well-being relationship. CONCLUSION: These findings offer initial evidence for long-term effects of surface acting and show how hospital nurses can avoid adverse effects of surface acting through fostering recovery experiences. IMPACT: Surface acting is a chronic stressor, having long-term effects on nurses' well-being. In contrast to positive expression, negative suppression has more detrimental impacts. Recovery experiences play a protective role by alleviating the adverse effects of surface acting. Managers and individuals are advised to differentiate distinct surface acting strategies. Managers should try best to facilitate employee recovery. Hospital nurses are well recommended to train themselves by adopting several recovery programmes.