Nurses' Risk Perception of Adverse Events and Its Influencing Factors: A Cross-Sectional Study.

To investigate clinical nurses' perception of adverse event risk and to analyze its influencing factors. A proportional stratified random sampling method was applied to recruit nurses from a hospital in Shiyan City, Hubei Province, China. The Nursing Adverse Event Risk Perception Scale, Organizational Support Questionnaire, Nurse Manager Leadership Behavior Questionnaire, Nursing Safety Behavior Questionnaire, and Burnout scale was used to investigate 1084 nurses. Univariate analysis, Pearson correlation analysis, and multiple linear regression analysis were used to analyze the influencing factors. The scores of the Nurses' Risk Perception of Adverse Nursing Event Scale, Organizational Support Questionnaire, Nurse Manager Leadership Behavior Questionnaire, Nursing Safety Behavior Questionnaire, and Burnout Scale were 14.98 ± 5.39, 52.57 ± 10.00, 88.98 ± 21.08, 56.42 ± 5.03, 30.90 ± 21.49, respectively. According to the correlation analysis, nurses' perception of adverse nursing events was positively correlated with the sense of organizational support (r = .457, P < .01), head nurses' leadership behavior (r = .348, P < .01), and nurse safety behavior (r = .457, P < .01), and negatively correlated with the level of burnout (r = -.384, P < .01). According to the Regression analysis, nurses' departments (ß = .226, P < .001), daily working hours (ß = 1.122, P < .001), adverse events experience (ß = -1.505, P < .001), organizational support (ß = .105, P < .001), head nurses' leadership behavior (ß = .072, P < .001), and burnout (ß = -.052, P < .001) held an influence on nurses' risk perception of adverse nursing event. These factors explained 42.5% of the total variation. Nurses' risk perception of adverse nursing events needs to be improved. Nursing managers need to strengthen organizational support for nurses, change the leadership behavior of nurse managers, reduce nurses' burnout, improve nurses' risk perception of adverse nursing events, prevent adverse events, and ensure patient safety.

L-shaped association between lean body mass to visceral fat mass ratio with hyperuricemia: a cross-sectional study.

BACKGROUND: Insufficient attention has been given to examining the correlation between body composition and hyperuricemia, leading to inconsistent findings. The primary objective of this research is to explore the association between lean body mass index (LMI), visceral fat mass index (VFMI), and hyperuricemia. A specific emphasis will be placed on assessing the link between the ratio of lean body mass to visceral fat mass (LMI/VFMI) and hyperuricemia. METHODS: The present study employed a cross-sectional design and involved a total of 9,646 individuals who participated in the National Health and Nutrition Examination Survey (NHANES). To explore the associations among the variables, logistic and linear regressions were employed. Additionally, subgroup analyses and sensitivity analyses were conducted based on various characteristics. RESULTS: The results showed that LMI was positively associated with hyperuricemia (for Per-SD: OR = 1.88, 95%CI: 1.75, 2.01; for quartiles [Q4:Q1]: OR = 5.37, 95%CI: 4.31, 6.69). Meanwhile, VFMI showed a positive association with hyperuricemia (for Per-SD: OR = 2.02, 95%CI: 1.88, 2.16; for quartiles [Q4:Q1]: OR =8.37, 95%CI: 6.70, 10.47). When considering the effects of In LMI/VFMI, an L-shaped negative association with hyperuricemia was observed (for Per-SD: OR = 0.45, 95%CI: 0.42, 0.49; for quartiles [Q4:Q1]: OR = 0.16, 95%CI: 0.13, 0.20). Subgroup and sensitivity analyses demonstrated the robustness of this association across different subgroups. Additionally, the segmented regression analysis indicated a saturation effect of 5.64 for the In LMI/VFMI with hyperuricemia (OR = 0.20, 95%CI: 0.17, 0.24). For every 2.72-fold increase of In LMI/VFMI, the risk of hyperuricemia was reduced by 80%. CONCLUSION: The LMI/VFMI ratio is non-linearly associated with serum uric acid. Whether this association is causal needs to be confirmed in further longitudinal studies or Mendelian randomization.

Association between the homeostasis model assessment of insulin resistance and coronary artery calcification: a meta-analysis of observational studies.

Background: Insulin resistance (IR), a risk factor for cardiovascular diseases, has garnered significant attention in scientific research. Several studies have investigated the correlation between IR and coronary artery calcification (CAC), yielding varying results. In light of this, we conducted a systematic review to investigate the association between IR as evaluated by the homeostasis model assessment (HOMA-IR) and CAC. Methods: A comprehensive search was conducted to identify relevant studies in PubMed, Embase, Scopus, and Web of Science databases. In addition, preprint servers such as Research Square, BioRxiv, and MedRxiv were manually searched. The collected data were analyzed using either fixed or random effects models, depending on the heterogeneity observed among the studies. The assessment of the body of evidence was performed using the GRADE approach to determine its quality. Results: The current research incorporated 15 studies with 60,649 subjects. The analysis revealed that a higher category of HOMA-IR was associated with a greater prevalence of CAC in comparison to the lowest HOMA-IR category, with an OR of 1.13 (95% CI: 1.06-1.20, I2 = 29%, P < 0.001). A similar result was reached when HOMA-IR was analyzed as a continuous variable (OR: 1.27, 95% CI: 1.14-1.41, I2 = 54%, P < 0.001). In terms of CAC progression, a pooled analysis of two cohort studies disclosed a significant association between increased HOMA-IR levels and CAC progression, with an OR of 1.44 (95% CI: 1.04-2.01, I2 = 21%, P < 0.05). It is important to note that the strength of the evidence was rated as low for the prevalence of CAC and very low for the progression of CAC. Conclusion: There is evidence to suggest that a relatively high HOMA-IR may be linked with an increased prevalence and progression of CAC.

Association between lean body mass to visceral fat mass ratio and bone mineral density in United States population: a cross-sectional study.

BACKGROUND: Studies have explored the correlation between body composition and bone mineral density (BMD), but there has yet to be a consensus. Thus, the present study aims to comprehensively investigate the association between lean body mass, adipose tissue, and BMD. METHODS: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) (2011-2018) with 11,227 subjects. Multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis were used to explore the association between lean body mass, visceral fat mass, and BMD. Also, we used the lean body mass to visceral fat mass ratio (Log LM/VFM) as a proxy variable to analyze its association with BMD alone. RESULTS: After adjusting for potential confounding factors, the results showed a positive correlation between lean mass and total BMD (for continuous: ß = 0.078, P < 0.001; for quartile: ß = 0.138, P < 0.001), while visceral fat mass was negatively correlated (for continuous: ß = -0.027, P < 0.001; for quartile: ß = -0.065, P < 0.001). A positive correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with BMD (for continuous: ß = 0.034, P < 0.001; for quartile: ß = 0.084, P < 0.001). In addition, subgroup analyses for gender, age, body mass index, hypertension, and diabetes showed that all subgroups except the diabetes subgroup showed a substantial degree of robustness (P < 0.05). The smoothed curve fitting showed a nonlinear relationship between Log LM/VFM and BMD, and there was a threshold effect with a critical value of 2.60. CONCLUSION: Maintaining a proper ratio of lean body mass and visceral fat mass is beneficial for increasing BMD.

Anticipated correlation between lean body mass to visceral fat mass ratio and insulin resistance: NHANES 2011-2018.

Objective: The relationship between body composition and insulin resistance (IR) is controversial. This study aimed to thoroughly examine the correlation between adipose tissue, lean body mass, and IR as evaluated by the Homeostatic Model Assessment (HOMA-IR). Methods: In this cross-sectional study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. Our study included 4981 subjects, and we employed multiple linear regression, smoothed curve fitting, threshold, and saturation effect analysis to investigate the relationship between lean body mass, visceral fat mass, and IR. Also, we used the lean body mass to visceral fat ratio (Log LM/VFM) as a proxy variable to analyze its association with IR alone. Results: The study discovered a negative link between lean body mass and IR, but the visceral fat mass was positively correlated after correcting for covariates. A negative correlation was observed when the alternative variable Log LM/VFM was analyzed separately for its association with IR. This association was present regardless of whether the exposure variables were analyzed as continuous or categorical. The data analysis revealed a nonlinear relationship between Log LM/VFM and IR, as evidenced by the generalized additive model. In addition, a threshold effect with a critical value of 1.80 and a saturation effect with a critical point of 2.5 were also observed. Further subgroup analysis for sex, age, BMI, active levels, hypertension, and diabetes showed considerable robustness between the relationship of Log LM/VFM and IR. Conclusion: Maintaining a proper ratio of lean body mass and visceral fat is beneficial for decreasing IR.

Research trends in readiness for hospital discharge between 2002 and 2021: A bibliometric analysis.

AIM: This study aimed to undertake a bibliometric analysis to provide comprehensive information in demonstrating the current status and outline the overall trends in the area of readiness for hospital discharge (RHD). DESIGN: A bibliometric and visual analysis of RHD literature was undertaken. METHODS: Articles were retrieved from the Web of Science network from 2002 to 2021. VOSviewer was used to identify the co-authorship network of countries/institutions, co-authorship and co-citation analysis of authors, and co-citation analysis of references and citation analysis of documents. CiteSpace was used to identify the keyword co-occurrence network and perform cluster analysis, detecting the keywords with citation bursts and speculated frontiers in this research field. RESULTS: A total of 512 articles were included in the final analysis. Key findings are: (1) There has been a continuous but somewhat fluctuating rise in the number of publications. (2) 56.05% of publications come from the USA with Marquette University making the highest contribution. (3) Most publications (17, 3.32%) in RHD research were from the Journal of Clinical Nursing, and Anaesthesia and Analgesia had the highest number of citations (584 citations). (4) Weiss ME (25, 4.88%) was the most productive author whose articles have been the most highly cited (646 citations). (5) Cited references from Weiss ME (2007) also made the largest contribution to co-citations, and the most cited reference was from Jack BW (2009) (1022 citations). (6) The 20 most frequent keywords and keywords with the strongest citation bursts were retrieved. There were seven research hotspots, and three emerging research frontiers were explored. CONCLUSIONS: The bibliometric analysis of material published in the last 20 years indicates that there have been statistically significant gains in comprehensive information on RHD, including the knowledge mapping of the countries, institutions, authors, references and keywords. The hotspots and frontiers, which have been explored can give guidance to researchers as to new angles and directions to take. IMPLICATIONS FOR NURSING MANAGEMENT: The effects of the implementation of ERAS on RHD-related risk for adverse post-discharge outcomes in surgical patients will be of increasing concern for healthcare professionals. It is important for patients and their relatives to be confident that on discharge they are sufficiently ready for hospital discharge to enable them to safely and smoothly make the transition to home. Improving the level of RHD in discharged patients can help nurse managers and researchers measure the effectiveness of discharge planning services.

Association between the triglyceride-glucose index and arterial stiffness: A meta-analysis.

BACKGROUND: Studies have shown a strong association between the triglyceride-glucose (TyG) index, a simple marker of insulin resistance, and various metabolic diseases. We performed a systematic review of the interaction between the TyG index and arterial stiffness. METHODS: Relevant observational studies assessing the association between the TyG index and arterial stiffness were thoroughly searched in PubMed, Embase, and Scopus, and a manual search of the preprint server was conducted. A random-effects model was utilized to analyze the data. The risk of bias for the included studies was assessed using the Newcastle-Ottawa Scale. A pooled effect size estimate with a random-effects model was used for the meta-analysis. RESULTS: Thirteen observational studies comprising 48,332 subjects were included. Of these, 2 were prospective cohort studies, and the remaining 11 were cross-sectional studies. According to the results of the analysis, the risk of developing high arterial stiffness was 1.85 times greater for those in the highest TyG index subgroup versus the lowest group (risk ratio [RR]: 1.85, 95% confidence interval: 1.54-2.33, I2 = 70%, P < .001). Consistent results were observed when the index was analyzed as a continuous variable (RR: 1.46, 95% confidence interval: 1.32-1.61, I2 = 77%, P < .001). A sensitivity analysis excluding each of the studies one by one yielded similar results (RRs for categorical variables: 1.67-1.94, P all <.001; RRs for continuous variables: 1.37-1.48, P all <.001). A subgroup analysis showed that different characteristics of the study subjects, such as type of study design, age, population, disease status, (including hypertension and diabetes), and pulse wave velocity measurement methods had no substantial effect on the results (P for subgroup analysis, all >0.05). CONCLUSIONS: A relatively high TyG index might be linked to an increased incidence of arterial stiffness.

Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators.

BACKGROUND: Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS: A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS: Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS: Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS: Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.

The Effect of Recombinant Human Interferon Alpha Nasal Drops to Prevent COVID-19 Pneumonia for Medical Staff in an Epidemic Area.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as Coronavirus disease-2019 (COVID-19), has caused the sixth world's public health emergency. Healthcare staff, as the frontline population fighting the pandemic, are exposed to a high risk of infection. Therefore, developing a protective intervention for medical staff is of significant importance. OBJECTIVE: The aim of the study was to explore the effectiveness and safety of recombinant human interferon alpha (rhIFN-α) nasal drops for the prevention of coronavirus disease 2019 (COVID-19) through administering it to medical staff. METHODS: This was a prospective open-label clinical trial with parallel intervention assignment conducted on 2944 medical staff including both doctors and nurses from Taihe Hospital, Shiyan City, Hubei Province, China from January 21, 2020 to July 30, 2020. The participants were bifurcated into two groups of low risk and high risk groups according to the level of direct exposure to COVID-19 patients. The individuals of the low-risk group received rhIFN-α nasal drops for one month in addition to first level protection, and the high-risk group received a combination of rhIFN-α nasal drops coupled with thymosin-α1 with either second or third-level protection protocol. Moreover, the new-outset of COVID-19 pneumonia diagnosed by chest computed tomography (CT), after thirty days, was the primary outcome. The adverse reactions were recorded in all participants. RESULTS: 2415 of 2944 individuals belonged to the low-risk group, while 529 to the high-risk group. There was no COVID-19 pneumonia in either of the group after thirty days. The pulmonary CT scans were negative for COVID-19 pneumonia in both the groups with no new clinical symptoms. No serious adverse event was observed during the course of the intervention. CONCLUSION: The rhIFN-α nasal drops along with augmented safeguards based on standard physical isolation could effectively protect medical staff against COVID-19 pneumonia.

Integrated Cox's model for predicting survival time of glioblastoma multiforme.

Glioblastoma multiforme is the most common primary brain tumor and is highly lethal. This study aims to figure out signatures for predicting the survival time of patients with glioblastoma multiforme. Clinical information, messenger RNA expression, microRNA expression, and single-nucleotide polymorphism array data of patients with glioblastoma multiforme were retrieved from The Cancer Genome Atlas. Patients were separated into two groups by using 1 year as a cutoff, and a logistic regression model was used to figure out any variables that can predict whether the patient was able to live longer than 1 year. Furthermore, Cox's model was used to find out features that were correlated with the survival time. Finally, a Cox model integrated the significant clinical variables, messenger RNA expression, microRNA expression, and single-nucleotide polymorphism was built. Although the classification method failed, signatures of clinical features, messenger RNA expression levels, and microRNA expression levels were figured out by using Cox's model. However, no single-nucleotide polymorphisms related to prognosis were found. The selected clinical features were age at initial diagnosis, Karnofsky score, and race, all of which had been suggested to correlate with survival time. Both of the two significant microRNAs, microRNA-221 and microRNA-222, were targeted to p27Kip1 protein, which implied the important role of p27Kip1 on the prognosis of glioblastoma multiforme patients. Our results suggested that survival modeling was more suitable than classification to figure out prognostic biomarkers for patients with glioblastoma multiforme. An integrated model containing clinical features, messenger RNA levels, and microRNA expression levels was built, which has the potential to be used in clinics and thus to improve the survival status of glioblastoma multiforme patients.

Can routine oral care with antiseptics prevent ventilator-associated pneumonia in patients receiving mechanical ventilation? An update meta-analysis from 17 randomized controlled trials.

BACKGROUND: Whether oral antiseptics could reduce the risk of ventilator associated pneumonia (VAP) in patients receiving mechanical ventilation remains controversial. We performed a meta-analysis to assess the effect of oral care with antiseptics on the prevalence of ventilator associated pneumonia in adult critically ill patients. METHODS: A comprehensive search of PubMed, Embase and Web of Science were performed to identity relevant studies. Eligible studies were randomized controlled trials of mechanically ventilated adult patients receiving oral care with antiseptics. The quality of included studies was assessed by the Jadad score. Relative risks (RRs), weighted mean differences (WMDs), and 95% confidence intervals (CIs) were calculated and pooled using a fixed-effects model or random-effects model. Heterogeneity among the studies was assessed with I (2) test. RESULTS: 17 studies with a total number of 4249 met the inclusion criteria. Of the 17 studies, 14 assessed the effect of chlorhexidine, and 3 investigated the effect of povidone-iodine. Overall, oral care with antiseptics significantly reduced the prevalence of VAP (RR=0.72, 95% CI: 0.57, 0.92; P=0.008). The use of chlorhexidine was shown to be effective (RR=0.73, 95% CI: 0.57, 0.93; P=0.012), whereas this effect was not observed in povidone-iodine (RR=0.51, 95% CI: 0.09, 2.82; P=0.438). Subgroup analyses showed that oral antiseptics were most marked in cardiac surgery patients (RR=0.54, 95% CI: 0.39, 0.74; P=0.00). Patients with oral antiseptics did not have a reduction in intensive care unit (ICU) mortality (RR=1.11, 95% CI: 0.95, 1.29; P=0.201), length of ICU stay (WMD=-0.10 days, 95% CI: -0.25, 0.05; P=0.188), or duration of mechanical ventilation (WMD=-0.05 days, 95% CI: -0.14, 0.04; P=0.260). CONCLUSION: Oral care with antiseptics significantly reduced the prevalence of VAP. Chlorhexidine application prevented the occurrence of VAP in mechanically ventilated patients but povidone-iodine did not. Further large-scale, well-designed randomized controlled trials are needed to identify the findings and determine the effect of povidone-iodine application.

Resveratrol inhibits ß-amyloid-induced neuronal apoptosis via regulation of p53 acetylation in PC12 cells.

The natural product resveratrol possesses diverse biological activities, including anti­inflammatory, anti­oxidant, anti­cancer and anti­aging effects in multiple organisms. The neuroprotective role of resveratrol has recently been reported in a cell model of amyloid (A)ß(25­35)­induced neurotoxic injury using PC12 cells. However, the pathomechanism by which resveratrol inhibits neuronal apoptosis has remained to be elucidated. The present study therefore aimed to confirm the neuroprotective effects of resveratrol in an Aß(25­35)­induced model of neurotoxicity in PC12 cells and elucidate the mechanisms underlying these effects. It was demonstrated that resveratrol exerted neuronal protection through inhibition of cell apoptosis, which was associated with an increased acetylation level of p53. In accordance with this effect, when the acetylation level of p53 was decreased by p53 acetylation inhibitor pifithrin­α, the protective effects of resveratrol were abrogated. In conclusion, it was revealed that resveratrol inhibited Aß(25­35)­induced cell apoptosis via the acetylation of p53 in PC12 cells.