Conectar
Proximal humerus fractures are common in clinical practice, and there are relatively a few studies on postoperative incision infections of such fractures. The purpose of this study was to explore the risk factors for surgical site infection (SSI) after internal fixation in patients with closed proximal humerus fractures. Patients with closed proximal humerus fractures who underwent surgery from January 2016 to January 2022 were retrospectively analysed. Cases with superficial or deep infections within 3 months after surgery were in the infection group and the remaining cases were in the non-infection group. The types of pathogenic bacteria in the infection group were analysed. The potential risk factors for SSI in all patients were recorded: (1) patient-related factors: gender, age, body mass index (BMI), smoking, comorbidities; (2) trauma-related factors: mechanism of injury, Injury Severity Score, visual analogue scale, fracture type, soft tissue condition and combined dislocation; (3) laboratory-related indexes: haemoglobin, albumin; (4) surgery-related factors: time from injury to surgery, American Society of Anesthesiologists anaesthesia classification, surgical time, fixation mode, intraoperative blood loss, suture method, bone graft and postoperative drainage. The risk factors for the occurrence of SSI were analysed using univariate analysis and multivariate logistic regression. The incidence of SSI was 15.7%. The most common bacterium in the infection group was Staphylococcus aureus. High BMI (p = 0.033), smoking (p = 0.030), an increase in mean time from injury to definitive surgery (p = 0.013), and prolonged surgical time (p = 0.044) were independent risk factors for the development of SSI after closed proximal humeral fractures. In patients with closed proximal humerus fractures, weight loss, perioperative smoking cessation, avoidance of delayed surgery, and shorter surgical time may be beneficial in reducing the incidence of SSI.
To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors.
Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking.
Multicentre cross-sectional study.
Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care-Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence.
In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care-related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence.
There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses.
The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training.
EQUATOR guidelines, STROBE checklist: cross-sectional studies.
All participants were clinical nurses. Participants were informed they could withdraw from the study at any time.
Increased intraocular pressure (IOP) is a risk factor for glaucoma. One treatment option is trabeculectomy. Antimetabolic agents are used in the operation to decrease the post-operative scarring of the wound. The two most common medicines are Mitomycin C (MMC) and 5-Fluorouracil (5-FU). The aim of this research is to assess the effect of MMC on post-operation wound healing in comparison with 5-FU in addition to trabeculectomy. Well, we went through four common databases. Our language was limited to English during the study. The last time we looked at the e-databases was August 2023. Case control studies were performed where MMC resulted in better wound healing than 5-FU. Researchers selected a total of 1023 trials and eventually selected six trials for data analysis. Four hundred and ninety one cases of glaucoma were treated with trabeculectomy. Among them, 246 were given MMC and 245 were given 5-FU during operation. Six trials showed that there was no statistical difference between MMC and 5-FU in the incidence of post-operative wound leak in glaucoma patients who received trabeculectomy (OR, 1.21; 95% CI, 0.63–2.30 p = 0.57); Five trials demonstrated that MMC was associated with a reduced risk of post-operative corneal damage compared to 5-FU injection (OR, 0.18; 95% CI, 0.06–0.56 p = 0.003); In both trials, the incidence of post-operative bleeding was not significantly different from that of 5-FU injected in the MMC group (OR, 0.33; 95% CI, 0.05–2.16 p = 0.25). Our results indicate that MMC is superior to 5-FU in the reduction of post-operative corneal injury. Additional comparisons between MMC and 5-FU are required in order to increase the reliability and effectiveness of these findings.
To investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality.
Population based cohort study.
US National Health and Nutrition Examination Survey (2003–2006 and 2011–2018).
22 652 US adults aged 20 years or older.
Fat and lean mass in specific regions obtained from the whole-body dual-energy X-ray absorptiometry.
All-cause and cardiovascular-related mortality.
During a median of 83 months of follow-up, 1432 deaths were identified. Associations between body composition metrics and mortality risks were evident above specific thresholds. For all-cause mortality, Android fat mass showed elevated HRs above 2.46 kg (HR: 1.17, 95% CI 1.02 to 1.34), while Android lean mass (ALM) had similar trends above 2.75 kg (HR: 1.17, 95% CI 1.03 to 1.33), and Android total mass above 5.75 kg (HR: 1.08, 95% CI 1.01 to 1.16). Conversely, lower HRs were observed below certain thresholds: Gynoid fat mass (GFM) below 3.71 kg (HR: 0.72, 95% CI 0.56 to 0.93), Gynoid lean mass below 6.44 kg (HR: 0.77, 95% CI 0.64 to 0.92), and Gynoid total mass below 11.78 kg (HR: 0.76, 95% CI 0.70 to 0.84). Notably, below 0.722 kg, the HR of visceral adipose tissue mass (VATM) was 1.25 (95% CI 1.04 to 1.48) for all-cause mortality, and above 3.18 kg, the HR of total abdominal fat mass was 2.41 (95% CI 1.15 to 5.05). Cardiovascular-related mortality exhibited associations as well, particularly for Android fat mass (AFM) above 1.78 kg (HR: 1.22, 95% CI 1.01 to 1.47) and below 7.16 kg (HR: 0.50, 95% CI 0.36 to 0.69). HRs varied for Gynoid total mass below and above 10.98 kg (HRs: 0.70, 95% CI 0.54 to 0.93, and 1.12, 95% CI 1.02 to 1.23). Android per cent fat, subcutaneous fat mass (SFM), AFM/GFM, and VATM/SFM were not statistically associated with all-cause mortality. Android per cent fat, Gynoid per cent fat, AFM/GFM, and VATM/SFM were not statistically associated with cardiovascular-related mortality. Conicity index showed that the ALM/GLM had the highest performance for all-cause and cardiovascular-related mortality with AUCs of 0.785, and 0.746, respectively.
The relationship between fat or lean mass and all-cause mortality varies by region. Fat mass was positively correlated with cardiovascular mortality, regardless of the region in which they located. ALM/GLM might be a better predictor of all-cause and cardiovascular-related mortality than other body components or body mass index.
Pressure ulcers (PUs) are a common complication in postoperative patients with traumatic brain injury, and this study used a meta-analysis to assess the effects of comprehensive nursing applied in PUs intervention in postoperative patients with traumatic brain injury. A computerised systematic search of the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database (CBM), VIP and Wanfang databases was performed to collect publicly available articles on randomised controlled trials (RCTs) on the effects of comprehensive nursing interventions in postoperative patients with traumatic brain injury published up to August 2023. Two researchers independently completed the search and screening of the literature, extraction of data and quality assessment of the included literature based on the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Twenty-eight articles were finally included, for a cumulative count of 2641 patients, of which 1324 were in the intervention group and 1317 in the control group. The results of the meta-analysis showed that, compared with conventional nursing, comprehensive nursing intervention helped to reduce the incidence of PUs in postoperative patients with traumatic brain injury (5.14% vs. 19.67%, odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.16–0.29, p < 0.00001) and reduced the incidence of postoperative complications (7.87% vs. 25.84%, OR: 0.22, 95% CI: 0.11–0.43, p < 0.0001), while increasing patient satisfaction (96.67% vs. 75.33%, OR: 9.5, 95% CI: 3.63–24.88, p < 0.00001). This study concludes that a comprehensive nursing intervention applied to postoperative patients with traumatic brain injury can significantly reduce the incidence of PUs and postoperative complications as well as improve nursing satisfaction, and it is recommended for clinical promotion. However, due to the limitations of the studies' number and quality, more high-quality, large-sample RCTs are needed to further validate the conclusions of this study.
by Youcai Ma, Zhaobing Cui
Innovation is the first driving force to lead development, how to improve manufacturing innovation performance has become a hot topic. Based on 47 listed companies in the computer, communication and other electronic equipment manufacturing industry in the A-share market, this paper adopted the Fuzzy set qualitative comparative analysis (fsQCA) to explore the influencing factors of technology, organization and environment on the innovation performance of manufacturing industry and the improvement path. The findings are as follows: (1) A single condition is not a necessary condition for high innovation performance in manufacturing industry, but government support plays a key role in improving innovation performance in manufacturing industry. (2) There are two improvement paths for high innovation performance in manufacturing industry, which are specifically explained as “technology-environment dual improvement path” and “technology-organization-environment collaborative improvement path”. (3) The improvement of innovation performance in the manufacturing industry is the result of multiple factors, showing the characteristics of “all paths lead to the same destination”. Different manufacturing enterprises have different paths to improve innovation performance based on their actual conditions. Based on these findings, this study may provide some implications for the effective improvement of manufacturing innovation performance.by Huanhuan Wang, Xiaoli Fan, Qilan Zhao, Pengfei Cui
Agrifood systems account for 31% of global greenhouse gas emissions. Substantial emissions reduction in agrifood systems is critical to achieving the temperature goal set by the Paris Agreement. A key challenge in reducing GHG emissions in the agrifood value chain is the imbalanced allocation of benefits and costs associated with emissions reduction among agrifood value chain participants. However, only a few studies have examined agrifood emissions reduction from a value chain perspective, especially using dynamic methods to investigate participants’ long-term emissions reduction strategies. This paper helps fill this gap in the existing literature by examining the impact of collaborations among agrifood value chain participants on correcting those misallocations and reducing emissions in agrifood systems. We develop a dynamic differential game model to examine participants’ long-term emissions reduction strategies in a three-stage agrifood value chain. We use the Hamilton-Jacobi-Bellman equation to derive the Nash equilibrium emissions reduction strategies under non-cooperative, cost-sharing, and cooperative mechanisms. We then conduct numerical analysis and sensitivity analysis to validate our model. Our results show that collaboration among value chain participants leads to higher emissions reduction efforts and profits for the entire value chain. Specifically, based on our numerical results, the cooperative mechanism results in the greatest emissions reduction effort by the three participants, which leads to a total that is nearly three times higher than that of the non-cooperative mechanism and close to two times higher than the cost-sharing mechanism. The cooperative mechanism also recorded the highest profits for the entire value chain, surpassing the non-cooperative and cost-sharing mechanisms by around 37% and 16%, respectively. Our results provide valuable insights for policymakers and agrifood industry stakeholders to develop strategies and policies encouraging emissions reduction collaborations in the agrifood value chain and reduce emissions in the agrifood systems.Due to the global increase in thoracic interventions, there is greater emphasis on refining post-operative care. The purpose of this study was to validate the visual analogue scale (VAS) as the valid method for measuring post-operative pain in thoracic surgery patients. From January 2020 to June 2022, this cross-sectional study investigated 240 adult patients who underwent elective thoracic surgeries in Thoracic Surgery Department of Heilongjiang Provincial Hospital. The participants were instructed to rate their discomfort using VAS at predetermined intervals after surgery. The following demographic and clinical information was recorded: age, gender, type of thoracic surgery, and history of chronic pain. Results showed a progressive decline in post-operative VAS scores over 72 h: 8.2 immediately after surgery, 6.0 at 24 h, 5.4 at 48 h, and 3.6 by 72 h. There were notable correlations between VAS scores and chronic pain history, with moderately positive correlation of 0.40 being observed. Mean scores for males and females were 3.8 and 3.9, respectively. The analysis by age revealed comparable mean scores for age categories below and above 40. With the exception of thoracic wall resection, which resulted in an average VAS score of 4.1 ± 1.0 (p < 0.05), the type of surgery had the minimal effect on variability of pain scores. The VAS is a reliable method for evaluating post-thoracic surgery discomfort. Given the substantial impact of pain history on VAS scores, there is an urgent need for personalized pain management strategies to improve post-operative care.
by Chuan Bo Liang, Bin Cui, Fu Rong Wang, Jing Peng, Jian Ying Ma, Mei Yin Xu, Jun Ke, Yi Tian, Zi Qi Cui
Cooking methods can change the composition of foods and have important effects on human health. The Chinese people have developed many distinct and unique cooking methods. However, the daily cooking patterns of Chinese people and the characteristics and evolution of trends in cooking patterns commonly used by Chinese consumers remain unclear. The objective of this study was to identify the major cooking patterns and discuss their effects on human health, as well as to identify the cooking pattern consumer clusters and the evolution of trends in Chinese consumer cooking patterns. From March to June 2021, this study interviewed 4,710 residents in Eastern China regarding the consumption frequency of each cooking method when food is prepared at home or when eating out. Exploratory factor analysis, K-Means cluster analysis, Chi-square test, pairwise comparisons of multiple sample rates, and multivariate linear regression were used to identify the cooking patterns and cooking pattern consumer clusters, to assess differences in consumption preferences between consumer clusters, and to examine the relationship between demographic characteristic variables and different cooking patterns. Results revealed three major cooking patterns, namely traditional Chinese (cooking methods with native Chinese characteristics), bland, and high-temperature cooking patterns, as well as seven cooking pattern consumer clusters and their demographic characteristics in the Eastern Chinese population. With increases in age, education level, and income, consumers tended to choose the healthy “Bland” cooking pattern. Further, there was a higher proportion of people aged 36–65 years in the C3 cluster, which is characterized by the “Bland” cooking pattern. However, participants who were male and younger made fewer healthy choices in their cooking patterns. Specifically, a higher proportion of participants aged 21–35 years were found in the C5 cluster, which is characterized by the unhealthy “High-temperature” cooking pattern. Therefore, culinary health education should focus on individuals who are male and young. Specifically, the shift in cooking patterns among people aged 21–35 years should receive special attention.Common mental disorders, including depression, anxiety and related somatic health symptoms, are leading causes of disability worldwide. Especially in low-resource settings, psychosocial interventions delivered by non-specialist providers through task-sharing modalities proved to be valid options to expand access to mental healthcare. However, such interventions are usually eclectic multicomponent interventions consisting of different combinations of evidence-based therapeutic strategies. Which of these various components (or combinations thereof) are more efficacious (and for whom) to reduce common mental disorder symptomatology is yet to be substantiated by evidence.
Comprehensive search was performed in electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Register of Controlled Trials—CENTRAL from database inception to 15 March 2023 to systematically identify all randomised controlled trials that compared any single component or multicomponent psychosocial intervention delivered through the task-sharing modality against any active or inactive control condition in the treatment of adults suffering from common mental disorders. From these trials, individual participant data (IPD) of all measured outcomes and covariates will be collected. We will dismantle psychosocial interventions creating a taxonomy of components and then apply the IPD component network meta-analysis (IPD-cNMA) methodology to assess the efficacy of individual components (or combinations thereof) according to participant-level prognostic factors and effect modifiers.
Ethics approval is not applicable for this study since no original data will be collected. Results from this study will be published in peer-reviewed journals and presented at relevant conferences.
Background
Early palliative care (PC) has received more attention for improving health-related outcomes for advanced cancer patients in recent years, but the results of previous studies are inconsistent.
Objectives
This study aimed to use meta-analysis and trial sequence analysis to evaluate the effect of early PC on health-related outcomes of advanced cancer patients.
Methods
All English publications were searched in PubMed, Web of Science, Embase, and the Cochrane Library from inception to March 2023, with a restriction that the study type was a randomized controlled trial.
Results
The results showed that early PC positively affected quality of life, satisfaction with care, and symptom burden reduction. However, early PC had no significant effect on anxiety or survival. Trial sequence analysis results showed that the effect of early PC on the quality of life was stable.
Discussion
This systematic review suggested that early PC could positively affect health-related outcomes for advanced cancer patients. Early PC can be used widely in clinical settings to improve health-related outcomes of advanced cancer. However, because of the trial sequence analysis results, further well-designed, clinical, randomized controlled trials with larger sample sizes are necessary to draw definitive conclusions. Single-port laparoscopy (SPL) has existed for several years. This meta-analysis was conducted to evaluate the efficacy of SPL compared with conventional laparoscopy (CL) in the treatment of benign gynecologic adnexal lesions. The purpose of this meta-analysis is to evaluate the superiority of SPL versus CL in the treatment of post-operative wound pain. The study looked for English-language publications from PubMed, Embase, Cochrane Library and the Web of Science until June 2023. The main result was the visual analogue scale (VAS) after 2, 4, 6, 8, 12, 24 and 48 h after operation. The paper contains 10 related papers by means of e-search. Of these, 4 were randomized controlled trials (RCTs), while 6 were non-RCTs. The results indicated that SPL and CL were significantly different after 2, 24 and 48 h after operation. SPL had lower post-operative pain after 2 h compared with CL (MD, −0.6; 95% CI, −0.98, −0.21; p = 0.002). After the operation, SPL also had a lower incidence of post-operative pain after 24 h compared with CL (MD, −0.59; 95% CI, −1.12, −0.06; p = 0.03). And the difference in pain was at 48 h after the most significant (MD, −0.49; 95% CI, −0.75, −0.23; p = 0.0002). But after 6, 8 and 12 h after operation, there was no significant difference in the degree of pain. Thus, SPL operations may result in a lower degree of pain than CL in both the post-operative and far post-operative phase.
Distal tibial fracture is the most commonly seen type of fracture of the lower extremities. Both intramedullary nail fixation (INF) and plate fixation (PF) have been used to treat distal tibial fractures, but the best way to treat them is still in dispute. The purpose of this meta-analysis is to compare INF versus PF fixation with respect to the incidence of injury. For studies that have been published between inception and June 2023, a systematic review has been carried out on PubMed, Embase, Cochrane Library and Web of Scientific databases. All of the trials that looked at INF and PF-related complications were enrolled. Data from the 13 primary results were analysed with RevMan 5.3. The meta-analyses comprised 13 randomized controlled trials (RCTs). INF indicates that there is a tendency for patients with distal tibia fractures to reduce the risk of operative site infection (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.40, 3.13; p = 0.0003) after surgery compared with PF. INF resulted in a reduction in total wound complications (OR, 14.20; 95% CI, 1.81, 111.57; p = 0.01) but shortened operation time (mean difference, 13.03; 95% CI, 2.08, 23.99; p = 0.02). In view of these findings, INF seems to be a preferred method of surgery for the treatment of distal tibial fractures with respect to the reduction of post-operative wound complications.
Dexmedetomidine has been demonstrated to be effective in the management of pain in total knee replacement (TKA). Nevertheless, a combination of a local anaesthetic and a dose of dexmedetomidine might be a better choice for post-operative pain management of TKA. The aim of this research is to determine if the combination of a local anaesthetic with dexmedetomidine during a knee replacement operation can decrease the post-operation pain. Furthermore, the effectiveness and security of dexmedetomidine combined with topical anaesthetic were evaluated for the management of post-operative TKA. Based on the research results, the author made a research on the basis of four big databases. The Cochrane Handbook on Intervention Systems Evaluation has also evaluated the quality of the literature. Seven randomized controlled trials have been established from this. It was found that the combination of local anaesthesia and dexmedetomidine had a greater effect on postoperative pain in 4 h (mean difference [MD], −0.9; 95% CI, −1.71, −0.09; p = 0.03), 8 h (MD, −0.52; 95% CI, −0.66, −0.38; p < 0.0001), 12 h (MD, −0.72; 95% CI, −1.04, −0.40; p < 0.0001), 24 h (MD, −0.49; 95% CI, −0.83, −0.14; p = 0.006), 48 h (MD, −0.51; 95% CI, −0.92, −0.11; p = 0.01). Nevertheless, because of the limited number of randomized controlled trials covered by this meta-analysis, caution should be exercised with regard to data treatment. More high quality research will be required to confirm the results.
Fast track surgery (FTS) is widely used in many procedures and has been shown to reduce complications and accelerate recovery. However, no studies have been conducted to assess their effectiveness in treating wounds after radical prostatectomy (RP). The objective of this study was to evaluate the impact of FTS on RP. We went through 4 major databases. A study was conducted by PubMed, the Cochrane Library, Embase, and the Web of Science to determine the effect of comparison of FTS versus conventional surgery in RP on postoperative wound complications as of 1 July 2023. Based on the review of literature, data extraction and literature quality assessment, we conducted meta-analyses with RevMan 5.3. In the course of the study, the researchers selected 6 of the 404 studies to be analysed according to exclusion criteria. Data analysis showed that the FTS method reduced the postoperative pain associated with VAS and also decreased the rate of postoperative complications in post-surgical patients. However, there was no significant difference between FTS and conventional surgery in terms of blood loss, operation time, and postoperative infection rate. Therefore, generally speaking, FTS has less impact on postoperative complications in patients with minimal invasive prostatic cancer, but it does reduce postoperative pain and total postoperative complications.
This analysis systematically reviewed the efficacy of evidence-based care on diabetic foot ulcers. A computerised literature search was conducted for randomised controlled studies (RCTs) of evidence-based care interventions for the treatment of diabetic foot ulcers using the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM) and Wanfang databases from the date of inception of each database to June 2023. The articles were independently screened, data were extracted by two researchers, and the quality of each study was assessed using the Cochrane bias assessment tool. Meta-analysis of the data was performed using RevMan 5.4 software. Twenty-five RCTs with a total of 2272 patients were included. Meta-analysis showed that, compared with other care methods, evidence-based care significantly improved the treatment efficacy of diabetic foot ulcers (odds ratio: 3.91, 95% confidence interval [CI]: 2.76 to 5.53, p < 0.001) and significantly reduced their fasting plasma glucose (mean difference [MD]: −1.10, 95% CI: −1.24 to −0.96, p < 0.001), 2-h postprandial glucose (2hPG) (MD: −1.69, 95% CI: −2.07 to −1.31, p < 0.001) and glycated haemoglobin (HbA1c) (MD: −0.71, 95% CI: −0.94 to −0.48, p < 0.001). Evidence-based care intervention is effective at reducing FPG, 2hPG and HbA1c levels and improving treatment efficacy in patients with diabetic foot ulcers.
Objetivo principal: Determinar el nivel agencia de autocuidado de las enfermeras durante pandemia de Covid-19 en Chile y su asociación con variables sociodemográficas, laborales y hábitos de salud. Metodología: Se realizó un estudio cuantitativo, asociativo, de corte transversal en una muestra de 343 enfermeros. Para la recolección de datos se utilizó una encuesta de antecedentes sociodemográficos, laborales, hábitos de salud y la Escala de Valoración de Agencia de Autocuidado, aplicados mediante formulario de Google Forms. Resultados principales: El 46,9% de los participantes presentó una baja capacidad de agencia de autocuidado, obteniendo una asociación estadísticamente significativa entre la actividad física y horas de sueño con el nivel de agencia de autocuidado de las enfermeras. Conclusión principal: Se concluye que durante la pandemia Covid-19 el mayor porcentaje de enfermeros clínicos presentó un bajo nivel de agencia de autocuidado asociado a una baja actividad física y reducidas horas de sueño.
FreshRSS 