Implementation of early prophylaxis for deep-vein thrombosis in intracerebral hemorrhage patients: an observational study from the Chinese Stroke Center Alliance.

BACKGROUND: There is substantial evidence to support the use of several methods for preventing deep-vein thrombosis (DVT) following intracerebral hemorrhage (ICH). However, the extent to which these measures are implemented in clinical practice and the factors influencing patients' receipt of preventive measures remain unclear. Therefore, we aimed to evaluate the rate of the early implementation of DVT prophylaxis and the factors associated with its success in patients with ICH. METHODS: This study enrolled 49,950 patients with spontaneous ICH from the Chinese Stroke Center Alliance (CSCA) between August 2015 and July 2019. Early DVT prophylaxis implementation was defined as an intervention occurring within 48 h after admission. Univariate and multivariate logistic regression analyses were conducted to identify the rate and factors associated with the implementation of early prophylaxis for DVT in patients with ICH. RESULTS: Among the 49,950 ICH patients, the rate of early DVT prophylaxis implementation was 49.9%, the rate of early mobilization implementation was 29.49%, and that of pharmacological prophylaxis was 2.02%. Factors associated with an increased likelihood of early DVT prophylaxis being administered in the multivariable model included receiving early rehabilitation therapy (odds ratio [OR], 2.531); admission to stroke unit (OR 2.231); admission to intensive care unit (OR 1.975); being located in central (OR 1.879) or eastern regions (OR 1.529); having a history of chronic obstructive pulmonary disease (OR 1.292), ischemic stroke (OR 1.245), coronary heart disease or myocardial infarction (OR 1.2); taking antihypertensive drugs (OR 1.136); and having a higher Glasgow Coma Scale (GCS) score (OR 1.045). Conversely, being male (OR 0.936), being hospitalized in tertiary hospitals (OR 0.778), and having a previous intracranial hemorrhage (OR 0.733) were associated with a lower likelihood of early DVT prophylaxis being administered in patients with ICH. CONCLUSIONS: The implementation rate of early DVT prophylaxis among Chinese patients with ICH was subpar, with pharmacological prophylaxis showing the lowest prevalence. Various controllable factors exerted an impact on the implementation of early DVT prophylaxis in this population.

Efficacy of an Omaha system-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders (WMSDs) - A randomized controlled study.

Purpose: Heavy biomechanical loadings at workplaces may lead to high risks of work-related musculoskeletal disorders. This study aimed to explore the efficacy of an Omaha System-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders among frontline nurses. Materials and methods: From July to October 2020, 94 nurses with self-reported pain in one of the three body parts, i.e., neck, shoulder, and low back, were selected and were randomly divided into two groups. The intervention group received a newly developed remote program, where the control group received general information and guidance on health and life. Program outcome was evaluated by a quick exposure check approach. Results: After 6 weeks, the intervention group exhibited significantly less stress in the low back, neck, and shoulder/forearms, compared to the control group (p < 0.05). In addition, the occurrence of awkward postures, such as extreme trunk flexion or twisting, was also significantly reduced (p < 0.05). Conclusions: The newly developed Omaha System-based remote intervention program may be a valid alternative to traditional programs for frontline nurses during the COVID-19 pandemic, reducing biomechanical loadings and awkward postures during daily nursing operations.

Comparison of complications and indwelling time of midline catheter at different tip locations: A systematic review and meta-analysis.

This review was performed to determine whether different tip locations of a midline catheter can cause differences in the incidence of complications and the catheter indwelling time. PubMed, Embase, Web of Science, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), and Wanfang were systematically searched. RevMan 5.3 software was used for the meta-analysis. Heterogeneity was evaluated, and the mean differences or odds ratios with 95% confidence intervals were calculated. Eight studies met the inclusion criteria. The meta-analysis showed statistically significant differences in the complication rates (OR = 0.53; 95% CI = 0.34-0.84; p = 0.006) and incidence of catheter-related thrombosis (OR = 0.29; 95% CI = 0.11-0.76; p = 0.01) between midline catheter tip positioning in the subclavian vein and axillary vein. There were no significant differences in the catheter indwelling time or other complications such as phlebitis, catheter-related occlusion, catheter-related infiltration, pain, and catheter dislodgement between midline catheter tip positioning in the subclavian vein and axillary vein. There were statistically significant differences in the complication rates (OR = 0.23; 95% CI = 0.36-0.57; p < 0.001), incidence of catheter-related occlusion (OR = 0.29; 95% CI = 0.10-0.83; p = 0.02), and incidence of catheter-related infiltration (OR = 0.33; 95% CI = 0.17-0.63; p < 0.001) between midline catheter tip positioning in the proximal and distal axillary vein. Placement of the midline catheter tip in the subclavian vein was superior to that in the axillary vein in terms of complication rates and the incidence of catheter-related thrombosis. Whether different midline catheter tip locations lead to differences in the catheter indwelling time or the rates of other complications remains unclear. More high-quality studies incorporating relevant outcomes are needed for confirmation.

Prevalence of Work-Related Musculoskeletal Disorders among Nurses: A Meta-Analysis.

Background: Work-related musculoskeletal diseases (WMSDs) have a greater negative impact on nurses' physical and mental health. However, the epidemiologic characteristics of nurse WMSDs are unclear, and the reported prevalence of WMSDs varies widely. The aim of this meta-analysis was to provide a quantitative synthesis of WMSDs' prevalence in nurses and estimate the pooled prevalence of its. Methods: The PubMed, ScienceDirect, Web of Science, Cochrane Library, EMBASE, CINAHL, Ovid, WANFANG, VIP, China Knowledge Integrated, and CBM databases were searched for relevant studies. The retrieval period extended from database initiation to Mar 2022. After data extraction and quality assessment, a meta-analysis was performed using the Stata 16.0 software package. Results: Overall, 42 articles were included, yielding a total sample size of 36,934. The annual prevalence of WMSDs among nurses was found to be 77.2% (95% confidence interval: 0.725-0.819). The three anatomical areas with the highest prevalence of WMSDs among nurses were the lower back (at 59.5%), neck (at 53.0%) and shoulder (at 46.8%). Nurses in developed countries have a higher prevalence of WMSDs than those in developing countries. Conclusion: There was currently moderate evidence to suggest a high prevalence of WMSDs in nurses. National policies should aim to reduce their prevalence in this population.

Predictors and outcomes of deep venous thrombosis in patients with acute ischemic stroke: results from the Chinese Stroke Center Alliance.

BACKGROUND: No large-scale, multicenter studies have explored the incidence rate and predictors of deep vein thrombosis (DVT) in patients with acute ischemic stroke (AIS). We aimed to determine the risk factors of DVT, and assess the association between DVT and clinical outcomes in AIS patients. METHODS: In total, 106,612 patients with AIS enrolled in the Chinese Stroke Center Alliance between August 2015 and July 2019 were included. The predictors of DVT in AIS patients were screened based on the logistic regression analysis for the comparison of the characteristics and clinical outcomes of patients with and without DVT. RESULTS: The overall incidence of DVT after AIS was 4.7%. Factors associated with increased incidence of DVT included advanced age, female sex, high admission National Institutes of Health Stroke Scale score, history of cerebral hemorrhage, transient ischemic attack (TIA), dyslipidemia, atrial fibrillation, and peripheral vascular disease, International Normalized Ratio (INR) <0.8 or >1.5, and blood uric acid >420 µmol/L. Ambulation and early antithrombotic therapy were associated with a lower incidence of DVT. Patients with DVT was associated with longer hospital stay (OR=1.44, 95% CI: 1.35-1.54), and higher in-hospital mortality (OR=1.68, 95% CI: 1.25-2.27). CONCLUSIONS: This large-scale, multi-center study showed that the occurrence of DVT in AIS patients is associated with various modifiable and objective indicators, such as abnormal INR and uric acid >420 µmol/L. Ambulatory status and early antithrombotic therapy can reduce the occurrence of DVT in AIS patients. In AIS patients, DVT may prolong the hospital stay and increase the risk of in-hospital mortality. Future research should focus on the clinical implementation of existing evidence on DVT prevention in AIS patients.

Comparative efficacy of 12 non-drug interventions on non-specific chronic low back pain in nurses: A systematic review and network meta-analysis.

BACKGROUND: Many non-drug interventions for decreasing non-specific chronic low back pain (NSCLBP) in nurses have been extensively studied, but the most effective approach is still unclear. OBJECTIVE: This systematic review and network meta-analysis evaluated the efficacies of 12 non-drug interventions in reducing NSCLBP in nurses. METHODS: PubMed, ScienceDirect, Web of Science, Cochrane, EMBASE, CINAHL, Medline, WANFANG, VIP, China Knowledge Integrated, and SinoMed were searched from their establishment to July 2019. Randomized controlled trials (RCTs) comparing non-drug interventions for NSCLBP in nurses were included and analyzed using Stata v15 statistical software. RESULTS: A total of 31 RCTs (n= 7116) and 12 non-drug interventions were included. The first three results with the highest surface areas under the curve ranking area (SUCRAs) were low back exercise plus healthy education, single low back exercise, and yoga (SUCRAs: 79.4%, 76.2%, and 75.1%, respectively). In addition, single yoga was inferior to protective equipment (standardized mean difference [SMD] = 3.88, 95% confidence interval [CI]: 0.92 to 6.84) and multidisciplinary intervention (SMD =-4.06, 95% CI: -7.33 to -0.78). CONCLUSIONS: Low back exercise plus health education may be the best approach to reduce NSCLBP in nurses. Considering the heterogeneity, our findings need to be confirmed in future multicenter large sample RCTs in different countries.

The factors of non-specific chronic low back pain in nurses: A meta-analysis.

BACKGROUND: Numerous studies have investigated factors for non-specific chronic low back pain (NSCLBP) in nurses, and have reached different conclusions. Evidence-based recommendations are required for the prevention and treatment of NSCLBP in nurses. OBJECTIVE: This meta-analysis aimed to systematically review and quantify the factors of NSCLBP in nurses. METHODS: Eleven databases were searched. The odds ratios (OR) with 95% confidence intervals (CIs) were pooled using meta-analysis, and either a fixed-effect or random-effect model was used based on heterogeneity across included studies. RESULTS: Eighteen publications including 11,752 nursing staff were included. Being female (pooled estimate [95% CI], 1.56 [1.24-1.96]; P< 0.001), married (1.89 [1.38-2.60]; P< 0.001), overweight (0.63 [0.43-0.93]; P= 0.02), working at least 10 years (0.65 [0.48-0.89]; P= 0.007), and working night shifts (2.19 [1.16-4.21]; P= 0.02) were positively related to NSCLBP. Junior college education (0.60 [0.47-0.77]; P< 0.001) and job satisfaction (0.58 [0.47-0.73]; P< 0.001) were negatively related. Age (0.80 [0.50-1.27]; P= 0.34) and physical exercise (0.99 [0.39-2.49]; P= 0.98) were not related. CONCLUSIONS: This is the first meta-analysis to quantify the risk factors for NSCLBP in nurses. Being female, married, working night shifts, overweight, working at least 10 years and dissatisfied with work are risk factors. High-quality prospective studies are required to validate the findings of this study.

In vivo evaluation of an antibacterial coating containing halogenated furanone compound-loaded poly(l-lactic acid) nanoparticles on microarc-oxidized titanium implants.

To prevent peri-implant infection, a new antibacterial coating containing a halogenated furanone compound, (Z-)-4-bromo-5-(bromomethylene)-2(5H)-furanone-loaded poly(l-lactic acid) nanoparticles, has been fabricated. The current study was designed to evaluate the preventive effect of the antibacterial coating under a simulated environment of peri-implant infection in vivo. Microarc-oxidized titanium implants treated with minocycline hydrochloride ointment were used as positive control group, and microarc-oxidized titanium implants without any treatment were used as blank control group. Three kinds of implants were implanted in dogs' mandibles, and the peri-implant infection was simulated by silk ligation and feeding high sugar diet. After 2-month implantation, the results showed that no significant differences were detected between the experimental and positive control groups (P>0.05), but the data of clinical measurements of the blank control group were significantly higher than those of the other two groups (P<0.05), and the bone-implant contact rate and ultimate interfacial strength were significantly lower than those of the other two groups (P<0.05). Scanning electron microscope observation and histological examination showed that more new bone was formed on the surface of the experimental and positive control groups. It can be concluded that the antibacterial coating fabricated on implants has remarkable preventive effect on peri-implant infection at the early stage.

Antibacterial activity and biological performance of a novel antibacterial coating containing a halogenated furanone compound loaded poly(L-lactic acid) nanoparticles on microarc-oxidized titanium.

Titanium implants have been widely used for many medical applications, but bacterial infection after implant surgery remains one of the most common and intractable complications. To this end, long-term antibacterial ability of the implant surface is highly desirable to prevent implant-associated infection. In this study, a novel antibacterial coating containing a new antibacterial agent, (Z-)-4-bromo-5-(bromomethylene)-2(5H)-furanone loaded poly(L-lactic acid) nanoparticles, was fabricated on microarc-oxidized titanium for this purpose. The antibacterial coating produced a unique inhibition zone against Staphylococcus aureus throughout a 60-day study period, which is normally long enough to prevent the infection around implants in the early and intermediate stages. The antibacterial rate for adherent S. aureus was about 100% in the first 10 days and constantly remained over 90% in the following 20 days. Fluorescence staining of adherent S. aureus also confirmed the excellent antibacterial ability of the antibacterial coating. Moreover, in vitro experiments showed an enhanced osteoblast adhesion and proliferation on the antibacterial coating, and more notable cell spread was observed at the early stage. It is therefore concluded that the fabricated antibacterial coating, which exhibits relatively long-term antibacterial ability and excellent biological performance, is a potential and promising strategy to prevent implant-associated infection.

Identifying high-risk areas of bacillary dysentery and associated meteorological factors in Wuhan, China.

Spatial distribution of bacillary dysentery incidence was mapped at the district level in Wuhan, China. And a generalized additive time series model was used to examine the effect of daily weather factors on bacillary dysentery in the high-risk areas, after controlling for potential confounding factors. Central districts were found to be the high-risk areas. The time series analysis found an acute effect of meteorological factors on bacillary dysentery occurrence. A positive association was found for mean temperature (excess risk (ER) for 1°C increase being 0.94% (95% confidence interval (CI): 0.46% to 1.43% on the lag day 2), while a negative effect was observed for relative humidity and rainfall, the ER for 1% increase in relative humidity was -0.21% (95% CI: -0.34% to -0.08%), and the ER for 1 mm increase in rainfall was -0.23% (95% CI: -0.37% to -0.09%). This study suggests that bacillary dysentery prevention and control strategy should consider local weather variations.

[Clinical evaluation of the effect of gold alloy and Ni-Cr alloy porcelain fused metal crown restorations].

PURPOSE: To observe the clinical effect of gold alloy porcelain fused metal (PFM) crown restoration and Ni-Cr alloy PFM crown restoration. METHODS: A total of 168 teeth from 48 patients were restored with gold alloy PFM crown. The other 48 patients, with a total of 179 teeth were restored with Ni-Cr alloy PFM crown. They were examined in integrality, retention, shade, cervical margin, and gingival health immediately, 6 months, one year, two years ,and three years after restoration. The date was analyzed by rank sum test using SPSS12.0 software package. RESULTS: The clinical effect of Ni-Cr alloy PFM crown was as good as gold alloy PFM crown when checked up after cementation at once. However, when they were examined 6 months, one year, two years ,and three years after restoration, the clinical effect of gold alloy PFM crown group was significantly better than that of Ni-Cr alloy PFM crown, P<0.05. CONCLUSION: The gold alloy PFM crown has better properties than Ni-Cr alloy PFM crown as a kind of long-term restoration, especially on the aspect of shade.