Haifang Wang

Post-extubation dysphagia (PED) is a prevalent and debilitating complication in intensive care unit (ICU) patients, yet the longitudinal heterogeneity of swallowing recovery remains poorly understood. This study was aimed to characterize distinct recovery trajectories of swallowing function in ICU patients with PED and to identify the clinical predictors associated with each pattern. This longitudinal observational study utilized convenience sampling to enroll ICU patients from a tertiary hospital. Swallowing function was evaluated using the Standard Swallowing Assessment (SSA) at seven time points post-extubation, at 4-6, 24, 48, and 72 h and 7, 14, and 28 days. Latent recovery trajectories were identified using growth mixture modeling (GMM), and independent predictors of group membership were determined by multivariate logistic regression. Of 495 intubated patients, 248 (54.98%) developed PED and were included; 209 completed all follow-up assessments. Three distinct trajectories emerged: Group HS (high level, slow improvement; 10.0%), Group HR (high level, rapid improvement; 22.5%), and Group LE (low level, early recovery; 67.5%). For both Group HR and Group HS, membership was predicted by older age, neurological diagnosis, higher peak inspiratory pressure, longer intubation duration, and early pharyngeal pain. In addition, membership in Group HR was uniquely associated with an APACHE II score of 10-14 and exposure to fiberoptic bronchoscopy. Post-extubation swallowing recovery follows distinct trajectories shaped by physiological, procedural, and disease-related factors. Early trajectory identification allows for personalized, stage-specific interventions to optimize functional outcomes and mitigate long-term morbidity.

Background: Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses’ specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects.Methods: Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training.Results: The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066,P < 0.001) and physical violence (Wald χ² = 9.100,P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05).Conclusions: The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses’ WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.

Objective: Although several studies have examined the association between estradiol and human aggression, a consistent understanding of their correlation has yet to be established. This study aimed to investigate this relationship comprehensively. Methods: We systematically searched five English databases (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) from their inception to June 5, 2023. Two authors independently screened publications and extracted data based on predefined inclusion and exclusion criteria. Statistical analyses were performed using Review Manager 5.4, and a random-effects model was used to pool the data. Results: We identified 14 eligible studies comprising data from 1820 participants that met the inclusion criteria. This meta-analysis indicated a positive correlation between estradiol and human aggression, albeit a weak one. The pooled Fisher z value was 0.16 (95% confidence interval = 0.05–0.26; I ² = 73%, p<.00001). Furthermore, we found that participants’ sex and age, the measures of aggression, and the literature quality might be sources of heterogeneity. Conclusions: Human aggression exhibited a weak positive correlation with estradiol concentration, whereas this relationship was influenced by participants’ sex and age, the measure of aggression used, and the quality assessment of the literature. Gaining a better understanding of the association between estradiol and aggression could aid in the identification of populations prone to aggression.

Background: Workplace violence (WPV) among nurses has become an increasingly serious public health issue worldwide. Investigating the status quo and characteristics of WPV among nurses in different time periods can help hospital managers understand the current status of WPV and its trends over time. This study aimed to understand the current situation of WPV among nurses in Suzhou general hospitals from 2010 to 2019 and analyze changes over time. Methods: A cross-sectional study was conducted to investigate 942, 2,110 and 2,566 nurses in 6 fixed polyclinic hospitals in Suzhou in 2010, 2015 and 2019, respectively. This study used the revised version of the hospital WPV questionnaire. The count data are described as frequencies and percentages, and the measurement data are represented as means and standard deviations. The general data of nurses during different time periods, the incidence of WPV, nurses’ cognition and attitudes toward WPV and the attitudes and measures of hospitals regarding WPV were analyzed by the chi-square test. Results: The incidence of WPV among nurses in Suzhou general hospitals in 2015 (69.0 %) and in 2019 (68.4 %) was higher than the incidence of 62.4 % in 2010 (PP˂0.05). Nurses who participated in the surveys in 2015 and 2019 scored higher on “having heard of WPV before”, “thinking WPV coping management organizations are needed” and “supporting a zero-tolerance policy” than those who participated in 2010 (PP<0.005). Conclusions: Despite an increase in nurses’ awareness and attitudes regarding WPV and significant improvements in hospitals’ attitudes and responses to WPV, the incidence of WPV remains high. Hospitals should continue to explore scientific training modes that are in accordance with the needs of nurses to reduce the incidence of WPV.

Objectives: This study investigated the clinical efficacy and safety of metformin hydrochloride sustained-release (SR) tablet (II) produced by Dulening and the original metformin hydrochloride tablet produced by Glucophage in the treatment of type 2 diabetes mellitus (T2DM). Methods: This randomized, open and parallel controlled clinical trial consecutively recruited a total of 886 patients with T2DM in 40 clinical centers between May 2016 and December 2018. These patients were randomly assigned to the Dulening group (n=446), in which patients were treated with Dulening metformin SR tablets, and the Glucophage group (n=440), in which patients were treated with Glucophage metformin tablets, for 16 weeks. The changes in the levels of glycated hemoglobin (HbAc1) and fasting blood glucose (FBG) as well as weight loss were compared between these two groups. Also, the overall incidence of adverse drug reactions (ADRs) and the incidence of ADR of the gastrointestinal system observed in patients of these two groups were also compared. Results: There were no significant differences in demographic and basal clinical characteristics between these two groups. The Dulening and Glucophage groups showed comparable levels of decrease in HbA1c levels, FBG and weight loss after 12-week treatment (all p>0.05). The Dulening group had a significantly lower overall incidence of ADRs as well as gastrointestinal ADR than the Glucophage group. Conclusions: Metformin SR tablets (II) and the original metformin tablets exhibit similar therapeutic efficacy in the treatment of T2DM, but metformin SR tablets (II) has the significantly lower incidence of ADRs than the original metformin tablets.

Previous studies on the relationship between the circulating level of interleukin‐17 (IL‐17) and disease activity in systemic lupus erythematosus (SLE) were contradictory. This study is aimed at quantitatively assessing the correlation between the circulating IL‐17 level and disease activity in SLE patients. A systematic search for related literature was conducted via PubMed, Web of Science, EMBASE, and Cochrane Library (up to January 26, 2021). The relationship between circulating IL‐17 levels and SLE activity was evaluated using Fisher’s z value, which was then converted to r. The standardized mean difference (SMD) and its 95% confidence interval (CI) were used to describe the difference between the circulating IL‐17 level in patients with active and inactive SLE. STATA 16.0 was used to perform statistical analysis. Random‐effects model was performed to synthesize data. Twenty‐six studies involving 1,560 SLE patients were included in this review. The pooled r value was 0.38 (95% CI: 0.25‐0.50; I² = 83.8%, P < 0.001) between the SLE activity and circulating level of IL‐17. Patients with active SLE had higher level of circulating IL‐17 than that of inactive (pooled SMD = 0.95, 95% CI: 0.38‐1.53; I² = 90.5%, P < 0.001). The subgroup analysis suggested that the region and detection method of circulating IL‐17 might not be a source of heterogeneity. No significant publication bias was found. In summary, circulating IL‐17 level has a low positive relationship with SLE activity. It is necessary to carefully consider the use of circulating IL‐17 as a biomarker of the disease activity in SLE patients. The relationship between the circulating level of IL‐17 and SLE activity should be further confirmed in randomized controlled studies.

Dietary patterns, which reflect overall diet and possible nutrient and food interactions, have been reported to be related to ovarian cancer (OC) risk. However, studies on the relationship between dietary patterns and OC risk have been inconsistent. Thus, we carried out a systematic meta-analysis to assess the relationship between dietary patterns and the risk of OC. Relevant studies are identified by searching the Medline and Embase electronic databases up to December 2016. The Cochrane Q statistic and the I ² statistical were used to evaluate heterogeneity. A total of 22 studies fulfilled the inclusion criteria and were included in this meta-analysis. There was evidence of a decreased risk for OC in the highest versus the lowest categories of healthy dietary pattern [odds ratio (OR)=0.86; 95% confidence interval (CI): 0.74–0.99; P=0.04]. An increased risk of OC was shown for the highest versus the lowest category of a western-style dietary pattern (OR=1.19; 95% CI: 1.01–1.41; P=0.04). No significant association with OC risk was observed in the highest versus the lowest category of a heavy drinking pattern (OR=0.89; 95% CI: 0.67–1.19; P=0.42). The results of this meta-analysis suggest that a healthy dietary pattern is associated with reduced risk for OC and a western-style dietary pattern is associated with an increased risk of OC. Further studies are needed to confirm our results.