Wen Tang

Background : Although physical exercise has been proven to yield beneficial outcomes for individual health, the dose–response association between physical exercise time and depression among adolescents remains unclear. This study aimed to investigate the association between exercise time and depression among adolescents, as well as the dose–response relationship. Methods : A logistic regression analysis was conducted to determine the correlation between physical exercise time and depression among adolescents. The model controlled for age, ethnicity, economic status, parental relationship, divorce, being an only child, and sleep time. A restricted cubic spline model was used to examine the nonlinear dose–response relationship. Results : A significant inverse correlation was demonstrated between adolescents’ physical exercise time and depression ( P = .014). Both insufficient exercise (odds ratios = 1.27; 95% CI, 0.98–1.65; P = .072) and excessive level (odds ratios = 2.14; 95% CI, 1.03–4.47; P = .041) showed positive associations with depression. Restricted cubic spline analysis indicated that appropriate exercise (2.0–9.5 h/wk) may prevent depression, while excessive exercise (>9.5 h/wk) may exacerbate it ( P -nonlinear < .001, P -overall < .001). Conclusions : Low physical exercise time is associated with higher risk for depressive symptoms in adolescents, whereas excessive exercise is also associated with higher risk of depression, particularly in boys. The findings of this study underscore the importance of adolescents increasing their physical exercise time, but also maintaining a balance to avoid excessive exercise.

Device‐related pressure injuries (DRPIs) prevail in the intensive care unit (ICU) and have much to do with medical devices and patients’ conditions. This meta‐analysis aims to systematically assess the incidence, prevalence and risk factors related to DRPIs among adults in ICU. Web of Science, Cochrane Library, MEDLINE, PubMed and CINAHL were searched from inception to March 2023. Observational studies were included, and the Newcastle‐Ottawa scale (NOS) was used to assess literature quality. The primary outcomes were the incidence, prevalence and risk factors regarding DRPIs among adults in ICU. The 19 studies conformed to the criteria for inclusion in the review. The estimated pooled incidence of DRPIs was 14.7% (95% CI: 9.7%–19.6%) in 10 studies (4866 participants). The estimated pooled prevalence of DRPIs was 19.0% (95% CI: 13.6%–24.3%) in 9 studies (5218 participants). The most significant risk factor for DRPIs was using mechanical ventilation. The pooled analysis of the four studies showed that DRPIs were more likely to occur in patients who required mechanical ventilation compared with patients who did not use mechanical ventilation (OR: 9.67, 95% CI: 5.03–18.61, p < 0.001) and using vasopressors, age, length of ICU stays, APACHE II score, Braden score, fever, sex, oedema, diabetes and number of medical devices, SOFA score was also related to pressure injuries risk. The incidence and prevalence of DRPIs in adult ICU were high, and the most significant risk factor for DRPIs was using mechanical ventilation. It is imminent to identify patients of increased risk with DRPIs early.

Aims and Objectives: To determine the global prevalence of nursing burnout syndrome and time trends for the last 10 years.Background: The prevalence of burnout syndrome varied greatly in different regions in the last 10 years, so the average prevalence and time trends of nursing burnout syndrome for the last 10 years were not completely clear.Design: A meta‐analysis conducted in the PRISMA guidelines.Methods: CINAHL, Web of Science, and PubMed were searched for trials on the prevalence of nursing burnout syndrome from 2012 to 2022 systematically. Hoy's quality assessment tool was used to evaluate the risk of bias. The global prevalence of nursing burnout syndrome was estimated, and subgroup analysis was used to explore what caused heterogeneity. Time trends for the last 10 years were evaluated by meta‐regression using Stata 11.0.Results: Ninety‐four studies reporting the prevalence of nursing burnout were included. The global prevalence of nursing burnout was 30.0% [95% CI: 26.0%–34.0%]. Subgroup analysis indicated that the specialty (p < .001) and the region (p < .001) and the year (p < .001) were sources of the high heterogeneity. Meta‐regression indicated that it tended to increase gradually for the last 10 years (t = 3.71, p = .006). The trends increased in Europe (t = 4.23, p = .006), Africa (t = 3.75, p = .006) and obstetrics (t = 3.66, p = .015). However, no statistical significance was found in ICU (t = −.14, p = .893), oncology (t = −0.44, p = .691) and emergency department (t = −0.30, p = .783).Conclusions: A significant number of nurses were found to have moderate‐high levels of burnout syndrome for the last 10 years. The meta‐analysis also indicated an increased trend over time. Therefore, more attention to the prevalence of nursing burnout syndrome is urgently required.Relevance to Clinical Practice: High prevalence of nursing burnout may attract more attention from the public. This analysis may serve as an impetus for relevant policy to change nurses' working conditions and reduce the occurrence of burnout.

The present study was designed to determine the association between Acute Physiology and Chronic Health Evaluation (APACHE) scale and elevated pressure injure (PI) risk in intensive care units (ICU) and also evaluate the predictive value of APACHE score in PI patients. Comprehensive strategies were used to search studies from PubMed, Web of Science, and Ovid Embase electronic databases for observational studies that provided data about APACHE scores related to PI in ICU. Eligible studies were selected based on inclusion and exclusion criteria. The pooled SMD with 95% confidence intervals were calculated. A summary ROC curve was plotted to calculate area under curve (AUC) for APACHE-II (15-20). Twenty-one studies involving 11,102 patients who met selection criteria were included. The 11.0% of patients (1229/11102) in ICU developed PIs. Overall, the PI group had a higher score compared with the non-PI group in the APACHE II (22.1 ± 8.0 vs. 14.5 ± 7.4, mean ± SD). The APACHE-III of PI patients was significantly more than that in the non-PI group (79.9 ± 25.6 vs. 59.9 ± 30.4, mean ± SD). The pooled SMD was 0.82 (95% CI: 0.58-1.06, I² = 91.7%, p-value < 0.001). The subgroup analysis revealed that the risk of PIs did not vary with the type of APACHE score (II, III, IV) and the type of study design (case-control, cross-sectional, cohort, longitudinal study). Proportion of males (I² = 91.68%, p value = 0.090), publish year (I² = 91.96%, p value = 0.187) and mean age of patients (I² = 91.96%, p value = 0.937) were not the sources of heterogeneity. APACHE-II (15-20) achieves the best predictive performance in PI, and the prediction accuracy was balanced with equal sensitivity and specificity (Sen: 0.72, 0.62-0.80; Spec: 1.72, 1.25-2.38). In conclusion, higher APACHE scores are frequently accompanied by a higher incidence of PI among critical-care patients. APACHE-II scores (15-20) satisfactorily predicted PI, and strategies to prevent PI should be aggressively implemented.

Wen Tang, MM, Hong-Lin Chen, PhD; Predictors of SARS-CoV-2 infection: is there a comprehensive analysis?, Clinical Infectious Diseases, , ciac099, https://doi.o

Purpose To explore the high-risk period of the occupation of suicide after diagnosis; and clarify the risk factors of suicidal behaviors (suicidal ideation, suicide attempt, and suicidal death) behind the lung cancer patients during the cancer cure process. Methods This scoping review was conducted through the whole month of April 2021. We extracted data of the suicide mortality after diagnosis and latent risk factors of suicidal behaviors among lung cancer patients where we used to study from the two online databases which are PubMed and Web of Science. Two online databases were searched and written in English without age restriction. To note that the standardized mortality ratio (SMR), person-years, and odds ratio (OR) associated with lung cancer were documented. Results Out of 570 records, 23 studies mentioned suicidal behaviors and lung cancer met the included criteria. Eleven (n = 47.8%) of the selected publications reported changes in suicide mortality. None of them reported suicidal ideation or suicide attempt after diagnosis. The individuals with lung cancer have significantly higher rates of suicidal death (SMR, 2.04–13.4) during the first years after diagnosis and decrease over subsequent years (SMR, 0.66–3.17). The median time from cancer diagnosis to suicide death was around 7 months. Across all studies with the 22 studies that examined factors, we extracted the data of the suicidal ideation (n = 3), suicide attempt (n = 1), and suicidal death (n = 18) in individuals. For patients with suicidal ideation, there was a significantly higher incidence in males than in females. Among patients who attempted suicide, the incidence of mental illness is greater than the incidence of physical illness. Factors for suicidal death, including gender (male, 56.3–100%), prognosis tumors (poor, 25.8–66.3%), marital status (widowhood or unmarried, 19–75.7%), and age of patients (> 70 years, 24.5–47%) with lung cancer, play a vital role. Treatment of lung cancer is expected to affect a patient in his/her mental state. Conclusion Overall, our finding indicates that lung cancer patients have been presented with a higher incidence of suicide death in a specific period, especially the early years after diagnosis. Discovering risk factors for suicide helps prevent potential suicide. It is essential to screen lung cancer patients for suicidal ideation, especially those with high-risk factors. Future prospective studies are necessary to confirm these findings to support care.