Factors Associated with Secondary Traumatic Stress among Emergency Nurses: An Integrative Review

Background: Emergency nurses are exposed to traumatized patients as part of their job. Secondary exposure to trauma may lead to traumatic stress similar to those experienced by the primary victim. Emergency nurses develop secondary traumatic stress symptoms more than other nurses due to nature of emergency departments. The consequences of secondary traumatic stress can be noticed at personal, interpersonal, or organizational level. Objectives: This integrative review aimed to explore the literature on the factors attenuate or enhance occurrence of secondary traumatic stress among emergency nurses, to identify these factors, and to provide recommendations for research in the field. Method: An integrative literature review of quantitative and qualitative studies on secondary traumatic stress in emergency nurses were published in English language between 2000 and 2017 through the following data bases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Medline, PubMed, Google Scholar, SAGE Journals, Wiley on Line Library, Science Direct and EBSCOhost Sources. Results: The review identified that factors associated with secondary traumatic stress can be classified into personal and organizational factors. Findings on personal factors such as age, gender, and experience are controversial, whereas organizational factors such as trauma case load and perceived organizational support were found to predict traumatic stress more than the personal factors. Conclusions: Emergency nurses are at risk to develop traumatic stress and need to be aware to the contributing factors in order to maintain their well being. Further research is required to explore the factors enhance or attenuate occurrence of secondary traumatic stress.

Clinical prognostic factors for disabling Crohn's disease: A systematic review and meta-analysis

AIM: To identify demographic and clinical factors asso-ciated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysisof observational studies, focusing on the factors that can predict the prognosis of different outcomes of CD was undertaken. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigat-ing the above mentioned factors in adult patients with CD. Studies were eligible for inclusion if they describe prognostic factors in CD, with inclusion and exclusion criteria defined as follows. Studies with adult patients and CD, written in English and studying association between clinical factors and at least one prognosis out-come were included. Meta-analysis of effects was un-dertaken for the disabling disease outcome, using odds ratio (OR) to assess the effect of the different factors in the outcome. The statistical method used was Mantel-Haenszel for fixed effects. The 16-item quality assess-ment tool (QATSDD) was used to assess the quality of the studies (range: 0-42). RESULTS: Of the 913 papers initially selected, sixty studies were reviewed and three were included in the systematic review and meta-analysis. The global QA-TSDD scores of papers were 18, 21 and 22. Of a total of 1961 patients enrolled, 1332 (78%) were classified with disabling disease five years after diagnosis. In two studies, age at diagnosis was a factor associated with disabling disease five years after diagnosis. Individu-als under 40 years old had a higher risk of developing disabling disease. In two studies, patients who were treated with corticosteroids on the first flare developed disabling disease five years after diagnosis. Further, perianal disease was found to be relevant in all of the studies at two and five years after diagnosis. Finally, one study showed localization as a factor associated with disabling disease five years after diagnosis, with L3 being a higher risk factor. This meta-analysis showed a significantly higher risk of developing disabling dis-ease at five years after initial diagnosis among patients younger than 40 years of age (OR=2.47, 95%CI: 1.74-3.51), with initial steroid treatment for first flare (OR=2.42, 95%CI: 1.87-3.11) and with perianal dis-ease (OR = 2.00, 95%CI: 1.41-2.85).CONCLUSION: Age at diagnosis, perianal disease, ini-tial use of steroids and localization seem to be indepen-dent prognostic factors of disabling disease.

Systematic review of risk factors for progressive ischemic stroke

OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studies of progressive ischemic stroke. SEARCH STRATEGY： A computer-based, online, literature search of PubMed （1966/2007）, China Biological Medicine Database （CBM-disc, 1979/2007） and CNKI （www.cnki.net, 1979/2007） was performed to screen for related studies. DATA SELECTION： Cohort or case-controlled studies that focused on risk factors of progressive ischemic stroke were selected for review. Two reviewers independently extracted data and assessed study quality according to Cochrane Collaboration guidelines. Statistical analysis was performed using RevMan software. MAIN OUTCOME MEASUREMENT： Risk factors for progressive ischemic stroke. RESULTS： Using the inclusion criteria, 29/781 studies published in English and Chinese were initially reviewed, including 19 cohort studies and 10 case-control studies. Despite variations in determination of progressive ischemic stroke and the intervals between 2 evaluations, all studies described the diagnostic criteria for progressive ischemic stroke. Logistic analysis was employed in 20 of the studies. Meta-analysis of primary data in the related studies determined that the following factors that significantly correlated with progressive ischemic stroke： fever [risk ratio （RR） = 2.26, 95% confidence interval （CO： 1.20-4.26, P = 0.01; odds ratio （OR） = 2.85, 95% CI： 1.64-4.98, P 〈 0.01 ）]; diabetes （RR = 1.38, 95% CI： 1.18-1.61, P 〈 0.01 ; OR = 2.48, 95% Ch 1.93-3.19, P 〈 0.01 ）; coronary heart disease （RR = 1.22, 95% CI： 1.08-1.38, P 〈 0.01）; neuroimaging transformation （RR= 1.55, 95%CI： 1.34-1.80, P〈 0.01; OR= 2.29, 95% CI： 1.47-3.58, P〈 0.01）; and hyperglycemia （RR = 2.62, 95% CI： 1.86-3.68, P 〈 0.01 ; OR = 3.49, 95% CI： 1.92-6.35, P 〈 0.01）. CONCLUSION： Fever, diabetes, coronary heart disease, neuroimaging transformation, and hyperglycemia are important risk factors for progressive ischemic stroke. Interventions for these risk factors could effectively prevent occurrence of progressive ischemic stroke.

Low rates of adherence for tumor necrosis factor-α inhibitors in Crohn's disease and rheumatoid arthritis: Results of a systematic review

AIM:To investigate adherence rates in tumor necrosis factor-α (TNF-α)-inhibitors in Crohn's disease (CD) and rheumatoid arthritis (RA) by systematic review of medical literature. METHODS:A structured search of PubMed between 2001 and 2011 was conducted to identify publications that assessed treatment with TNF-α inhibitors providing data about adherence in CD and RA. Therapeutic agents of interest where adalimumab, infliximab and etanercept, since these are most commonly used for both diseases. Studies assessing only drug survival or continuation rates were excluded. Data describing adherence with TNF-α inhibitors were extracted for each selected study. Given the large variation between definitions of measurement of adherence, the definitions as used by the authors where used in our calculations. Data were tabulated and also presented descriptively. Sample size-weighted pooled proportions of patients adherent to therapy and their 95%CI were calculated.To compare adherence between infliximab, adalimumab and etanercept, the adherence rates where graphed alongside two axes. Possible determinants of adherence were extracted from the selected studies and tabulated using the presented OR. RESULTS:Three studies on CD and three on RA were identified, involving a total of 8147 patients (953 CD and 7194 RA). We identified considerable variation in the definitions and methodologies of measuring adherence between studies. The calculated overall sample size-weighted pooled proportion for adherence to TNF-α inhibitors in CD was 70% (95%CI:67%-73%) and 59% in RA (95%CI:58%-60%). In CD the adherence rate for infliximab (72%) was highercompared to adalimumab (55%), with a relative risk of 1.61 (95%CI:1.27-2.03), whereas in RA adherence for adalimumab (67%) was higher compared to both infliximab (48%) and etanercept (59%), with a relative risk of 1.41 (95%CI:1.3-1.52) and 1.13 (95%CI:1.10-1.18) respectively. In comparative studies in RA adherence to infliximab was better than etanercept and etanercept did better than adalimumab. In three studies, the most consistent factor associated with lower adherence was female gender. Results for age, immunomodulator use and prior TNF-α inhibitors use were conflicting. CONCLUSION:One-third of both CD and RA patients treated with TNF-α inhibitors are non-adherent. Female gender was consistently identified as a negative determinant of adherence.

Investigational growth factors utilized in animal models of spinal fusion: Systematic review

BACKGROUND Over 400000 Americans annually undergo spinal fusion surgeries, yet up to 40%of these procedures result in pseudoarthrosis even with iliac crest autograft, the current "gold standard" treatment. Tissue engineering has the potential to solve this problem via the creation of bone grafts involving bone-promoting growth factors(e.g., bone morphogenetic protein 2). A broad assessment of experimental growth factors is important to inform future work and clinical potential in this area. To date, however, no study has systematically reviewed the investigational growth factors utilized in preclinical animal models of spinal fusion.AIM To review all published studies assessing investigational growth factors for spinal fusion in animal models and identify promising agents for translation.METHODS We conducted a systematic review of the literature using PubMed, Embase,Cochrane Library, and Web of Science databases with searches run on May 29 th,2018. The search query was designed to include all non-human, preclinical animal models of spinal fusion reported in the literature without a timespan limit. Extracted data for each model included surgical approach, level of fusion,animal species and breed, animal age and sex, and any other relevant characteristics. The dosages/sizes of all implant materials, spinal fusion rates,and follow-up time points were recorded. The data were analyzed and the results reported in tables and text. PRISMA guidelines were followed for this systematic review.RESULTS Twenty-six articles were included in this study, comprising 14 experimental growth factors: AB204(n = 1); angiopoietin 1(n = 1); calcitonin(n = 3);erythropoietin(n = 1); basic fibroblast growth factor(n = 1); growth differentiation factor 5(n = 4), combined insulin-like growth factor 1 +transforming growth factor beta(n = 4); insulin(n = 1); NELL-1(n = 5); noggin(n= 1); P-15(n = 1); peptide B2 A(n = 2); and secreted phosphoprotein 24(n = 1).The fusion rates of the current gold standard treatment(autologous iliac crest bone graft, ICBG) and the leading clinically used growth factor(BMP-2) ranged widely in the included studies, from 0-100% for ICBG and from 13%-100% for BMP-2. Among the identified growth factors, calcitonin, GDF-5, NELL-1, and P-15 resulted in fusion rates of 100% in some cases. In addition, six growth factors-AB204, angiopoietin 1, GDF-5, insulin, NELL-1, and peptide B2 A-resulted in significantly enhanced fusion rates compared to ICBG, BMP-2, or other internal control in some studies. Large heterogeneity in animal species, fusion method,and experimental groups and time points was observed across the included studies, limiting the direct comparison of the growth factors identified herein.CONCLUSION Several promising investigational growth factors for spinal fusion have been identified herein; directly comparing the fusion efficacy and safety of these agents may inform clinical translation.

Risk factors from HBV infection among blood donors:A systematic review

Objective:To perform a systematic review of the scientific literature to identify risk factors associated with hepatitis B viruses(HBV) infection among blood donors.Methods:The literature search was carried out on Pub Med and Scopus databases using the keywords "risk factors" "HBV infection" and "blood donors".No date or language restrictions were applied to the search.This literature review was completed in March2014.The selection process and the reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.The Newcastle Ottawa scale was using to evaluate the quality of each single primary study.Results:Out of 172 records resulted in the search,5 papers were included in the final analysis because they are within acceptance criteria.Two of the selected studies were cross-sectional and three of them were case-control studies.Significant association resulted with some demographic and behavioral risk factors,such as marital status,dental treatment/procedure history,no stable relationship or multiple partners and family history of HBV infection.Conclusions:The systematic review performed encourages to conduct further research among blood donors in order to fully understand risk factors among donors in more extensive thus to provide valuable information about surveillance.

Systematic review and meta-analysis on the association of tuberculosis in Crohn's disease patients treated with tumor necrosis factor-α inhibitors(Anti-TNFα)

AIM To perform a meta-analysis on the risk of developing Mycobacterium tuberculosis(TB) infection in Crohn's disease(CD) patients treated with tumor necrosis factoralpha(TNFα) inhibitors.METHODS A meta-analysis of randomized, double-blind, placebocontrolled trials of TNFα inhibitors for treatment of CD in adults was conducted. Arcsine transformation of TB incidence was performed to estimate risk difference. A novel epidemiologically-based correction(EBC) enabling inclusions of studies reporting no TB infection cases in placebo and treatment groups was developed to estimate relative odds.RESULTS Twenty-three clinical trial studies were identified, including 5669 patients. Six TB infection cases were reported across 5 studies, all from patients receiving TNFα inhibitors. Eighteen studies reported no TB infection cases in placebo and TNFα inhibitor treatment arms. TB infection risk was significantly increased among patients receiving TNFα inhibitors, with a risk difference of 0.028(95%CI: 0.0011-0.055). The odds ratio was 4.85(95%CI: 1.02-22.99) with EBC and 5.85(95%CI: 1.13-30.38) without EBC.CONCLUSION The risk of TB infection is higher among CD patients receiving TNFα inhibitors. Understanding the immunopathogenesis of CD is crucial, since using TNFα inhibitors in these patients could favor mycobacterial infections, particularly Mycobacterium avium subspecies paratuberculosis, which ultimately could worsen their clinical condition.

Risk Factor of Postoperative Lumbar Surgical Site Infection: A Literature Review

Nowadays there have been various advanced techniques to overcome disparate types of lumbar degenerative diseases. However, post-operation complications such as Surgical Site Infection (SSI) still give the surgeon with a big challenge. This article is going to study the risk factor that causes the lumbar SSI by reviewing all the articles that can be assessed through PubMed, websites of science and other internet data base. Numerous articles have stated different reported prevalence rates of 0.7% to 16% for surgical site infection. This article will document the most common and significant risk factors for SSI. At last, we suggest that there should be preoperative patient screening and postoperative internal environment maintenance, this will be the best way to reduce postoperative SSI rate or prevent SSI from happening.

椎间盘退变中胶原蛋白的代谢失衡

背景:腰椎间盘退行性疾病是导致腰痛和下肢神经症状的常见疾病。胶原代谢的平衡在维持椎间盘的稳定中发挥着重要的作用。目的:对椎间盘退变中胶原蛋白代谢失衡的研究进展作一综述。方法:由第一作者在中国知网、PubMed、Web of Science数据库中检索2024年5月之前发表的相关文章,中文检索词为“椎间盘退变疾病”“胶原代谢”“胶原酶家族”“胶原合成相关因子”“细胞因子”,英文检索词为“degenerative disc disease”“Collagen metabolism”“Collagenase family”“Collagen synthesis related factors”“Collagen breakdown related factors”。最终纳入76篇文献进行综述。结果与结论:在椎间盘退变的过程中,胶原蛋白代谢的平衡在维持正常椎间盘的稳定中起到至关重要的作用。当椎间盘发生退变时,椎间盘内分泌大量促炎因子、胶原酶,并发生氧化应激反应等,使椎间盘内胶原蛋白分解增加,同时抑制生长因子、胶原蛋白合成酶、胶原蛋合成相关因子的生成,使椎间盘内胶原蛋白合成减少。上述两种情况共同作用使椎间盘内胶原蛋白的代谢平衡被打破,进一步加剧了椎间盘退变的进程。

血小板衍生生长因子BB参与生长板损伤修复的作用与机制

背景:在生长板损伤炎症初期,血小板衍生生长因子BB通过促进间充质祖细胞浸润、软骨形成、成骨反应以及调控骨重塑来促进生长板损伤的修复。目的:总结血小板衍生生长因子BB在生长板损伤修复中的作用机制。方法:检索PubMed、维普、万方数据和中国知网数据库,中文检索词为“生长板损伤,骨桥形成,血小板衍生因子BB,修复”,英文检索词为“growth plate injury,bone bridge,PDGF-BB,repair”,最终筛选66篇文章进行综述。结果与结论:生长板损伤经历早期炎症、血管重建、纤维骨化、结构重塑等病理进程,伴随着软骨细胞、血管内皮细胞、干细胞、成骨细胞、破骨细胞多种细胞交叉对话。血小板衍生生长因子BB作为损伤早期炎症反应的重要因子通过介导多种细胞炎症反应调控损伤修复过程,靶向血小板衍生生长因子BB介导的炎症刺激可能通过改善破骨细胞、成骨细胞、软骨细胞功能活性延缓生长板损伤骨桥形成进程,实现生长板损伤修复。血小板衍生生长因子BB对生长板损伤部位的血管生成和骨修复组织形成以及未损伤生长板的软骨内骨延长功能具有重要作用,抑制血小板衍生生长因子BB启动的血管形成与软骨内成骨之间的偶联效应将有可能实现生长板损伤修复。

Analysis of pathogenesis and risk factors associated with retinopathy of prematurity

Retinopathy of prematurity(ROP)is a disease associated with the vasculogenesis of the developing retina and in particular,in preterm newborns.The long term visual outcome of this disease includes increased risk of blindness and visual disabilities.The increasing prevalence of ROP,the leading cause of blindness in infants,necessitates the implementation of preventive measures to halt this trend,and this,most certainly,calls for the thorough understanding of the pathogenesis and various risk factors associated with the disease.Risk factors for ROP are among the main targets for improving health outcomes.Angiogenic factors including VEGF and IGF-1,maternal factors,oxidative stress and others(erythropoietin and inflammatory cytokines)are among the few of the most important risk factors that need to be addressed.A growing body of evidence suggests that subjects with ROP who have prenatal or postnatal risk factors are at increased risk of more severe ROP.These consistent observations have given rise to hopes of identifying the potential new risk factors and coming up with more efficient prevention and therapeutic strategies.However,studies focusing on incidence rates of ROP over time have painted an inconsistent picture.Individual studies have unequivocally demonstrated an association with the aforementioned risk factors,whereas epidemiological data however,is at best inconclusive.We have tried to integrate the studies,past and present,to identify the pathogenesis and novel risk factors.

年轻成年癌症病人社会隔离研究进展

主要从年轻成年癌症病人社会隔离的概述、影响因素、测量工具、对病人产生的影响以及干预措施进行综述,旨在阐明年轻成年癌症病人社会隔离的含义,让医护人员更深入地了解社会隔离在年轻成年癌症病人心理健康中的作用。

企业绿色转型研究述评

实现“双碳”目标、推进经济发展方式的绿色转型,核心问题是加快企业发展方式的绿色转型。本文从概念内涵、理论依据、影响因素、路径选择和量化研究五个方面对企业绿色转型进行梳理和归纳,分析发现,未来需要立足于企业绿色转型的复杂性,开展对不同类型企业的研究,并将研究视角覆盖到绿色转型的全过程,同时更加注重绿色转型理论在包括工业企业在内的实体企业中的实践应用。

Review Expert Collaborative Recommendation Algorithm Based on Topic Relationship

The project review information plays an important role in the recommendation of review experts. In this paper, we aim to determine review expert's rating by using the historical rating records and the final decision results on the previous projects, and by means of some rules, we construct a rating matrix for projects and experts. For the data sparseness problem of the rating matrix and the 'cold start' problem of new expert recommendation, we assume that those projects/experts with similar topics have similar feature vectors and propose a review expert collaborative recommendation algorithm based on topic relationship. Firstly, we obtain topics of projects/experts based on latent Dirichlet allocation (LDA) model, and build the topic relationship network of projects/experts. Then, through the topic relationship between projects/experts, we find a neighbor collection which shares the largest similarity with target project/expert, and integrate the collection into the collaborative filtering recommendation algorithm based on matrix factorization. Finally, by learning the rating matrix to get feature vectors of the projects and experts, we can predict the ratings that a target project will give candidate review experts, and thus achieve the review expert recommendation. Experiments on real data set show that the proposed method could predict the review expert rating more effectively, and improve the recommendation effect of review experts. © 2014 Chinese Association of Automation.

食管癌放疗病人发生放射性食管炎的影响因素及护理对策研究进展

对食管癌放疗病人放射性食管炎发生的高危因素及护理对策进行综述,旨在为食管癌放疗病人制定有效的护理方案提供借鉴。

城市轨道交通低碳效应研究综述

城市轨道交通低碳效应研究是科学认识其环境效益,为行业政策补贴提供理论依据的重要基础。通过文献计量方法,全面梳理了城市轨道交通低碳效应相关研究问题,为该领域进一步研究明确了方向。基于VOSviewer软件对轨道交通碳排放相关研究进行了文献计量学分析,详细阐述城市轨道交通低碳效应的研究边界和碳减排机理,在探究城市轨道交通碳减排潜力量化评估视角及方法的基础上,系统性剖析影响城市轨道交通低碳效应的要素,涉及城市轨道交通基础设施建设、客流量、交通模式转移等多方面。最后,基于城市轨道交通碳减排潜力影响因素分析结果,研究提出提升城市轨道交通低碳效应的对策措施。研究可为城市轨道交通低碳效应研究提供学术参考。

基于行为改变轮的慢性病病人数字健康干预行为影响因素研究进展

基于行为改变轮,总结慢性病病人参与数字健康干预的影响因素,提出相关建议,以期促进慢性病病人的数字健康干预,全面提高慢性病病人的自我管理能力。

交通碳排放研究综述::核算方法、影响因素及作用机理

交通运输业是碳减排的重要行业,关于交通碳排放核算方法、影响因素及作用机理的研究一直是交通碳排放研究领域的一个热点。本文从交通碳排放量核算方法、交通碳排放影响因素辨识、交通碳排放作用机理分析三个方面来进行综述。在交通碳排放量核算方法部分按照直接获取、“自上而下”法、“自下而上”法、机动车排放模型四种方法进行分类。在交通碳排放影响因素辨识部分从IPAT模型、Kaya恒等式、直接选取三点进行综述,并对近年学者们选取的影响因素进行了总结。在交通碳排放作用机理分析部分综述了脱钩模型、因素分解法、计量经济学方法、系统动力学方法,进而对用不同方法分析的交通碳排放作用机理进行了总结,其中Tapio脱钩模型和对数平均迪氏指数分解法是应用较为广泛的方法。最后,探讨了交通碳排放核算方法、影响因素及作用机理研究中的关键问题,指出本领域的研究难点主要集中于交通碳排放核算方法的优化及统一、影响因素选取体系的形成上。

急诊患者不复苏决策现状及影响因素的研究进展

本文对不复苏(do not resuscitate,DNR)决策的概念和意义、现状以及急诊患者DNR决策的影响因素进行了综述,指出应结合国情考虑患者和家属、医患沟通以及机构政策在DNR决策中的重要性,提出急诊推广DNR的需求,旨在优化急诊医疗资源,改善急诊临终患者生活质量,为推进急诊安宁疗护工作的开展提供参考。