Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Construction of a Self-Powered System for Simultaneous In Situ Remediation of Nitrate and Cr(VI) Contaminated Synthetic Groundwater and River Sediment

A novel self-powered system was constructed to in situ remove nitrate and Cr(VI) from synthetic groundwater and achieve river sediment remediation simultaneously. The sediment organic matter in an anodic chamber was used as a carbon source to provide self-powered energy to reduce the cathode’s contaminants. With the acceptance of protons and electrons, nitrate and Cr(VI) were transformed into nitrite and Cr(III), respectively. In a 72 h test with both nitrate and Cr(VI) present, nitrate was removed at a rate of 70.96 mg/m3·h and Cr(VI) at a rate of 8.95 mg/m3·h. When a phosphate buffer was used in the test, their removal rates were changed to 140.83 mg/m3·h and 8.33 mg/m3·h, respectively. The results showed that the self-powered system could achieve the simultaneous reduction of nitrate and Cr(VI), although the presence of Cr(VI) hindered nitrate reduction. This system could realize simultaneous in situ groundwater and sediment remediation, with no need for additional energy or materials

A facile process to prepare copper oxide thin films as solar selective absorbers

Copper oxide thin films as solar selective absorbers were conveniently prepared by one-step chemical conversion method. X-ray diffraction (XRD), scanning electron microscopy (SEM), UV-vis-NIR spectra and Fourier transform infrared (FTIR) spectra were employed to characterize the composition, structure and optical properties of thin films. The results indicated that the composition, structure and optical properties of thin films were greatly influenced by reaction temperature, time and concentration of NaOH. When reaction temperature was fixed at 40 degrees C, the as-prepared films consist of pure cubic Cu(2)O. The surface morphology of thin films was changed from square-like structure (reaction time = 30 min) with the elongation of reaction time. While for thin films prepared at 60 degrees C and 80 degrees C, single Cu(2)O was observed after 5 min reaction. When reaction time is longer than 5 min, CuO appears and the content of CuO is increasing with the elongation of reaction time. With the increase of reaction temperature, the belt-like structure was easily formed for 60 degrees C/10 min and 80 degrees C/5 min. Decreasing concentration of NaOH also could result in the formation of CuO and porous belt-like structure. Simultaneously, the film thickness is increasing with the increase of reaction time, temperature and concentration. Films containing CuO with belt-like structure exhibited high absorptance (>0.9), and the emissivity of films increased with elongation of reaction time. Combination of the composition, structure and optical properties, it can be deduced that the porous belt-like structure like as a light trap can greatly enhance absorbance (alpha), while the composition, thickness and roughness of thin films can greatly influence the emissivity (epsilon). The highest photo-thermal conversion efficiency was up to 0.86 (alpha/epsilon = 0.94/0.08) for thin films prepared at 80 degrees C/5 min, which proved that the CuO(x) thin films can be served as high performance solar selective absorbers. (C) 2011 Elsevier B. V. All rights reserved

Antiatherosclerosis Properties of Total Saponins of Garlic in Rats

Garlic has been proven effective in the prevention and treatment of atherosclerosis (AS), which is widely used as a food and medicine by people in daily life. Garlic saponins are the main active nonsulfur compounds of garlic, which have a variety of pharmacological activities against cardiovascular diseases. In this study, the antiatherosclerosis properties and mechanism of total saponins of garlic (TSG) in rats were explored. The AS animal model was established by a combination of high-fat feeding, intraperitoneal injection of vitamin D3, and ovalbumin-induced inflammation in SD rats. Then, the atherosclerotic rats were gavaged daily by TSG for 4 weeks. Administration of TSG markedly decreased atherosclerotic lesions in the aorta of atherosclerotic rats. TSG restored the serum lipid profile by significantly decreasing the lipid levels and had effective antioxidation by inhibiting the content of malondialdehyde (MDA) and restoring the reduced activity of superoxide dismutase (SOD). Additionally, the ratio of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) could be maintained in a relatively stable dynamic balance after administration of TSG to maintain the vascular homeostasis. In summary, TSG had therapeutic effects on AS, which are promising as functional foods or nutraceuticals for the prevention and treatment of AS

Establishment of season-specific nutrient thresholds and analyses of the effects of nutrient management in eutrophic lakes through statistical machine learning

Eutrophication and subsequent harmful cyanobacteria blooms are global water quality problems, and identifying the key drivers of water eutrophication and estimating nutrient thresholds for it in waterbodies have long been challenges for water quality managers. Data-intensive machine learning models have been shown to be better able to reveal the nonlinear relationships between variables in the study of complex biotic community dynamics than traditional mechanistic models. In this study, we applied random forest models to long-term datasets from nutrient monitoring and meteorological observations to characterize the relationships between algal growth and different environmental drivers in three eutrophic lakes in China. We further attempted to estimate the season-specific nutrient thresholds in these lakes, and assess the potential decreases in chlorophyll a concentrations that could be achieved through nutrient management. In general, chlorophyll a concentrations predicted by the random forest models were consistent with the values observed in the lakes, and successfully displayed the same seasonal variations. The estimated total nitrogen (TN) and total phosphorus (TP) nutrient thresholds were quite variable among months, and were higher in summer than in winter. To maintain chlorophyll a concentrations below 20 μg/L, the estimated TN thresholds in Lakes Taihu, Dianchi, and Chaohu in August were 2145 ± 683, 2372 ± 918 and 1527 ± 71 μg/L (mean ± standard deviation), respectively, and the corresponding TP thresholds were 82 ± 24, 149 ± 22, and 120 ± 22 μg/L. The modelling results indicated that it was more important to control the TP concentrations in these lakes than the TN concentrations to control algal growth in summer. In summary, the strong seasonal variation in the estimated nutrient thresholds suggests that a ‘one-size-fits-all’ nutrient control target could overprotect these water bodies. Seasonal variation in nutrient concentrations and environmental drivers should thus be considered when establishing nutrient criteria and setting nutrient control targets