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

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Algorithms for Studying the Impact of Travel Time Reliability Along Multisegment Trucking Freight Corridors

Performance measures allow planners and engineers to monitor and evaluate transportation facilities or projects and to justify the allocation of funds among alternative transportation improvement options. To capture the impact of corridor congestion on freight vehicles, new tools and methodologies are developed to analyze data from commercial vehicles and produce performance measures such as travel time, speed, and travel time reliability. Because long freight corridors comprise segments with varying reliability characteristics, the objective was to develop a programming logic that would use available truck Global Positioning System data to (a) identify natural segments or regions in a corridor between urban centers, Interstate junctions, or rural areas and (b) estimate corridorwide impact of travel time unreliability. The case study presented investigates the I-5 corridor in Oregon. The research applies statistical techniques to compute vehicle travel time and reliability for freight movements within each segment. The proposed methodology has been used successfully to identify distinct segments and characteristics of travel time reliability in freight corridors. Travel time information was used to compute cost effects of delays within rural and urban areas along the I-5 corridor. The research presents an advance in the processing and aggregation of Global Positioning System truck data to produce succinct yet informative performance measures and segments. For more information: http://archives.pdx.edu/ds/psu/1148

Chemical Characterization and Source Apportionment of PM10 Using Receptor Models over the Himalayan Region of India

This study presents the source apportionment of coarse-mode particulate matter (PM10) extracted by 3 receptor models (PCA/APCS, UNMIX, and PMF) at semi-urban sites of the Indian Himalayan region (IHR) during August 2018–December 2019. In this study, water-soluble inorganic ionic species (WSIIS), water-soluble organic carbon (WSOC), carbon fractions (organic carbon (OC) and elemental carbon (EC)), and trace elements of PM10 were analyzed over the IHR. Nainital (62 ± 39 µg m−3) had the highest annual average mass concentration of PM10 (average ± standard deviation at 1 σ), followed by Mohal Kullu (58 ± 32 µg m−3) and Darjeeling (54 ± 18 µg m−3). The annual total ∑WSIIS concentration order was as follows: Darjeeling (14.02 ± 10.01 µg m−3) > Mohal-Kullu (13.75 ± 10.21 µg m−3) > Nainital (10.20 ± 6.30 µg m−3), contributing to 15–30% of the PM10 mass. The dominant secondary ions (NH4+, SO42−, and NO3−) suggest that the study sites were strongly influenced by anthropogenic sources from regional and long-range transport. Principal component analysis (PCA) with an absolute principal component score (APCS), UNMIX, and Positive Matrix Factorization (PMF) were used for source identification of PM10 at the study sites of the IHR. All three models showed relatively similar results of source profiles for all study sites except their source number and percentage contribution. Overall, soil dust (SD), secondary aerosols (SAs), combustion (biomass burning (BB) + fossil fuel combustion (FFC): BB+FFC), and vehicular emissions (VEs) are the major sources of PM10 identified by these models at all study sites. Air mass backward trajectories illustrated that PM10, mainly attributed to dust-related aerosols, was transported from the Thar Desert, Indo-Gangetic Plain (IGP), and northwestern region of India (i.e., Punjab and Haryana) and Afghanistan to the IHR. Transported agricultural or residual burning plumes from the IGP and nearby areas significantly contribute to the concentration of carbonaceous aerosols (CAs) at study sites